There are no copays for preventive and urgent care services. You do not need an approval from your PCP for these types of care: For more information about services that need preapproval, please see your member handbook. Get translation and interpretation services free of charge. If you need help with any of the following, call our Customer Care Center at 1-866-781-5094 (TTY 1-866-773-9634). Interested in becoming a provider in the Healthy Blue network? Search for up-to-date drug information, including hundreds of brand-name and generic medications. * - Drugs For The Blood, *Hematopoietic Agents* - Drugs For Nutrition, *Hypnotics/Sedatives/Sleep Disorder Agents* - Drugs For The Nervous System, *Local Anesthetics-Parenteral* - Drugs For Pain And Fever, *Medical Devices And Supplies* - Medical Supplies And Durable Medical Equipment, *Migraine Products* - Drugs For The Nervous System, *Minerals & Electrolytes* - Drugs For Nutrition, *Miscellaneous Therapeutic Classes* - Vitamins And Minerals, *Mouth/Throat/Dental Agents* - Drugs For The Mouth And Throat, *Musculoskeletal Therapy Agents* - Drugs For Muscles, Ligaments, Tendons, And Bones, *Nasal Agents - Systemic And Topical* - Drugs For The Nose, *Neuromuscular Agents* - Drugs For Nerves And Muscles, *Passive Immunizing And Treatment Agents* - Biological Agents, *Psychotherapeutic And Neurological Agents - Misc. Additional search options are not required but will help you to create a very specific directory. We can send you free, printed copies of the directory upon request. Our 24-Hour Nurseline is a resource you call when life throws you a curve ball: 1-866-577-9710 (TTY 1-800-368-4424). Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Provider manual Already a member? Would you like to continue? SC Medicaid Portal | SC Medicaid Portal Chat with a live person or send us a secure message. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. Below is a list of resources that help health care professionals do what they do best care for our members. Would you like to continue? Understanding your benefits. Free infant car seat for going to prenatal visits. Availity is an independent company that provides a secure portal on behalf of BlueChoice HealthPlan. DentaQuest is an independent company providing dental benefit services on behalf of BlueChoice HealthPlan. P.O. Mercy Health, Anthem agree to 90-day transition period for Anthem Families may also choose different PCPs based on each family members unique needs. Advise you on where to go when you need care. We want you to understand your benefits and receive the best possible care. VSP is an independent company providing vision benefit services on behalf of BlueChoice HealthPlan. At Healthy Blue, we are committed to addressing racism in our society through open discussions about trauma, injustice, and inequality. VSP is an independent company providing vision benefit services on behalf of BlueChoice HealthPlan. SC Medicaid Portal. These requirements and limits may select a drug from the list below to see all coverage details regarding the www.cdc.gov/coronavirus To access the secure member area of our website, youll need to create your account. Pharmacy Check our Preferred Drug List Services billed with the following revenue codes ALWAYS require prior authorization: 0632 Pharmacy multiple sources Related information Prior authorization forms Prior Authorization Lookup Tool Provider Manual and Guides Referrals Forms Provider Education Pharmacy Information Electronic Data Interchange (EDI) Already a member? This link leads to a third-party website. Register now Forgot Username or Password With access to your secure account, you can: Change your primary care provider (PCP). and Pharmacists from the Provider community. Healthy Connections Medicaid. Would you like to continue? and Pharmacists from the Provider community. Find a Doctor | Healthy Blue of South Carolina Find a doctor We've partnered with many providers in your area. Find learning opportunities to assist with administering your patients health plan using Availity Essentials multi-payer features and payer spaces applications. Medical policies are used by all plans and lines of business unless Federal or State lawas well as contract language, including definitions and specific contract provisions or exclusionstake precedence over a medical policy. Medicaid for South Carolina | Healthy Blue of South Carolina Type at least three letters and well start finding suggestions for you. You should have received your Healthy Blue member ID card in the mail. Registered nurses are available anytime, day or night. We are happy to announce the availability of the South Carolina Medicaid Web Portal. We look forward to working with you to provide quality services to our members. Call the Customer Care Center at 1-866-781-5094 (TTY 1-866-773-9634). They can: Call the 24-Hour Nurseline 24 hours a day, seven days a week at 1-866-577-9710 (TTY 1-800-368-4424). certain product, please contact us at 1-866-757-8286. You can apply in one of these ways: For everyone in your household, youll need the following to apply: Apply online Healthy Blue Search for Providers. Healthy Blue is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Fax: 912-233-4010 or 912-235-3246 Notice of Language Assistance and Non-discrimination, Copyright 2021 BlueCross BlueShield of South Carolina. Healthy Blue is contracted with CVS Specialty as a medical specialty pharmacy (MSP). Please note that if you choose to search by a street address you will need to enter City & ZIP too. These links lead to third party sites. We encourage you to review the privacy practices of the External Site. If you have questions, call us at 1-866-781-5094 (TTY 1-866-773-9634). BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. These requirements and limits may DentaQuest is an independent company providing dental benefit services on behalf of BlueChoice HealthPlan. Effective for dates of service on and after March 1, 2022, the following medication codes billed on medical claims from current or new Clinical Criteria documents will require prior authorization. View or print your member ID card. Your PCP will work with us to get the approval you need. Get translation and interpretation services free of charge. Complete benefit information can be found in your member handbook. Vision Service Plan (VSP) is an independent company providing vision benefit services on behalf of BlueChoice HealthPlan. Its easy! Medical Policies and Clinical UM Guidelines, Guide to Drug Coverage Under Medical Benefit, Healthcare Effectiveness Data and Information Set (HEDIS), Screening, Brief Intervention and Referral to Treatment (SBIRT), Early and Periodic Screening, Diagnostic and Treatment. These links lead to third party websites. Subscribe to News Updates. Renewing your benefits. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. See some of the benefits of being a member of BlueChoice HealthPlan. The formulary changes reviewed and approved at the third quarter 2021 Pharmacy and Therapeutics Committee meeting. Youll get a notice in the mail when its time to renew. Services provided at local health departments, Behavioral health and substance use services, Durable medical equipment (DME) and disposable supplies, Institutional long-term care facilities and nursing homes, Care from a provider who doesnt work with your plan. Find the application you need by going to the coverage group table. When youre part of the BlueCross BlueShield of South Carolina,you get all your regular Medicaid benefits and services, plus lots of free extras just for being our member. . To find a provider, call 1-888-271-5210 (TTY 1-800-466-7566) or visit the DentaQuest website. Call us Have questions about your benefits? Print a Directory - Doctor & Hospital Finder Before you can choose Healthy Blue as your health plan, you'll need to apply for Medicaid benefits with the South Carolina Department of Health and Human Services (SCDHHS). If you're a Healthy Connections Medicaid member, go online to: Revised June 2023 SCAN ME apply.scdhhs.gov . The program encourages you to receive the care you need to create a healthy lifestyle and then rewards you with gift cards to popular retailers. Weve partnered with many providers in your area. To determine which clinical utilization management guidelines have been adopted by your plan, or to determine if there are applicable other criteria, you can use the guideline adoption link provided below. Call the Customer Care Center at 1-866-781-5094 (TTY 1-866-773-9634). * - Drugs For The Nervous System, *Respiratory Agents - Misc. Finding a provider near you. not listed on the formulary are considered to be non-formulary and are subject BlueChoice HealthPlanis an independent licensee of the Blue Cross and Blue Shield Association. Whether youre thinking about having a baby, pregnant, already a new mom, or youre not planning to have a baby, we can help you take steps to stay healthy at every stage. All Rights Reserved. . They will determine if you qualify for Healthy Connections Medicaid. As a new member, youll fill out a Health Risk Assessment (HRA). 1-866-910-7689 | Schedule your ride online. After you've finished the assessment, please mail or fax the completed health assessment to us at: Provider education and training. DentaQuest is an independent company providing dental benefit services on behalf of BlueChoice HealthPlan. Find a Doctor How to Enroll How to Renew Get your ID card We're happy you're here As a new member, we know you have questions, and we want you to get the most out of your benefits. Columbia, SC 29260-6170 Free prenatal program with pharmacy and nutritional counseling. Mercy Health, Anthem agree to 90-day transition for Medicaid members If you dont know which application to choose, call Healthy Connections at 1-888-549-0820 (TTY 1-888-842-3620). DentaQuest is an independent company providing dental benefit services on behalf of BlueChoice HealthPlan. There are several factors that impact whether a service or procedure is covered under a members benet plan. Find the right care for you across our expansive network of doctors, hospitals and other providers. You can search by name, specialty or location. This link leads to a third-party website. For questions about your dental benefits or to find a dentist, call DentaQuest at 1-888-307-6552. This document provides a summary of customizations to the MCG Care Guidelines 27th Edition (Publish date March 1, 2023). Customizations to MCG Care Guidelines 27th Edition. Health Risk Assessment for Adults English, Health Risk Assessment for Children English, Health Risk Assessment for Adults Spanish, Health Risk Assessment for Children Spanish. Read our tips to help you get started with your new health plan. Phone: 866-902-1689 Discounts on Boys & Girls Club fees for eligible members ages 618 at participating clubs. Mail Stop: AX-E13; Phase 3 Floor 4 Reporting changes, such as a new address or phone number They will determine if you qualify for Healthy Connections Medicaid. Healthy Blue is committed to supporting you in providing quality care and services to the members in our network. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. Log in to your member account Not signed up? Our all-inclusive office visit copayment makes health visits easy. There are several different dates that may be associated with a medical policy or clinical utilization management guideline. age limits, step therapy or Center for Medicare and Medicaid Services (CMS) coverage requirements. Customizations to MCG Care Guidelines 25th Edition Getting your member ID card. Were here for you! Free Uber gift card or free annual oil change. Getting help in other languages or formats for things like discussing your health care, talking to us, or for getting health plan materials we send to you in other languages. medication. Healthy Blue Attn: Upon linking you are subject to the terms of use, privacy, copyright and security policies of the External Site. Healthy Blue Formulary . These companies are solely responsible for the contents and privacy policies on their sites. Vision services include: BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Free circumcision for boys up to 1 year old. Healthy Blue BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. include prior authorization, quantity limits, age limits, step therapy or Center for Medicare and Medicaid Services (CMS) coverage requirements. * - Drugs For The Lungs, *Ulcer Drugs/Antispasmodics/Anticholinergics* - Drugs For The Stomach, *Urinary Antispasmodics* - Drugs For The Urinary System, *Vaginal And Related Products* - Drugs For Women. Members age 21 and older can get up to $750 per year to use for covered dental services like: There are no copays for emergency services. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Healthy Blue members in South Carolina receive vision benefits through Vision Service Plan (VSP). We believe that continuing the discussion we started at our June 2022 event to deepen the conversation about the disability experience for people of color is critically important. These links lead to third party sites. 1-800-877-7195 (TTY 1-800-428-4833) |vsp.com Theres a $3.40 copay for other dental services. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. Visit the Pharmacy page to find a pharmacy near you and check if your medicine is covered. However, some providers may have age requirements for the patients they serve. If you need help applying online, call SC Thrive at 1-800-726-8774 or visit scthrive.org. This may include but is not limited to decisions involving prior authorization, inpatient review, level of care, discharge planning and retrospective review. The latest articles and announcements on claims filing, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Fill out the Health Plan and Doctor Selection Form and mail it using the postage-paid return envelope found in your Healthy Connections Choices enrollment packet: Call our Healthy Blue Customer Care Center, and tell us by phone at: Enter your Healthy Connections Medicaid member ID and PIN, and follow the step-by-step instructions to choose a PCP. These companies are solely responsible for the contents and privacy policies on their sites. Availity is an independent company that provides a secure portal on behalf of BlueChoice HealthPlan. View dental benefits Theres no copay for routine vision services. Clinical criteria for drugs and biologics paid under the medical benefit for certain Medicare/Medicaid marketscan be found on the CarelonRx website. Need help making your appointment? Call Healthy Connections Choices at 1-877-552-4642 (TTY 1-877-552-4670), Healthy Connections Choices Customer Service Center: 1-877-552-4642 (TTY 1-877-552-4670) Monday through Friday from 8 a.m. to 6 p.m. Eastern time. Phone: 866-757-8286 Some medications listed may have additional BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. Find a Dentist, Vision benefits are provided by Vision Service Plan (VSP). If youre already a member, log in to your account to send us a message. Get the latest news and information from the Centers for Disease Control and Prevention (CDC) at CarelonRx is an independent company providing pharmacy benefit management services on behalf of BlueChoice HealthPlan.

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