AmeriBen

Contact Us (In-State Medical) 

AmeriBen

PO Box 7186
Boise, ID 83707

Hours of Operation

M-Th 7am-6pm

Contact Information

1-855-258-6467
www.myameriben.com

BCBS

Contact Us (OOS Medical) 

BlueCross BlueShield
of Arizona

PO Box 2924
Phoenix, AZ 85062

Hours of Operation

M-F 6am-6pm

Contact Information

1-866-288-5788
www.azblue.com

CVS

Contact Us (In & OOS Rx)
Non-Medicare Eligible 

CVS/Caremark

PO Box 52136
Phoenix, AZ 85072-2136

Hours of Operation

24 hours / 7 days a week

Contact Information

1-855-264-5048
www.caremark.com

SilverScript_logo_RGB

Contact Us (In & OOS Rx)
Medicare Eligible 
 

SilverScript

PO Box 52136
Phoenix, AZ 85072-2136

Hours of Operation

24 hours / 7 days a week

Contact Information

1-844-416-1298
www.mesaaz.silverscript.com

Important Forms 

Out-of-State Medical Enrollment Form

In-State Medical Claim Form

Out-of-State Medical Claim Form

Rx Claim Form

MyAmeriBen Mobile App

AZBlue Mobile App

Important Notices & Documents 

Plan Document

Federally Mandated Notices

Summary of Benefits and Coverage (SBC)

Current Preferred Drug List

Current Specialty Drug List

Medical/Prescription Drug Plans (Retiree)

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About Us Header

In-State (Arizona) Plan

The City of Mesa is contracted with a third party administrator (TPA) AmeriBen, to deliver the medical benefit program including coverage, verification, claims processing, pre-certification, case management, and disease management. Members may contact Ameriben customer service (Monday through Friday from 7am to 6pm MST) or visit the member portal to access Explanation of Benefits (EOB)'s, PPO provider directory, and other tools to navigate healthcare needs.

Contact Information/Claims Address:

Medical Plan administered by:
Address:
PPO Network:
Group Number:
Customer Service Number:
Pre-Certification Number:
24 Hour Nurse Help Line:
Website:
AmeriBen
PO BOX 7186, Boise, ID 83707
Blue Cross Blue Shield of Arizona
CM001
1.855.258.6467
1.855.778.9053
1.866.422.2729
www.myameriben.com


Out-of-State Plan

Members who reside out of state more than 4 months out of the year may enroll in the out-of-state to allow access to network providers on a multi-state basis.  Complete an Out-of-State Medical Plan Enrollment Form to enroll. Blue Cross Blue Shield of Arizona (BCBSAZ) is the Out-of-State third party administrator for the medical benefit program including medical coverage questions, claims processing, pre-certification, case management, and disease management.  Premiums and/or plan design are the same as the in-state medical plans.

Out-of-state members must use BCBS providers for in-network coverage.  You will enter "MDK" in the "Already A Member" section of the search field when using the Provider Search tool on the website.  The Blue Card Program provides additional information about Non-Arizona network usage in the Out-of-State Plan.

Contact Information/Claims Address:

Medical Plan administered by:
Address:
PPO Network:
Group Number:
Customer Service Number:
Pre-Certification Number:
24 Hour Nurse Help Line:
Website:
Blue Cross Blue Shield of Arizona
PO BOX 2924, Phoenix, AZ 85062
Blue Cross Blue Shield National PPO
29231
1.866.288.5788
1.602.864.4320
1.866.422.2729
www.azblue.com


City of Mesa Medical Plan Highlights (In and Out-of-State)

Members may choose among three different medical plans depending upon coverage needs.

Medical Highlight


Prescription Drug Plan for Non-Medicare Eligible Retirees and Non-Medicare Eligible Dependents (In and Out-of-State)

The City of Mesa is contracted with CVS/Caremark, to provide prescription drug benefit administration to Non-Medicare eligible Retirees who choose either In or Out-of-State medical plans.  Prescription drug services include coverage, verification, claims processing, pre-authorization, and specialty drug services.  Members may contact CVS/Caremark Customer Care 24 hours a day, 7 days a week, or visit the member portal to access various tools to navigate your prescription drug care needs to include the CVS Preferred Drug List and Specialty Drug List.

Contact Information/Claims Address:

Rx Plan administered by:
Address:
Rx Group Number:
Customer Service Number:
Website:
CVS/Caremark
PO BOX 52136, Phoenix, AZ 85072-2136
RX119
1.855.264.5048
www.caremark.com


Prescription Drug Plan for Medicare Eligible Retirees and Medicare Eligible Dependents
(In and Out-of-State)

SilverScript Insurance Company (SSI) is the prescription drug provider sponsored by City of Mesa for Medicare-eligible retirees and covered Medicare-eligible spouses and dependents. 

The SilverScript plan combines the benefits of a standard Medicare Part D prescription drug plan with additional coverage provided by City of Mesa.  As a result of this combined coverage, drug benefits remain similar to the prescription drug coverage for retirees who are Non-Medicare eligible.

Medicare Eligible Retirees and their Dependents can have prescriptions filled at one of SilverScript’s approximately 66,000 network pharmacies across the country, including retail, mail order, long term care, home infusion and other pharmacies.  Medicare-eligible retirees and their covered Medicare-eligible spouses and dependents may contact SilverScript Customer Care 24 hours a day, 7 days a week, or visit the member portal to access various tools to navigate your prescription drug care needs.

Contact Information/Claims Address:

Rx Plan administered by:
Address:
Rx Group Number:
Customer Service Number:
Website:
SilverScript
PO Box 52136, Phoenix, AZ 85207-2136
RXCVSD
1.844.416.1298
www.mesaaz.silverscript.com      


City of Mesa Prescription Drug (Rx) Plan Highlights (In and Out-of-State)

Covered drugs under the City's Prescription Drug Benefit in each of our Medical Plans, are divided into three tiers with progressive cost share for members as you move "up" the tiers.  Tier 1 is covered generic drugs.  Tier 2 is preferred brand name drugs (also known as Formulary Drugs) and Tier 3 is non-preferred brand name drugs (also known as Non-Formulary Drugs).

Formulary changes can occur at any time under our prescription drug program--new drugs may enter one of the Tiers and drugs may move around the tiers (e.g., a drug can move from Tier 2 to 3 or vice versa).  Drugs may also go "off" formulary altogether (i.e., no longer available or covered under the Plan).

Changing to a generic or formulary drug alternative, where available, may help you avoid higher copayments.  Contact your doctor and ask whether changing to a preferred alternative would be right for you, where available. It is up to your doctor to choose the best medicine for you.  All medications on the formulary list, including generics, have been FDA approved/indicated and evaluated for effectiveness and safety (e.g., side effects and drug-to-drug interactions).

Rx Retiree


Medical/Prescription Plan Monthly Premiums (Retirees):

Due to various factors that are considered in calculating individual retiree premiums (years of service, plan, coverage level, ASRS/PSPRS subsidy, Medicare discount, etc.), retiree premiums cannot be posted.  This information is communicated directly to each eligible retiree when they first enroll or make a subsequent qualifying event or open enrollment change and/or following general rate changed during open enrollment.  If you have a question about the calculation of your current retiree premium, please contact the Employee Benefits Office at 480.644.2299 or via email at benefits.info@mesaaz.gov.

FAQs

  • How and where can I get my flu shot?
  • What are Mail-order prescriptions and how can it save me money?
  • Why is my pharmacist telling me my medication needs a Prior Authorization? What is it and what do I need to do?
  • How do I register online with Out-of-State Blue Cross Blue Shield?
  • How do I register online with AmeriBen (In-State)?
  • How do I register online with CVS/Caremark?
  • Why should I go to an In-Network rather than an Out-of-Network provider?
  • So how does the plan choose which provider is In or Out-of-Network?
  • What if my doctor refers me to a specialist who’s not in our network?
  • What if I did all my due diligence to make sure that everyone is in-network, but later I get an out-of-network bill from an “unknown” provider that I had not expected to provide service?
  • What about emergency room services? Do I need to worry whether the emergency room and emergency physicians are in or out-of-network?
  • So now that I know the difference between in and out-of-network… how can I make sure my provider is in-network?
  • What can I do if I'm trying to help my spouse or adult dependent with a claim or eligibility issue, or my spouse or adult dependent is trying to help me with a similar issue?
  • What does medical plan precertification really mean?
More FAQs