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This form is to be used when filing for any medical services rendered by a non-PPO or non-network provider in the MHIP State High Risk Pool Program. This form should be used for both administering carriers. There is not a separate claim form available for Blue Cross and Blue Shield of Kansas City so you can use the same form but it must be mailed to: Blue Cross and Blue Shield of Kansas City, P.O. Box 419169, Kansas City, MO, 64179-01 47.
This form is to be used by persons currently enrolled in the MHIP to change existing information such as Contact, Mailing Address, etc. It is to also be used when changing your deductible option plan choice during the MHIP's annual open enrollment that occurs in November of each year.
This document is the Plan Document whereas the "Benefit Brochure" is a more general summary. If there is any discrepancy between the Certificate and the Brochure, the Certificate supercedes.
Getting the Most from Your Prescription Benefit Program
This is a listing of the larger pharmacy chains and stores that participate in the Catalyst Rx pharmacy network. If you fill your prescriptions at one of these pharmacies, you maximize the coverage and benefits available under the MHIP's prescription drug card program. For a complete listing of all participating pharmacies access the following link http://www.catalystrx.com/.
Click the link to register with Walgreens Mail Service. You can also register by phone by calling the Customer Care Center at 866-845-3590. Remember: If you purchase a 90-day supply through the mail-order program, your applicable copayment is tripled.
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