What is the difference between my insurance cards I received from MUST?

MUST members are issued a card for medical and vision for each member, including dependents who are enrolled in those benefits. To quickly identify the medical card, please note the red ‘PPO’ on the lower left-hand side of the benefit card.

Dental cards are only issued to the policyholder and are valid for all covered family members. If there are covered family members on the policy, then two (2) identical cards are issued.

Where can I find a full list of preventive benefits?

To view the preventive benefits flyer, click HERE

A comprehensive listing of preventive benefits may be found in the MUST Summary Plan Document (SPD) which is posted to Blue Access for Members (BAM); located under the medical coverage tab. To use Blue Access for Members (BAM) visit www.bcbsmt.com. You may also refer to “Preventive Care” under Section I (Benefits) of the SPD. A listing of the U.S. Department of Health & Human Services preventive care services is available HERE.

What is an Explanation of Benefits (EOB) and how can I read it?

An EOB is created after a claim payment has been processed by your health care plan. It explains the actions taken on a claim such as the amount that will be paid, the benefit available, reasons for denying payment and the claims appeal process. Please watch the video on Blue Access for Members in the member tab called Understanding my Explanation of Benefits (EOB).

What card do I use for a vision exam?

You should use your medical ID card when getting a vision exam. MUST plans cover one (1) vision exam per benefit period under the medical plan at 100% of the allowable fee.

Does my plan cover behavioral health?

MUST plans do cover behavioral health. Depending on the plan you are enrolled in, the first three (3) visits are covered at no cost to the member. Under a High Deductible Health Plan (HDHP), all behavioral health services are applied to the deductible. In accordance with federal regulations, the HDHP plans do not have a ‘first dollar’ benefit.

Does my plan cover physical therapy or chiropractic visits?

All MUST plans cover physical therapy, which is a different benefit than chiropractic. Chiropractic and acupuncture services are a combined benefit with a visit limit for all plans except the MUST Basic Plan, which does not cover chiropractic or acupuncture.

Is my insurance under Blue Cross Blue Shield of Montana or MUST?

Montana Unified School Trust (MUST), as a self-funded health plan is the insurer. Your insurance is purchased through MUST by your employer. MUST contracts with Blue Cross and Blue Shield of Montana (BCBSMT), a third party administrator, to perform certain services. Services provided by BCBSMT include, but are not limited to, claims processing, payment to providers, and medical management, as well as a first-class customer advocate team.

Why are my rates at my school district higher than other school districts?

Because rating for your school district is impacted by the composition of employees, age, and health, as well as past claims experience, rates vary between school districts.

What is a Health Savings Account (HSA) Account? How do I set it up an HSA and how do I qualify?

An HSA may be used in conjunction with a High Deductible Health Plan (HDHP). Check with your payroll clerk to see if the plan you are enrolled in qualifies for an HSA and if they offer the option of an HSA account. The decision to offer an HSA is made at the group level.

I participated in the MUST Healthy Futures Wellness Program, when do I receive my incentive?

Upon completion and submission of the Total Health Management (THM) Assessment form to Blue Cross and Blue Shield of Montana (BCBSMT), if you provided a legible email address you will get a notice when your form is received.  In the next benefit year under a MUST medical plan, you will receive a $100 credit to your plan deductible.

Understanding Coverage for Air Ambulance Service

MUST recognizes Montana is a big, rural state and medical care is often far away, which means an air ambulance may be needed in the event of a serious accident or a condition where you may not survive an emergency trip in a land ambulance.

What is an air ambulance? Air ambulance is any form of aircraft equipped with medical supplies, equipment and qualified medical professionals that will provide mobile medical care to a patient during transport to a medical facility specialized in responding to the medical needs of the patient in transport. Air ambulances are largely used in emergency medical situations or situations where timing is of the essence in helping a patient receive treatment.

The specific air ambulance service used matters. Why? Because you could end up paying large out of pocket costs if you use an out of network provider. According to the National Association of Insurance Commissioners, the average cost for one 52 mile air ambulance trip is between $12,000 and $25,000. If you (and your physician) utilize an in-network air ambulance provider, you will not be balanced billed for the difference in the reimbursement amount and the amount charged. Using an out-of-network provider, including air ambulance, can result in significant balance billed amounts after insurance has paid its portion. You are responsible for that balance bill amount out of your own pocket charged by out-of-network providers. The current listing of Montana BCBSMT in-network air ambulance providers include:

  • Benefis Healthcare Mercy Flight Communication Center: 1-800-972-4000
  • Billings Clinic Hospital: 1-800-325-1774
  • Kalispell Regional Hospital: 1-866-302-9767
  • Life Flight Network: 1-800-232-0911 or 1-208-367-3114
  • MT Medical Transport: 1-406-457-8205
  • Northeast Stat Air: Dispatch line: 1-800-992-7828
  • St. Vincent’s Healthcare: 1-800-538-4357

Currently, there is no control over the large disparity that air ambulance providers charge in relation to the services provided. MUST’s third-party administrator, Blue Cross and Blue Shield of Montana (BCBSMT), currently reimburses all air ambulance providers at 225% of the Medicare reimbursement rate, with BCBSMT in-network air ambulance providers accepting that amount as payment in full.

Are air ambulance services covered by MUST? Yes, air ambulance services are covered by MUST when the service is considered medically necessary, meaning the service is required for the treatment of a covered medical condition. Air ambulance is subject to your health plan’s deductibles and co-insurance like your other coverages.

While no one anticipates an emergency medical situation, it is helpful to be an informed consumer and know your available benefits. BCBSMT has conducted outreach to all facilities in the state of Montana to make them aware of the in-network air ambulance providers in an effort to limit members exposure to high cost out of network charges.

For more information on the Provider Finder click HERE.

Looking for the RIGHT doctor and how much a procedure will REALLY cost you?

You’re now in charge with more information.  The new Blue Cross and Blue Shield of Montana (BCBSMT) online Provider Finder is an innovative tool for helping you chose a provider, plus estimate the cost of hundreds of medical procedures and your estimated costs.  The tool allows you to know more about the providers who take care of you or your family and compare provider costs by location.  The Provider Finder tool is available at bcbsmt.com by logging in to Blue Access for Members (BAM) or by downloading the BCBSMT app to your smartphone where you can:

  • Find a network primary care physician, specialist or hospital
  • Filter search and compare results by a doctor, specialty, ZIP code and gender – even get directions
  • Estimate the cost of procedures, treatments and tests and your deductible/out-of-pocket expense based on your actual MUST benefit plan
  • Review quality designations for facilities and physicians
  • View patient reviews on physicians

For more information on the Provider Finder click HERE.