Offer does not apply to online orders with monthly payment more than $179.99. Offer does not reduce the total cost of ownership. The address, phone number, e-mail address, and fax number are provided at the bottom of the form.*"Gets You Started" offer is not a discount. Forms received without the required screening data (cholesterol, blood sugar, blood pressure, height, weight and BMI) will not be accepted and therefore will not qualify you for the insurance premium discount. The physician will need to complete, sign, and date Section 2 of the form, and you or your physician may submit the completed screening form to the Healthy Tigers office by mail, fax, hand deliver, or email. Forms received without all identifying information (name, date of birth, contract #, Banner ID # if applicable, etc.) will not be accepted and therefore will not qualify you for the insurance premium discount. The employee or the covered spouse (or sponsored adult dependent) must complete and sign Section 1 of the form including all contact information and AU BCBS contract number. The employee will need to print the Healthcare Provider Screening Form and follow the instructions. If an employee or his/her spouse (or sponsored adult dependent) has visited a physician and has had lab work completed in the current calendar year, those results can be used. See your BCBS Summary of Benefits for more information and consult with your doctor or his/her office staff to determine how this might affect you and if you may be responsible to pay for the full amount of the testing. If screening is performed by your physician and you visit a physician for an additional wellness visit, you will incur costs for the second visit. The AU BCBS insurance plan only allows one wellness visit from your physician in a calendar year. Please note: Lab, office visit and other screening costs associated with some of the Healthy Tigers screening procedures, if conducted by your physician, may be billable to you unless they are deemed to be medically necessary. If you choose to have your screening performed by your physician, you are not required to have an additional screening performed at the AUPCC. That is perfectly fine you simply need to print the Healthcare Provider Screening Form from the Healthy Tigers website and take it with you to your physician's office. The fax number and address are noted on the referral form. The employee will receive a Healthy Tigers referral form to take to the physician and the physician's office will be instructed to waive the physician co-pay for this initial follow up visit (a $30 value).Īfter the employee completes the follow up appointment, the physician may fax the completed referral form to the Healthy Tigers office or the employee may mail, fax, hand deliver, or email it back to the Healthy Tigers office himself/herself. The physician co-pay for the first follow up visit will be waived. If the screening results are above established thresholds, then the employee will be required to follow up with a physician before the discount will be activated (exception BMI alarm value self-management plan OR Dietician through the AUPCC) The screening thresholds are:Ī systolic blood pressure (top number) equal to or greater than 160 mmHgĪ diastolic blood pressure (bottom number) equal to or greater than 100 mmHgĪ total cholesterol level equal to or greater than 250 mg/dLĪ blood glucose equal to or greater than 200 mg/dL The screening process will also qualify as the discount for 2022. In order to reinstate the premium discount for 2021, you and/or your covered spouse, or covered sponsored adult dependent, must complete the screening process during 2021, at which time your premium discount will be reinstated within 60 days for the remainder of the 2021 calendar year. 10, 2021.įor instance, if you and/or your covered spouse, or covered sponsored adult dependent, did not complete the screening process in calendar year 2020, your premium discount will cease after Dec. 1, 2022 the employee and his/her covered spouse, or covered sponsored adult dependent, must have all paperwork submitted by Dec. In order for the discount to start in Jan. Once the screening process is complete, the premium discount will go into effect within 60 days after the screening. An employee and his/her covered spouse, or covered sponsored adult dependent, who are screened during any given month will qualify for the discount for the remainder of the calendar year and for the following calendar year. There is no set deadline for qualifying for the Healthy Tigers program.
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