How it Works

Your annual deductible, coinsurance and maximums

The 3M Advantage plans work just like most other health insurance plans. There is an annual deductible, then the cost of care is shared through coinsurance, and then the plans limit your cost with of an out-of-pocket maximum (see definitions). Note: Medical and prescription drug expenses are combined toward your annual deductible (except for the costs of drugs on the preventive drug list).


However, unlike the Basic PPO plan, you can use your HSA to help pay for qualified medical expenses. The two plans give you choices in annual deductibles (and how the family annual deductible is met), maximums and premiums.


See how the plan and account work through the year

Back to top


Differences between Prime Advantage and Choice Advantage plans

 

PRIME ADVANTAGE

CHOICE ADVANTAGE

ANNUAL DEDUCTIBLE

In-Network

 

 

   Individual

$1,300

$2,600

   Family

$2,600

$5,200

Out-of-Network

 

 

   Individual

$2,600

$5,200

   Family

$5,200

$10,400


OUT-OF-POCKET MAXIMUM    

In-Network

 

 

   Individual

$2,600

$5,200

   Family

$5,200

$10,400

Out-of-Network

 

 

   Individual

$5,200

$10,400

   Family

$10,400

$20,800


COINSURANCE    

In-Network

You 10% / 3M 90%

You 10% / 3M 90%

Out-of-Network

You 35% / 3M 65%

You 35% / 3M 65%


Meeting your annual deductible for family coverage

With family coverage in the Choice Advantage plan, one person is able to meet the individual annual deductible amount ($2,600) on his/her own, then the plan will cover that person’s care at 90 percent of the allowed amount for in-network services. Once another member of the family meets the individual annual deductible, or collectively the other family members meet the remaining family amount, everyone’s care is covered at 90 percent for most in-network services. (This is called an “embedded” annual deductible.)

 

With family coverage in the Prime Advantage plan, all family members must contribute toward the annual deductible of $2,600 before any member’s care is covered at 90 percent for in-network services. (This is a “non-embedded” annual deductible.)


Annual deductible, out-of-pocket maximum and premium amounts

The Prime Advantage plan’s annual deductibles and out-of-pocket maximums are half of the Choice Advantage plan’s amounts. However, the Prime Advantage plan features higher premiums(PDF) (still lower than the Basic PPO plan premiums). You choose the plan that works best for your needs.

Back to top

How a claim is paid

The 3M Advantage plans work together with the Health Savings Account (HSA) to help pay for qualified medical expenses. The Advantage plans provide the comprehensive medical, vision and prescription drug coverage while your HSA can be used to pay for your portion of the costs for the care you receive.

 

Claims are administered by different vendors depending on the type of care you receive:

  • Blue Cross and Blue Shield administers the medical benefits
  • CVS Caremark administers the prescription drug benefits
  • VSP administers the vision benefits

In addition, starting in 2013, your HSA will be managed through PayFlex, which allows you to manage payments and reimbursements conveniently through its HealthHub website.

 

To illustrate how a medical claim is paid, here is what happens when you visit an in-network provider under one of the 3M Advantage plans:


 

 

 

 


Your visit.

Depending on your plan, you may be required to pay an office copay at the time of service. Your provider will know this because your member ID card will indicate the amount in the office copay field.

one

 

two

Your in-network provider submits your claim to Blue Cross.

two

 

Blue Cross processes your claim within two weeks of receiving all the necessary paperwork from your provider.

three

 

four

You receive an EOB.

If you owe something to your provider, you will receive an Explanation of Benefits (EOB) in the mail. It’s not a bill — it’s a record of what you’ll pay when your provider sends you an invoice.

Note: Each covered family member can see their own EOBs on their home page after they register and sign in at bluecrossmn.com/3M.

You can view your own EOBs and those for covered dependents who are 12 and under.

EOB and you

 

five

Provider’s bills typically arrive within two weeks after you receive your EOB.

 

six

Compare your EOB to your provider’s bill.

Make sure the amount on the bill matches what is listed on your EOB. If not, contact Blue Cross customer service.

Compare EOB and bill

 

7

Pay your provider.

paye your provider



* You can pay with Debit Card, Click to Pay or Auto Pay options (PDF).


Learn about reaching your deductible and out-of-pocket maximum
Learn about your HSA

Ways to save on health care costs

As you take more ownership of your health and the care you receive, it’s important to make wise choices on when and where to spend your money. That’s what it means to be a good health care consumer. Here are things you can do to make sure you’re using care wisely and getting the best value for your dollar.


Always use in-network providers

You receive the highest level of benefits and pay the lowest cost when you use doctors, pharmacies and other health care providers that are in-network. It also helps 3M save money by taking advantage of the discounts the plan has negotiated with these providers for their services. See if your doctor is in-network.


Get recommended preventive care

All 3M plans cover qualified preventive medical care at 100 percent when you use in–network providers. In addition, the 3M Advantage plans cover a list of preventive drugs at 90 percent before having to meet your annual deductible. Getting regular exams, screenings and immunizations can save you a lot of money and keep you healthy by detecting concerns early and even preventing them altogether. Learn more.


Research and shop for high-value care

Providers don’t charge the same amount for their services and more expensive care isn’t necessarily better. Take advantage of your plan’s online tools that let you compare costs for common services and quality ratings for providers. These tools are designed to help you find the best value for your money. When you sign in to myBlueCross at bluecrossmn.com/3M, and search for doctor and hospitals, you’ll have a wealth of information to help you choose the best providers based on both cost and quality.


Choose the right level of care

When you need care, knowing your options can save you time and money. (Fewer dollar signs = lower relative cost.)

  • 24-Hour Nurse Advice Line (no cost to you)
    When you face a difficult medical situation, like when a family member is sick late at night or you’re not sure whether to take your child to the emergency room — our toll-free nurse advice line is ready to help. Call 1-800-858-0722 anytime.
  • Retail or online health clinic ($)
    Retail or “convenience” clinics, including newer online clinics, offer quick, convenient and affordable treatment for many common illnesses, like allergies, sinus infections, bladder infections, bronchitis, ear infections, strep throat and more.
  • Doctor’s office ($$)
    Your primary care or family care physician offers a wide variety of services from routine checkups to diagnosis of a health issue. You can also check with your doctor’s office to see if they offer expanded hours of care on nights and weekends.
  • After-hours/weekend/urgent care center ($$$)
    Urgent care centers handle many problems that can be treated in a primary care physician’s office. However, these centers or clinics can offer an alternative to the emergency room if your doctor is not available or does not provide after-hours care on nights and weekends.
  • Emergency room ($$$$)
    An emergency room (or “ER”) should be used only for the most serious or life-threatening conditions.

Save money on prescription drugs

  • Ask for generic drugs
    Generic drugs are significantly less expensive but are just as safe and effective as their brand name counterparts. On average, generic drugs cost 60-80 percent less than brand-name drugs, and all generics are FDA-approved and contain the same active ingredients as the brand-name versions.
  • Preventive drugs covered at 90 percent
    The 3M Advantage plans provide 90 percent coverage for drugs on the preventive drug list (PDF). The list includes drugs to treat diabetes, hypertension (high blood pressure), high cholesterol, asthma and other conditions and the coverage is available before you meet your annual deductible.
  • Fill maintenance medications through home delivery or at your local CVS pharmacy
    Maintenance medications are drugs that you take on regular basis. When you purchase up to a 90-day supply of these drugs, you can save time and money. Better discounts and lower out-of-pocket costs are available for these prescriptions when you fill them through CVS Caremark’s home delivery program or at your local CVS retail pharmacy. Learn about CVS Caremark’s home delivery and Maintenance Choice® programs external link.

Take advantage of your plan’s health programs and discounts

The 3M Advantage plans include programs and discounts that can help you save money and support you in managing or improving your health. Learn about your health support programs and discounts.


There are many other ways you can become a wise health care consumer. Find out more about choosing wisely external link.