Regence BlueShield of Idaho is an Independent Licensee of the Blue Cr
oss and Blue Shield Association
Member Reference
Guide
Table of Contents
Welcome to Regence
Member Resources Guide
myRegence.com
Blue Card
Case Management
RegenceRx
Prescription Prior Auth
Prescription Prior Auth List
Welcome to the
Regence community.
We look forward to a long and healthy future with you.
Now that you have Regence coverage, what happens next?
• First, take your coverage information home to share with your covered family members.
• Let your doctor and pharmacy know you have a new plan with Regence and when the plan begins.
If you are currently taking prescription medications:
• Get your prescription refilled before the end of the last month of your old coverage if it’s due to expire within the first two weeks of the start of your new coverage.
• Review the Prescription Prior-Authorization List in your enrollment packet to check whether your prescriptions require any special handling.
If you are expecting, have a medical procedure scheduled or will need care before you receive your member card:
• Complete a transition-of-care form. (See your benefit administrator) • Find your provider in the Regence four-state area (Idaho, Oregon, Utah
or Washington) at regence.com.
• If you travel outside the four-state area (including travel around the world), find a BlueCard® provider at bcbs.com.
Once you receive your member card, please refer to the Regence Member Resources Guide to help you take full advantage of the wealth of features and benefits available to you as a Regence member.
Regence BlueShield of Idaho
is an Independent Licensee of the Blue Cross and Blue Shield Association05226-id / 04-12
start to your
Get a healthy
member resources guide
Most of what you’ll need you’ll find on myRegence.com. If you’re new to myRegence.com:
1. Go to myRegence.com (have your Regence member card handy). 2. Click Register Now. Have your member card ready as it has details
you’ll need.
3. Create a user name and password.
Once you’re on myRegence.com, you will be able to find answers to your benefit questions, including details on your pharmacy benefit, finding a doctor or hospital, joining online health and wellness programs, understanding treatment costs and options, participating in the Rewards incentive program, and much more.
To find details about your benefits on myRegence.com, follow this path:
My Navigator > Benefits. If you prefer a hard copy of your benefit details, give us a call at the telephone number found on the back of your member card.
step 1
how to find your benefit info
Regence Member Resource GuideThis guide will help you find answers to commonly asked questions. If you are viewing it electronically, you may go to any of the websites listed by simply clicking on the address.
Your plan is built on your choice of provider (doctors, hospitals, clinics, etc.). All providers set their own fees for their services. We negotiate lower fees (called allowed amounts) with many of them. While most providers accept these allowed amounts, some don’t.
When you choose a provider in Category 1 (indicated by a $ symbol in your Provider Search results) or Category 2 ($$), they accept our allowed amounts as payment in full. Your out-of-pocket costs are lower. When you choose a provider in Category 3 ($$$), you may be billed for any balance over the allowed amount. You may choose a provider from any category at any time, based on your needs.
• Find a provider by following this path on myRegence.com:
My Navigator > Provider Search.
• Search by name and location or other available search fields.
• The search results will give you useful information about network providers, including specialty, location, education, board certifications, subspecialties and languages spoken. You can see how other members have rated the doctor, and even rate the doctors you have seen.
• In the My Advisor section, you can get information about expected costs using the Treatment Cost Estimator, or view quality information on hospitals.
Whether you’re on the road or living outside the service area, your coverage goes with you. Thanks to the BlueCard® Program, you can see providers that are contracted with their local Blue Cross and/or Blue Shield Plan anywhere in the country, as well as contracted providers in 200 countries around the world. Their covered services are available to you at Category 1 reimbursement levels, which means you pay lower out-of-pocket costs.
Call 1 (800) 810-BLUE (2583) or go to My Navigator > Provider Search > BlueCard Worldwide®.
step 2
step 3
understanding your
prescription coverage
Any covered prescription medication will fall into one of these three types:
• Generics ($)
• Brand-name formulary ($$) • Brand-name non-formulary ($$$)
A formulary is a list of medications your plan covers. If a medication is not on the formulary, your costs will be higher.
Your benefits for brand-name and generic medications
The amount you pay for prescription medications is determined by the RegenceRx Maximum Allowable Cost policy. Please read this portion of your benefit summary carefully to find out coverage details if choosing a brand-name medication when a generic equivalent is available.
You’ll find the formulary for your plan on myRegence.com under My Navigator > My Account > Benefits Booklet.
Postal Prescription Services (PPS) offers mail order for many prescriptions. Follow the path My Navigator > Forms > Prescription Medication Claim Form > RegenceRx Member website. Download or print the Postal Prescription Services (PPS) Registration and Prescription Order Form.
step 3
step 4
how to file a claim
Most providers will bill us on your behalf. But if you need to request reimbursement for services you paid for out of your pocket (such as when you see a provider in Category 3), use the claim form you’ll find on myRegence.com at My Navigator > Forms.
Send claim forms and original receipts to: Regence BlueShield of Idaho
P.O. Box 31603
HAVE A QUESTION?
We can help! You can get convenient answers through
“click to chat” on the myRegence.com main page.
You can also call us at the phone number found on the
back of your member card. Both are available Monday
through Friday, 6 a.m. to 6 p.m. Pacific time.
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Imagine a place where you can find answers and support for all of your health needs. myRegence.com is your complete source of health and wellness information. And it’s simple to understand. So whether you want to get started on an exercise program, need tips on eating healthier, or just want to know if we’ve paid your claim, visit myRegence.com today.
myRegence.com
Everything you’ve always wanted to know about your health. In one place.
® ® ® ® ® ® ® ®
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
Reward
Healthy living has its own rewards, but Regence Rewards points can help.
• Earn points for browsing our health news, podcasts and videos.
• Receive points for healthy everyday activities—such as eating fruits and veggies and walking the dog , or joining an online wellness program.
• Redeem points for an Amazon.com gift card.
Navigate
Discover tools that help you track your coverage and make informed decisions about your health care.
• Review details about your coverage.
• Manageyour claims online and eliminate paper Explanation of Benefits.
• Find a doctor or specialist and read patient reviews—online or on your mobile device.
• Create a secure, confidential Personal Health Record.
• Discuss a variety of important health and wellness topics on My Community, a nationwide social networking site.
Advise
Consider health care decisions, explore treatment options and plan ahead for financial needs.
• Compare cost and quality of hospitals, clinics and providers.
• Research treatment options and out-of-pocket cost estimates.
• Learn about medical conditions, medications and cost-saving generics.
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myRegence.com
Want more value for your health care dollars? Log on to myRegence.com and discover online resources and interactive experiences focused on your health. It’s easy to join and you’ll earn 5,000 points with Regence Rewards just for registering.
Become an informed health care consumer.
Log on today and earn 5,000 points.
Simply use the information on your member card and follow these steps.
1. Go to myRegence.com.
2. Click New Member Registration.
3. Complete the required MyMember Account Information fields. The name, member and group numbers you enter must match your member card. 4. Create a user name and secure password.
5. Click Register and Login.
Take a confidential General Health Assessment. Earn up to 10,000 points.
Learn how you’ve been managing your health to date, and get practical tips on how to improve your health and well-being.
Manage stress and get into shape. Earn 5,000 points at completion.
Reach for a healthy lifestyle with wellness programs on Weight Loss, Healthier Diet, Stress Relief, Healthy Aging, going Smoke-Free and more.
Keep your health history at your fingertips. Earn up to 6,000 points.
Create a secure, confidential record of your medical history with the Personal
Health Record tool. Input your own information about allergies, immunizations, emergency contacts and more.
Get social in My Community. Earn up to 2,400 points.
Join the conversation and earn points for posting in My Community—an online health and wellness social networking site where members nationwide are talking, asking questions of our experts, following bloggers and receiving support in achieving their goals.
What are you waiting for? Register now at myRegence.com!
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© 2012. Regence BlueShield of Idaho, all rights reserved.
® ® ® ® ® ® ® ®
Regence has you covered
A C R O S S T H E C O U N T R Y A N D
A R O U N D T H E W O R L D.
With coverage from Regence, your employees can take their health care benefits with them—across the country and around the world. The BlueCard Program provides access to doctors and hospitals almost everywhere, giving your employees peace of mind knowing they’ll be able to find the health care provider they need, regardless of where they are.
Choices
Regence membership gives your employees a world of options. They are free to choose the doctors and hospitals that best suits the needs of their families in more than 200 countries and territories around the world through the BlueCard Worldwide® Program.
Designed to save money
In most cases, when your employees travel or reside outside the Regence service area, they can take advantage of lower rates the local Blue Plan has negotiated with doctors and hospitals in the area.
For covered services, employees should not be responsible for any amount above these negotiated rates and will only pay applicable out-of-pocket expenses.
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
The BlueCard
®Program
BlueCard Program Advantages
PROVIDER CHOICE Employees have access to more than 85% of providers and 96% of hospitals nationwide. BENEFIT CONSISTENCY
BlueCard ensures members receive in-network benefits when choosing participating providers of any Blue Cross and/or Blue Shield Plan.
BILLING PROTECTION
Accessing a Blue Cross and/or Blue Shield Plan participating provider ensures that members are not responsible for any balance billed amount.
To learn more about the BlueCard program, contact your Producer or a Regence sales representative.
BlueCard and BlueCard Worldwide are registered service marks of the Blue Cross and Blue Shield Association.
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Regence member sees a provider outside the Regence service area
Participating provider
provides care for the Regence member
Local Blue Plan
prices the claim and submits it to Regence
Processes the claim and authorizes payment Sends an explanation of benefits to the member
Local Blue Plan
pays provider
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
Regence case management services
Navigating the health care system can be a challenge in the best of circumstances, but when you’re facing a health crisis, it can be even more daunting. In times like those, a helping hand can make all the difference. That’s where the Regence case management program comes in. If you or your family ever faces a serious or sudden medical situation, you have easy access to one-on-one support at no extra cost. Registered nurses and social workers are available to help you make sense of your coverage and get the best possible care. Regence case management is not
insurance, but is offered in addition to your medical plan to help you get information and support when you need it.
How can case management help you?
No one wants to be confronted with a serious illness or injury. But if it happens, Regence case managers offer the comfort of a compassionate listener and the wisdom of a medical expert to help you get through it. Regence case managers are registered nurses and social workers who are specialists at navigating the health care system.
With a Regence case manager on your side, you can take comfort in knowing that a knowledgeable, dedicated advocate is looking out for your best interests. So you’re free to focus on what’s most important—yourself and your family.
Your case manager will:
• Answer questions and provide information about your condition, illness or injury
• Be your advocate and help you navigate the health care system • Work with your doctors and support your treatment plan
• Help you make informed decisions based on all your treatment options • Make sure you’re getting the most from your benefit plan
Sometimes a case manager might reach out to you directly if it appears that you could use some help.
Compassionate listener.
M E D I C A L E X P E R T.
Who uses Regence case management services?
Case management provides support for a variety of medical concerns. Here are some real-life examples of members who’ve been helped by a Regence case manager:
• Three young brothers, all living with hemophilia, who require constant monitoring and infusion of life-saving medications
• An 84-year-old man whose leg wounds were infected with antibiotic-resistant bacteria
• A 48-year-old man suffering from a rare lung disease who now receives intravenous treatment in the comfort of his own home
• A 17-year-old student whose kidney transplant saved her life
Regence case management earned an
overall satisfaction rate of 95% in a recent
survey of Regence members.
Your rights under case management
Your case manager is there to help you and your caregivers make informed decisions. When you work with a case manager, here’s what you can expect:
• Participation is voluntary, so you have the right to refuse case management services.
• You are entitled to case management services even if you cannot actively participate in the assessment phase (the time when we compile all the information necessary to get started on your case).
• If you or your caregivers are unable to provide input during the assessment phase, then you can expect your case manager to gather that information from alternative sources.
• You have the right to give input into your case management plan. • We’ll keep you informed of your options as we work together to make
decisions regarding your care.
• We must honor your life and advance-care directives as applicable. • We’ll tell you our criteria for deciding when to close a case.
• We’ll notify you when we change or close your case, and tell you exactly why.
If these rights don’t make sense or you don’t know what they mean, then your case manager will provide further education to help you understand them.
For more information or to make a referral, call 1 (866) 543-5765.
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Find your way
around your Rx plan
I N A F L A S H.
A quick guide to your RegenceRx® prescription program
Here’s a quick reference sheet to help you better understand your prescription benefits and find the Rx information you need. It’s one more tool you can use to navigate the health care system and make informed decisions about your care. Check it out!
With more than 65,000 pharmacies in our network, it’s easy to find one near you.
Using your Rx benefits
Simply present your Regence member card at the pharmacy, and the pharmacist will submit your claim online. The system will calculate the claim cost based on your pharmacy benefit, then the pharmacist will tell you how much you owe.
Your member card
Take a minute to look at your member card. It verifies that you have prescription coverage and gives our participating pharmacies everything they need in order to submit your claim online. If you have questions, just call us at the phone number on the back of your card.
Your deductible and copay
If you have a plan with a pharmacy deductible, then you’ll pay for each covered prescription in full until you’ve met your deductible. (The pharmacist will still submit your claim as usual so that your purchase counts toward your deductible.) After you meet your deductible, then you’ll simply pay your portion of the cost (copay/coinsurance).
If you have a plan with a copay only (no deductible), then you’ll just pay that amount for each covered prescription medication when you pick it up. You’ll find your prescription deductible and copay amounts summarized in your benefits booklet on myRegence.com.
Generics: another way to save
You’ll save money by using generic medications whenever possible. If the medication you need is not available in generic form, ask your doctor if another generic can be used to treat the same condition, or if there is a less expensive brand-name medication. Your doctor is the best person to determine the medication that’s right for you.
Prior authorization and our Generics First policy
Some brand-name medications require prior authorization to ensure they’re covered, such as antidepressant, diabetes, pain, heartburn and cholesterol medications. Go to regenceRx.com and click on “Prior Auth/Medication Quantities” in the “Learn About Medications” section for a list of medications needing prior authorization.
If you take one of these medications or keep one on hand to use as needed, then you’ll need to do one of two things in order to be sure your medication will continue to be covered:
1. Try a generic first! Switch to a generic version of the brand-name medication you are taking. Just ask your pharmacist to fill your prescription with the generic rather than the brand-name.
or
2. Get prior authorization for that brand-name
medication. The brand-name medication might be denied if it hasn’t been approved ahead of time. Ask your doctor or pharmacist to send a prior authorization request with your medical or medication history before your next refill. Your pharmacist may fax your prescription profile to 1 (888) 437-1510 or call 1 (800) 572-0316.
Filing claims and getting reimbursed
The pharmacist will file your claim for you, and we’ll pay the pharmacy directly, so you won’t have to worry about paperwork or getting reimbursed. In the rare event that you do need to file a claim, we make it painless. Just go to regenceRx.com to download the proper claim form, or give us a call at the number on the back of your member card.
If you misplace your member card, we’ll replace it. Just call us toll-free at 1 (888) 367-2117 or visit myRegence.com.
Explore regenceRx.com: a site devoted to your Rx benefits
Visit regenceRx.com for information specifically related to your RegenceRx prescription benefit. Use it to:
• Find a participating pharmacy • Access our formulary
• Learn about your medication choices
• Preview medications to learn if they require prior authorization, or if they have any limitations or restrictions
• Print out a prescription claim form
Go to myRegence.com to make the most of all your benefits
To discover all the advantages of your Regence membership beyond prescriptions, go to
myRegence.com. There you can view and manage details related to your medical and prescription coverage, explore events and rewards for healthy living, and plan ahead using our Health Cost Estimators.
Maximize your benefit: Always
show your member card to the
pharmacy where you purchase
your prescriptions.
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Prior authorization helps
protect our members
from harm and high costs.
Prior authorization is a small step that has a huge impact on safety and savings
We sometimes need more information about a medication before we can cover it. We get that information through the prior authorization process. Not all medications need prior authorization. But for those that do, this process helps ensure that you get the best in safety and value.
Here are some reasons a prescription might need prior authorization:
• It has been proven to benefit only a limited number of people • Unusually large doses are
requested for coverage • Equally effective but more
affordable generic options are available
• It’s prescribed for conditions not covered by your health plan • It hasn’t been thoroughly tested
by the scientific community or approved by the FDA for certain uses
If your medication is on our prior authorization list, we’ll need information from your doctor or pharmacist.
When prior authorization works
Our pharmacists and doctors tirelessly research medications for safety, effectiveness and overall value. We’re committed to sharing this information with you through the prior authorization list. The prior authorization process is simple:
• Your doctor or pharmacist can request prior authorization by going to regencerx.com/pa, calling 1 (800) 643-5918, or faxing 1 (800) 884-4282.
• Our team of clinical pharmacists and pharmacy technicians carefully reviews each request, taking into consideration our evidence-based reviews of scientific research. Any request that can’t be approved is then reviewed by a physician medical director.
• We’ll contact you, your doctor, and your pharmacy within two business days with our decision. • If we find that the medication is
the best value for your condition, the medication will generally be authorized. If not, the medication won’t be covered.
• If your medication isn’t covered, we’ll share a clear explanation of our reasons, along with potential covered alternatives, if available.
Your prior authorization support
Naturally, you and your doctor are the best people to determine the medication that’s right for you. If you have questions or concerns about prior authorization, we’re here to help. Here’s how you can reach us:
• To determine if a medication needs approval, visit
www.regencerx.com and look under Learn About
Medications.
• To review our medication policies, visit www.regencerx. com/learn/policy/index.html. • To speak to Pharmacy Customer
Service, call 1 (800) 643-5918.
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
Prescription Prior Authorization
Prior authorization helps ensure that covered medications provide the best safety and value. It is needed when a medication has only been proven to benefit a limited number of people or if unusually large doses are requested for coverage.Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
These medications require prior authorization
because alternatives may offer a better value Possible alternatives Cholesterol
atorvastatin, Crestor® simvastin (Zocor®), pravastatin (Pravachol®), lovastatin (Mevacor®) Lipitor®, Livalo®, Vytorin® simvastin (Zocor®), pravastatin (Pravachol®), lovastatin (Mevacor®),
Crestor®
Depression
Cymbalta®, Lexapro®, Pristiq™, Viibryd™
bupropion SR (Wellbutrin SR®), bupropion XL 300mg (Wellbutrin XL®),
fluoxetine (Prozac®), fluvoxamine maleate, mirtazapine (Remeron®),
paroxetine (Paxil®), sertraline (Zoloft®)
Diabetes
ACTOplus Met™, Actos®, Avandamet®, Avandaryl™, Avandia®, Bydureon™, Byetta®, Duetact™, Janumet®, Janumet® XR, Januvia™, Jentadueto™, Juvisync™, Kombiglyze™ XR, Onglyza™, Tradjenta™, Victoza®
metformin (Glucophage®), glimepiride (Amaryl®), glipizide (Glucotrol®),
glyburide (Diabeta®), insulin
High Blood Pressure
Benicar®, Benicar HCT®, Micardis®, Micardis HCT® benazepril/HCT (Lotensin/HCT
®), captopril/HCT (Capoten/Captozide®)
enalapril /HCT(Vasotec/Vaseretic®), fosinopril/HCT (Monopril/HCT®),
lisinopril/HCT (Zestril/Zestoretic®, Prinivil/Prinzide®), losartan/HCT (Cozaar/Hyzaar®), moexipril/HCT (Univasc/Uniretic®), quinapril/HCT (Accupril/Accuretic®), trandolapril (Mavik®)
Amturnide™, Atacand®, Atacand-HCT®, Avalide®, Avapro®, Azor®, Diovan®, Diovan HCT®, Edarbi™, Exforge®, Exforge HCT®, Tekamlo™, Tekturna®, Tekturna HCT®, Teveten®, Teveten HCT®, Tribenzor™, Twynsta®, Valturna®
benazepril/HCT (Lotensin/HCT®), captopril/HCT(Capoten/Captozide®)
enalapril/HCT (Vasotec/Vaseretic®), fosinopril/HCT (Monopril/HCT®),
lisinopril/HCT (Zestril/Zestoretic®, Prinivil/Prinzide®), losartan/HCT (Cozaar/Hyzaar®), moexipril/HCT (Univasc/Uniretic®), quinapril/HCT (Accupril/Accuretic®), trandolapril (Mavik®), Benicar®, Benicar HCT®, Micardis®, Micardis HCT®
Mental Health
Abilify®, Fanapt®, Geodon®, Invega®, Latuda®, Saphris®,
ziprasidone
clozapine (Clozaril®), olanzapine (Zyprexa®), risperidone (Risperdal®), Seroquel®, Seroquel XR®
Migraines
Maxalt®, Maxalt-MLT®, Relpax® sumatriptan (Imitrex®) Alsuma™, Amerge®, Axert®, Frova®, naratriptan HCL,
Sumavel™ DosePro™, Treximet™, Zomig®, Zomig-ZMT® sumatriptan (Imitrex®), Maxalt®, Maxalt-MLT®, Relpax®
Multiple Sclerosis
Extavia® Avonex®, Copaxone®, Rebif®
Betaseron® Avonex®, Copaxone®, Rebif®, Extavia®
Nasal Steroids
Beconase AQ®, Nasonex®, Omnaris®, Rhinocort Aqua®, Veramyst®
flunisolide (Nasalide®), fluticasone (Flonase®), triamcinolone
acetonide (Nasacort® AQ)
Pain and Inflammation
Celebrex®
Generic non-steroidal anti-inflammatory medications (NSAIDs) such as: diclofenac (Voltaren®), etodolac (Lodine®), flurbiprofen (Ansaid®),
ibuprofen (Motrin®), indomethacin (Indocin®), ketoprofen (Orudis®),
nabumetone (Relafen®), naproxen (Naprosyn®), oxaprozin (Daypro®),
piroxicam (Feldene®), salsalate (Disalcid®), sulindac (Clinoril®), tolmetin (Tolectin®)
Stomach Acid
Dexilant™, Kapidex™, lansoprazole omeprazole (Prilosec®)
Aciphex®, Nexium®, Prevacid®, Vimovo™ omeprazole (Prilosec®), Dexilant™, Kapidex™
Effective 03/12
NOTE: Our medication Prior Authorization List is subject to change. If the requested medication is authorized, there maybe limits to the amount of medication that is eligible for coverage. Please call our Customer Service Department if you have any questions.
Medications that need Prior Authorization
The Bottom Line – Safety is our top priority and our prior authorization program helps you and your doctors choose quality medications that provide the most value. Some alternatives might also help you save money.
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These medications require prior authorization to determine if they can be covered for your medical condition
Abstral® Actiq® Actonel®
Actonel® with Calcium Adcirca™
Afinitor®
Amphetamine-
Dextroamphetamine ER cap (Mfgs: Global, Barr/Teva) Ampyra™
Arcalyst™ Atelvia™
Blood Glucose test strips and meters (Mfgs: Abbott, Lifescan/JJ/Roche) Boniva® ciclopirox (solution) Cimzia® CNL 8™ Egrifta™ Embeda™ Enbrel® Erivedge™ Fentora™ Firazyr® Forteo® Gilenya™ Gleevec® Growth Hormone Humira® Incivek™ Increlex™ Inlyta® itraconazole Jakafi™ Kalydeco™ Kineret® Lamisil® Lazanda® Letairis® Lyrica® Nexavar® Nuvigil® Onsolis™ Orencia® SQ injection OxyContin® Pegasys® PEG-Intron® PenLac® Promacta® Provigil® Qualaquin™ Relistor™ Revatio™ Revlimid® Savella™ Simponi™ Sporanox® Sprycel® Sutent® Sylatron™ Tarceva® Tasigna® terbinafine Tracleer® Tykerb® Tyvaso® vandetanib Ventavis® Victrelis™ Votrient™ Xalkori® Xenazine® Xyrem® Zavesca® Zelboraf™ Zolinza™ ZolpiMist™ Zytiga™
These medications require prior authorization
if prescribed above the maximum quantity Maximum quantity per month unless otherwise specified
Ambien CR™ (zolpidem tartrate er) 14 tablets
Edluar™ 14 tablets
Exalgo™ 120 tablets
Imitrex® (sumatriptan succinate) tablet 12 tablets Imitrex® (sumatriptan succinate) injection 6 injections Imitrex® nasal spray 6 canisters Infergen® injection 12 injections
Lunesta® 14 tablets
Opana® ER 80 mg per day
Relenza® 10 discs (2 treatment courses) per 6 months
Rozerem™ 14 tablets
Tamiflu® 30mg 40 capsules (2 treatment courses) per 6 months Tamiflu® 45mg & 75mg 20 capsules (2 treatment courses) per 6 months Tamiflu® 12mg/ml 150ml (2 treatment courses) per 6 months
NOTE: In addition to the above medications, there are limits to the amount of medication eligible for coverage for all prescriptions. These limits are based on your prescription benefit along with information from the FDA and scientific literature about maximum, safe, effective dosages.
Feeling good
d o e s n ’ t h a v e t o c o s t a l o t.
Regence Advantages
As a Regence member, you can enjoy savings on the following
health-related products and services. This discount program is offered to all Regence members at no additional cost (although some
discounted programs offered by vendors may carry separate fees).
Regence Advantages is not insurance but is offered in addition to your medical and/or dental plan(s) to help you stay healthy and live better.
• TruVision™:Significant discounts are offered on laser vision
correction procedures such as LASIK and PRK. Also, save 10% to 15% on mail-order contact lenses.
• TruHearingTM: TruHearing™ is a discount medical organization that offers
deep discounts on state-of-the-art digital hearing aids, and contracts with a national network of audiologists and hearing instrument specialists to provide lower costs on expert advice and service. It offers two programs to choose from—TruHearing ValueAdd™ and TruHearing MemberPlus. Both include special health plan-contracted pricing on hearing aids, one-time loss or damage replacement for three years, a 45-day money back guarantee and 48 batteries per hearing aid purchased. Similar to warehouse memberships, TruHearing MemberPlus saves you an additional $300 to $1,100 on hearing aids for an annual membership fee of $108.
• QualSight®: Save 40% to 50% on traditional or custom LASIK through the QualSight network. IntraLase bladeless LASIK is also available for an additional $450 per eye.
• Epic® Dental: Purchase smile-protecting supplies at 25% off,
including mouthwash, gums, mints and toothpaste. All items contain xylitol, a natural ingredient that fights cavities.
• CHP CAMaffinity Program: As a Regence member, you’re eligible for the CHP CAMaffinity Program, which provides a 20% discount on complementary and alternative medicine (CAM) services offered through The CHP Group’s growing network of chiropractors,
acupuncturists, naturopathic physicians and massage therapists.
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
Regence is completely independent from the companies that provide these products and services. Regence does not endorse or guarantee the products and services offered or their effectiveness. Regence reserves the right to change the program at any time without prior notice.
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© 2011. Regence BlueShield of Idho, all rights reserved.
• CHP Active and Healthy: CHP Active and Healthy is the discount program that gets you up,
moving, and saving money! With discounts offered by thousands of participating vendors (e.g. health clubs, ski resorts, sporting events, museums, etc.) for a small annual fee, it’s your source for great deals on healthy and fun activities.
• Banfield® Pet Hospital: As a Regence member, you receive a waived enrollment fee for Banfield Pet Hospital’s Optimum Wellness Plans®, packages of preventive care that include annual blood work, vaccinations, de-worming, unlimited office visits, plus much more. Banfield is the largest veterinary hospital in the world with 800 hospitals in 43 states; most located inside PetSmartTM. Learn more
at banfield.com/regence.
• Take Shape for Life®: This safe weight management and health program uses clinically proven Medifast® products and a personal health coach to provide one-on-one guidance and encouragement. The program helps you lose weight and manage disease and health through nutritional intervention, free access to health care professionals, educational materials, and healthy habits that last a lifetime. The goal: to help you optimize your health to lead a richer and more fulfilling life. There are no hidden costs or start-up fees. Learn more at myhealthyhuddle.com. Special savings for Regence members: –$25 special credit on your
first order
–Additional $25 to $50 off first month’s order for the progressive “BeSlim” savings plan: 5% to 10% off monthly order and free shipping (minimum order required)
–Free “The Secret is Out” book
–Redeemable rewards points
• CorCell® Saving Baby’s Cord Blood®: Cord blood stem cells are now being used to treat more than 70 diseases, and research is ongoing to find treatments for even more. Regence has partnered with CorCell to offer a $350 discount when you bank your baby’s umbilical cord blood. Protect your child or give the gift of cord blood preservation to your grandchild, niece, nephew, friend or other loved one. Visit corcell.com for more information. • HearPO®: Receive a 40%
discount on diagnostic services, including hearing exams, and significant savings on hearing aids. You’ll enjoy a 60-day no-risk trial period; one-year follow-up care; a three-year warranty, including coverage for loss and damage; and free batteries (160 cells per hearing aid)—all with a lowest-price guarantee. • EyeMed Vision Care®: Save 35%
on a complete pair of glasses (frames and lenses). Save 15% on non-disposable contacts and $10 on contact lens fittings. These discounts are available at leading retailers and many private practice locations.
• Jenny Craig®: Jenny Craig plans are personalized and offer one-on-one support from trained weight-loss consultants. With every Jenny Craig Program you’ll receive weekly scheduled consultations, planned or personalized menus, and free etools and online support at jennycraig.com. Choose from these options:
–A Free 30-day Program* –25% off a Premium Program*
• Beltone™**: Receive a free screening, a 25% discount on Beltone hearing aids, a one-year supply of hearing-aid batteries and free follow-up visits and testing.
• Newport Audiology Centers**: Receive a free hearing exam if you’re a senior, or $25 off an exam if you’re at least age 15. Save 32% on all hearing-aids and receive a free two-year supply of batteries (up to 96 batteries) with a hearing-aid purchase. • Safe Beginnings®: Enjoy a 15%
discount on everything you need to baby-proof your home, including safety gates, cabinet locks, outlet covers, window guards, and other items to help keep your baby safe.
Want to learn more?
Go to myRegence.com/advantages
or regence.com
* Food and, if applicable, shipping not included. Offer applies to initial membership fee only and is valid at participating centers in the United States, Canada and Puerto Rico and through Jenny Craig At Home. Each offer is a separate offer and can be used only once per person. Restrictions apply.
** Discounts through HearPO (also includes extended family), TruHearing, Beltone and Newport Audiology are available to members and their parents and grandparents.
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