Ann Arbor Post-65 Retirees/Dependents: people whose ...



Access to Specialized Care at Michigan Medicine

Through an agreement with Michigan Medicine (formerly known as the University of Michigan Health System), colleagues who are covered by a Trinity Health benefit plan have access to advanced quaternary care not provided by Trinity Health facilities such as burn care, transplants and many pediatric specialties.

The agreement complements the services both organizations offer without duplicating best-in-class services that already exist. There is nothing you need to do to sign up for these services as they are automatically covered at a Tier 1 level for all plans.

The following services at Michigan Medicineare covered as a Tier 1 / domestic provider for Trinity Health Michigan benefits enrollees:

➢ Pediatric Specialty Clinic referrals listed below.

➢ Unique UM Programs/Services listed below.

➢ Hospital-to-UM Hospital Inpatient Transfers

➢ ER-to-UM ER transfers

Please note: Not all claims will automatically process at the Tier 1 level. Please watch your Explanation of Benefits (EOBs) closely and reach out to Blue Cross Blue Shield of Michigan (BCBSM) for any questions regarding your claims. The contact information is on the back of your BCBSM card.Some services may require reprocessing.

Pediatric Clinics

|General |Otolaryngology |

|Behavioral Medicine Clinic |Pediatric Otolaryngology Clinic |

|Teenage and Young Adult Health Clinic | |

|Pediatric Psychology Clinic | |

|Pediatric Cardiology Clinic | |

|Pediatric Endocrinology Clinic | |

|Pediatric Gastroenterology Clinic | |

|Pediatric Genetics Clinic | |

|Pediatric Infectious Disease Clinic | |

|Pediatric Neonatal/Perinatal Medicine Clinic | |

|Pediatric Nephrology Clinic | |

|Pediatric Neurology Clinic | |

|Pediatric Neurology Sleep Disorders Clinic | |

|Pediatric Epilepsy Clinic | |

|Pulmonary Clinic Pediatric | |

|Pulmonary Function Lab Pediatric | |

|Pediatric Rheumatology Clinic | |

| |Dermatology |

| |Pediatric Dermatology Clinic |

| |Ophthalmology |

| |Pediatric Ophthalmology and Strabismus Clinic |

| |Surgery |

| |Pediatric Surgery Clinic |

| |Pediatric Comprehensive Weight Management Clinic |

| |Pediatric Colorectal Surgery Clinic |

| |Pediatric Surgery Clinic |

| |Pediatric Vascular Anomalies Clinic |

| |Pediatric Plastic Surgery Clinic |

|Orthopaedic Surgery |Urology |

|Pediatric Orthopaedic Surgery Clinic |Pediatric Urology Clinic |

|Physical Med and Rehab |Psychiatry |

|Multidisciplinary Pediatric Neuromuscular Disorders Clinic |Pediatric Psychiatry Services |

|Pediatric Occupational Therapy | |

|Pediatric Physical Medicine and Rehabilitation Clinic | |

|Pediatric Physical Therapy | |

|Pediatric Concussion Clinic | |

| |Cancer Center |

| |Hematology/Oncology Clinic Pediatric |

| |Neurosurgery |

| |Pediatric Neurosurgery Clinic |

PROGRAMS / SERVICES UNIQUE TO Michigan Medicine

(Currently not provided at Trinity Health's Michigan facilities)

OVERALL

• Solid-organ transplants

• Bone marrow transplants

• Pediatric subspecialty medical/surgical/psychiatric services

• Survival Flight

• ECMO for adult, pediatric and neonatal patients

• Clinical Trials that are not offered at Trinity Health's Michigan facilities

CANCER

• MIBG treatment

HEART/CARDIOVASCULAR/CARDIAC SURGERY

• Pediatric ventricular assist devices and heart transplantation

• Surgery for pediatric renovascular hypertension

• Neurodevelopmental follow-up program for congenital heart patients

• Adult congenital heart procedures

• Pulmonary hypertension (advanced and experimental therapies)

• Circulatory support with new mechanical devices and ECMO

• Total artificial hearts for adults and children

• Percutaneous repair of prosthetic mitral leaks

• Genetic cardiovascular diagnoses

• Complex VT ablation

• Carotid stenting with flow reversal

• Pulmonary thromboendartretomy

NEUROSCIENCES

• Surgical treatment for intractable epilepsy

• Deep brain stimulation for Parkinson’s disease

• Care of complex multiple sclerosis

OBSTETRICS AND GYNECOLOGY

• Fetal Therapy

o CVS

o Patients needing fetal echo due to other risk factors

o Radiofrequency ablation

• Management of transgender care

• Michigan Bowel Control Program

• Healthy Healing after Delivery Program

• Vulvar Diseases Program (including complex surgical management of vulvar diseases)

• Medical and Surgical Management of Chronic Pelvic Pain Complex patients to UM

• Integrated/Multidisciplinary Management of Interstitial Cystitis

OTOLARYNGOLOGY

• Cranial base surgery

• Facial nerve reanimation/rehabilitation programs

• Acoustic neuroma

• Cochlear implants

PEDIATRICS

• Pediatric Genetics, Metabolism and Genomic Medicine Program for children with congenital anomalies, autism, developmental delay and genetic syndromes

• MMGL genetic test services, including chromosomal microarray, Fragile X DNA testing, genetic sequencing tests, methylation PCR, familial mutation testing, BRCA1/BRCA2 sequencing and deletion/duplication testing

• Neonatal Therapeutic Hypothermia

• Neonatal Peritoneal Dialysis

• Infant/Pediatric Home Ventilation Program

• Cardiovascular Genetics Services

• Fetal Alcohol Syndrome diagnostic services

• Fragile X Clinical services and diagnostic testing

• Disorders of Sexual Development program Cancer genetics

• Biochemical genetics care services for inborn errors of metabolism and newborn screen disorders

• Comprehensive Pediatric and Adult Cystic Fibrosis Center

• Multidisciplinary Clinic for Osteogenesis Imperfecta

• Multidisciplinary Clinic for Pediatric Endocrine Surgical Disorders

• Multidisciplinary Clinic for Prader-Willi Syndrome

• Multidisciplinary Pediatric Sleep Disorder Program

• Multidisciplinary Aerodigestive Program (cilary disease)

• Multidisciplinary Eosinophilic Esophagitis Program

• Therapeutic joint injections for children with arthritis

• Interdisciplinary Rheumatology-Nephrology Clinic to treat systemic inflammation such as lupus

• Interdisciplinary Immunohematology Clinic for patients with immunodeficiency disorders

PHYSICAL MEDICINE AND REHABILITATION

• Pediatric ventilator-dependency services

• Pediatric brachial plexus injury care

• Selective dorsal rhizotomy for cerebral palsy

• Adults with Cerebral Palsy Clinic

• Post-Polio clinic

PSYCHIATRY

• Psychiatry Neuromodulation Program- including rTMS

• PsychOncology Clinic

• Psychiatry Infant/Early Childhood clinic

• Geropsychiatry Clinic

RADIOLOGY

• Neurointerventional radiology for intracranial aneurysms malformations and tumors

OTHER AREAS

• Dermatology Day Treatment Center for psoriasis and other inflammatory skin conditions

• PCDx test

• Level One trauma center and burn center

• Level One pediatric trauma center and burn center

• Primary ciliary dyskinesia

• Aerodigestive clinic

• Bronchopulmonary dysplasia

• Treatment and prevention of neurological sports injuries

• Critical care membrane-based pheresis for sepsis with multisystem organ failure

• Disorders of sexual development

• Congenital adrenal hyperplasia

• Airway reconstruction

• Integrative Family Medicine Program

• Japanese Family Health Program

• Deaf Health Program (physicians and staff who communicate via sign language)

|DISCLAIMER: The information provided in this summary is designed to assist you with understanding your options under Trinity |

|Health’s welfare benefit plans and programs. It is only an overview and is not intended to be a comprehensive description of the |

|benefit plans and programs available to you. It does not constitute a contract and is not meant to interpret, extend or change any |

|plan or program provisions in any way. The summary plan descriptions and official plan and program documents describe the plans and|

|programs in more detail and you should refer to these documents for answers to your specific questions regarding the plans and |

|programs, including what services are covered by a plan. If there is a discrepancy between printed materials, the official plan and|

|program documents will prevail. Trinity Health retains the right to make changes to or terminate its benefit plans and programs at |

|any time, including making changes to comply with and exercise its options under the Affordable Care Act and other applicable laws.|

| |

|To view the summary plan descriptions and certificates of coverage, visit the mybenefits Internet site at |

|. For any plan or program in which you participate, you also have the right to request from |

|the colleague’s employer or Total Rewards Benefits & Well-Being, Trinity Health, 20555 Victor Parkway, Livonia, MI 48152, a full |

|printed copy of the summary plan description or certificate of coverage and other official plan or program documents. There will be|

|no charge for the printed copies. |

|All Trinity Health group health plans provide care coordination, care management, utilization review and referral services to help |

|manage the healthcare provided to covered members. By enrolling in a Trinity Health group health plan you understand that the plan |

|will provide services to manage each covered member’s care. These services may be provided through independent third-party |

|administrators, a clinically integrated network of hospital, physicians and other health care providers and professionals ("CIN") |

|and other healthcare providers. Your participation in a Trinity Health group health plan means that the persons contracted to |

|provide these services will have access to your personal health information, including health information you disclose through |

|wellness programs and well-being activities. Trinity Health facilities and healthcare providers and professionals affiliated with |

|Trinity Health facilities participate in certain CINs. You may be contacted about your health care by a CIN, including by |

|individuals at a Trinity Health facility or provider who are performing services for the CIN or directly for the group health plan.|

|Information about your medical treatment at any facility and from any healthcare provider or professional may be accessed and used |

|by individuals who work at a Trinity Health facility or provider (including your employer) participating in a CIN or the group |

|health plan not only for treatment but also to manage and coordinate your healthcare. Any access to, use or disclosure of |

|protected health information will comply with the privacy and security regulations under the Health Insurance Portability and |

|Accountability Act and any applicable state privacy and security laws. |

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