Trustmark Group Select

How can I verify that my coverage is current?	Top
Please contact the plan administrator at your employer, or you can go online and visit our Medical Claim, Eligibility and Benefits Look-Up system at www.trustmarkins.com/groupselect/members/claiminterim.cfm.

How do I check the status of my claim?
You may either call the claim office at the Eligibility/Benefits phone number listed on the back of your ID card or visit our Medical Claim, Eligibility and Benefits Look-Up system at www.trustmarkins.com/groupselect/members/claiminterim.cfm.

I lost my ID card. How do I get a replacement?
Please contact the plan administrator at your employer. Your plan administrator can order new Trustmark Group Select I.D.cards for you and your covered dependents.

How do I change my beneficiary?	Top
Click here for a Beneficiary Change Form, or contact the plan administrator at your employer.

Where can I get a copy of my group certificate?
Your plan administrator at your employer should have a supply of extra certificate booklets

Where can I get claim forms?
A medical claim form is not required in order to submit a claim. In most all instances, your healthcare provider will bill Trustmark Group Select directly for healthcare service and supplies you receive. If you need to file a claim, please mail a copy of the claim to the address found on the back of your ID card. If you prefer, you may access claim forms by contacting your plan administrator at your employer or go to www.trustmarkins.com/groupselect/members/claims.cfm.

Questions related to managed care networks
What is a provider network?	Top
A provider network is comprised of a group of physicians, hospitals and other healthcare providers with whom the managed care organization has an agreement to offer services to members at discounted rates.

How do I know if my doctor or hospital participates in the network?
You can check a list of participating hospitals and physicians in your network by using the Physician/Hospital Look-up feature of the Trustmark Group Select website.

Am I limited to only my network of hospitals and physicians?
An important feature of Group Select PPO plans is the freedom to choose any hospital or physician. However, when you choose a provider participating in the network, your out-of-pocket expenses are reduced.

When do I need to precertify?	Top
Pre-certification is needed for any inpatient hospitalization (for any medical services including maternity, transplants, mental illness, mental or nervous disorders, or for alcohol and chemical abuse treatment). Precertification is now required for the following: Skilled nursing facility admissions Home health care services, such as home infusion and in-home physical, occupational or speech therapy Sub-acute medical and rehabilitation inpatient admissions Hospital care services Residential Behavioral Health Services (Mental/Nervous and Chemical & Alcohol) Pre-certification is no longer required for any outpatient surgery. You or your physician must call the pre-certification number on your ID card prior to admission to obtain pre-certification.

Where can I get information regarding my WellPoint drug benefit?
Please refer to your Certificate of Insurance to review your prescription drug benefit. To access other information, please look through the Prescription Drug Benefit section of this website.

Where can I get information regarding the CORPHEALTH mental health/substance abuse program?
Visit CORPHEALTH's website at www.corphealth.com.

Questions related to HIPAA (Health Insurance Portability and Accountability Act)
I have an ongoing medical condition and have been subject to a preexisting condition exclusion period under my current employer's health plan. I have been continuously enrolled in the plan for more than 12 months. Will HIPAA help me obtain coverage for this condition?	Top
Yes. As long as benefits for the condition are otherwise covered under the terms of the plan, a preexisting condition exclusion period may generally not last longer than 12 months. Because you have been covered by your current plan for at least 12 months without a 63-day break in coverage, your employer will no longer be able to impose the preexisting condition exclusion period when HIPAA becomes effective for your plan.

I hear the HIPAA law makes health insurance portable. How does this work?
Once an individual has health insurance, this coverage can be accumulated as a record to reduce or eliminate any preexisting condition exclusion that might be applied if an individual moves to another employer’s group health plan. The concept of “portability” is one of receiving credit for maintaining health coverage, even under different health plans or policies. “Portability,” in this case, doesn’t mean that individuals can carry health benefits or their current plan or policy with them when moving from one health plan or policy to another (such as when changing or losing jobs).

Can I lose coverage if my health status changes?
Group health plans and issuers may not establish eligibility for enrollment based on your health status, medical condition (physical or mental), claims experience, receipt of health care, medical history, genetic information, evidence of insurability or disability. For example, you cannot be excluded or dropped from coverage which the health plan offers just because you have a particular illness. Although employers may establish limits or restrictions on benefits or coverage for similarly situated individuals under a plan, they may not require an individual to pay a premium or contribution which is greater than that for a similarly situated individual based on health status. They may also change plan benefits or covered services if they give participants notice of any “material reductions” within 60 days after the change is adopted.