[...]... when you place the call If you choose to disenroll in the Claim-Free program, you will need to submit your claims to Medicare as discussed below Supplement to Original Medicare Benefits Subject to benefits being covered by Medicare while you are enrolled under the PERSCare Supplemental Plan, the PERSCare Supplemental Plan will pay the amounts shown below under Plan Payments for medically necessary... who do not accept Medicare assignment, within the limits of applicable law PERSCare Supplement to Original Medicare Plan - 9 BENEFITS BEYOND MEDICARE Benefits Beyond Medicare Summary Benefits for “Benefits Beyond Medicare will be determined at the same time your Supplement to Original Medicare benefits are determined for services and supplies covered under both parts of the Plan To obtain reimbursement... not PERSCare Supplement to Original Medicare Plan - 8 MEDICARE & YOU 2 The PERSCare Supplemental Plan payment plus the Medicare payment will be accepted as payment in full by providers who are not Blue Cross Physician Members but who DO accept Medicare assignment 3 Plan Members will be responsible for the difference between the amount paid by PERSCare Supplemental Plan and Medicare and the charges... Payment of Supplement to Original Medicare Benefits Deductibles When a Member is receiving concurrent benefits from Medicare, the PERSCare Supplemental Plan pays one hundred percent (100%) of the Medicare Part A and B deductibles Plan Payments When a Member is receiving concurrent benefits from Medicare, the PERSCare Supplemental Plan payments for covered charges are provided according to whether the... respect to hospital providers are the actual cost to the Plan Member for hospital services and supplies that are benefits of the Plan PERSCare Supplement to Original Medicare Plan - 12 VISION CARE BENEFITS How to Use Vision Care For California Residents If you are a California resident, your routine vision care benefits are administered by Vision Service Plan (VSP) To receive maximum benefits under this Plan, ... another benefit section of the Plan, it is not a Covered Expense under the Outpatient Prescription Drug Program benefit PERSCare Supplement to Original Medicare Plan - 25 BENEFIT LIMITATIONS, EXCEPTIONS AND EXCLUSIONS This Plan supplements your Medicare benefits and provides benefits beyond Medicare Benefits provided by this Plan beyond those covered by Medicare are subject to review for medical necessity... PERSCare Supplemental Plan ID card Simply present this card to receive medical services and prescription drug benefits of the Plan If you need a replacement card, call the Blue Cross Customer Service Department at 1-877-737-7776 Possession of a PERSCare Supplemental Plan ID card confers no right to services or benefits of this Plan To be entitled to services or benefits, the holder of the card must be a Plan. .. yourself for Supplement to Original Medicare professional and hospital benefits as long as your provider billed Medicare directly NOTE: The Claim-Free program does not apply to the “Benefits Beyond Medicare listed on pages 10 through 12 See page 10 for more information on how to obtain reimbursement for those benefits Once enrolled in the Claim-Free program, your Supplement to Original Medicare benefits... Welcome to the PERSCare Supplemental Plan! This PERSCare Supplement to Original Medicare Plan (PERSCare Supplemental Plan) is designed for Members enrolled in the California Public Employees’ Retirement System’s (CalPERS) health benefits program who are also enrolled in both Parts A (hospital insurance) and B (medical insurance) of Medicare After you or your eligible family members are enrolled in this Plan, ... PERSCare Supplemental Plan, who is not eligible for Medicare and continues in the PERSCare Basic Plan must enroll in this Plan when he or she is eligible to enroll in Medicare Please note that this Plan does not cover custodial care in any facility or situation, including a skilled nursing facility As a PERSCare Supplemental Plan Member, you are responsible for meeting the requirements of the PERSCare Supplemental . Protonix). PERSCare Supplement to Original Medicare Plan - 1 PERSCare SUPPLEMENT TO ORIGINAL MEDICARE PLAN - SUMMARY OF BENEFITS PERSCare Supplement to. regarding Plan payments. PERSCare Supplement to Original Medicare Plan - 3 PERSCare Supplement to Original Medicare Plan - 4 Benefit Category Medicare