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

MUST members are issued one card for medical for each member, including dependents who are enrolled in those benefits. Each card will include the subscriber and dependent name.

Beginning in 2022, insurance cards are no longer required for dental and vision. MUST will not issue ID cards so we encourage you to create an online account to access your information.

With Delta Dental, members only need to provide their name, birthdate, and enrollee ID or Social Security number when visiting the dentist. If your family members are covered under your plan they will need to provide your information. If you prefer to have a card, simply login to your account at deltadentalins.com to view or print your card.

Using your Vision Benefit is just as easy! Create an account on vsp.com to view your in-network coverage, find the VSP network doctor who’s right for you, and discover savings with exclusive member extras. At your appointment, just tell them you have VSP. PLEASE NOTE: If you have elected medical under your plan, please present your BCBS card for the exam. A vision exam is considered preventive under your medical coverage and is limited to 1 exam per benefit member.

Where can I find a full list of preventive benefits?

All MUST plans include a rich menu of preventive benefits. These benefits now include a vision exam and contraceptive coverage for all groups. Preventive benefit levels apply when provided by a network provider. If non-network providers are used, the member is subject to deductible, co-insurance, and any charges beyond MUST’s allowable limits otherwise known as balance billing.

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).

Where can I get Dental and Vision cards?

Effective 7/1/22, MUST began offering vision benefits through VSP and dental benefits through Delta Dental. Neither of these benefits require ID cards to obtain services.

With Delta Dental, you can simply provide your name, DOB, and enrollee ID or SSN. Any dependents will be required to provide your information when visiting the dentist. If you prefer to have an ID card, you can create an account at https://www1.deltadentalins.com/members.html to obtain a card, find a dentist, or learn about your dental benefits. You may also contact the customer service line at 800-521-2651.

To utilize your vision benefit, create an account at vsp.com to view your benefits, find an in-network doctor, and discover savings with exclusive member extras. At your appointment, simply let them know you’re enrolled in VSP. No ID card is required. To speak with a VSP customer service representative, call 800-877-7195.

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.

Who am I insured by?

Montana Unified School Trust (MUST), as a self-funded health plan is the insurer. Your insurance is purchased through MUST by your employer. Administering a large health-benefits trust requires many strong relationships to ensure the health and wellness needs of its members are met.  MUST partners with the following organizations  to keep member premiums at a minimum while ensuring only the highest quality benefit plans and options.

Blue Cross and Blue Shield of Montana (BCBSMT) is contracted 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.

Delta Dental is contracted to offer comprehensive, high quality oral health care coverage to our enrollees and is built on the strongest network of dental providers in the country.

VSP  is contracted to offer well-vision exams, essential medical eye care, and comprehensive hardware benefits.

To learn more about our other affiliates click HERE

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)? 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.

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.