Welcome MHBP Value Plan Members

Transcription

1 Welcome MHBP Value Plan Members Welcome to the Mail Handlers Benefit Plan. We are delighted that you chose to enroll in our newest health plan option. We are proud of our long heritage in serving federal and postal employees and annuitants, and we are excited to have the opportunity to serve you. We are committed to being there for you whenever you need us, ensuring that you have comprehensive and affordable coverage and providers available where you need. We look forward to this new beginning with you and your family. We aim to serve you with complete satisfaction for years to come. (continued on page 2) Spring 2008 Issue Highlights: New Feature at MHBP Network Update...3 Got a Change of Address?...3 Don t Forget...3 How is Your Hearing? Ways to Maximize Your Benefits...5 LASIK Discount Program Name Change Amerisight to QualSight...5 1

2 (continued from page 1) Affordable, Comprehensive Coverage MHBP works hard to keep health care premiums affordable, which is why your new Value Plan has the lowest premium of all the PPO plans in FEHB. Valuable coverage is just as important. That s why your PPO benefits provide: 100% coverage for an annual physical exam 100% coverage for preventive screenings and immunizations 100% coverage for lab tests when using Quest Diagnostics Generic prescriptions for a low $10 copayment at retail, $30 through mail order Outpatient surgery covered at 100% after a $200 facility copayment Coverage for doctor s visits, hospitalization and more This is a summary of the benefits and features of the MHBP Value Plan. Refer to the official Plan brochure for complete benefits information. Preventive Care That s Always There Preventive care has always been an important aspect of the coverage provided by MHBP, which is why all three of our plans provide benefits for annual physical exams, well-child care, preventive screenings and immunizations. Early detection and prevention is your best defense, so be sure to take advantage of your preventive benefits to promote better health. PPO Providers Wherever You Are MHBP has PPO providers where you live, work and travel nationwide. Use our online electronic directory at to find providers by specialty, name, city, state or zip code. You can also find participating lab program (Quest Diagnostics) providers, dental providers (if you have MHBP Supplemental Dental), pharmacies, vision care providers and more. Call us at if you need help locating a PPO provider. Service at Its Best When you have questions about your coverage, claims, eligibility, general health and more, you can call us anytime at or visit us at MHBP is here to serve you. New Feature at We re always looking to improve the information available to you on our website. Our latest addition is our new My Cost of Care tool. Using this tool, you can estimate your average cost of care based on actual health plan data. As a health care consumer, you have ready access to the average costs of care in your area for common diseases and conditions, diagnostic procedures, office visits, surgical procedures and inpatient stays. Visit today to try this new feature. Select Member Services from the home page, click Decision Support Tools and select My Cost of Care and you are there. 2

3 Got a Change of Address? Please report your new address by either calling , or in writing to the address below. MHBP PPO Network Update We have made some changes to our PPO network that you should be aware of. These changes were effective January 1, 2008: In the states of New Jersey and Ohio, the Coventry National Network has established a partnership with the leading PPO network in each state. As a result, the network you will access in New Jersey is the QualCare network. In Ohio, you will access the MMO SuperMed Plus network. These two networks will replace the Coventry National Network only in the states of New Jersey and Ohio. Please note: To locate New Jersey and Ohio providers on from the home page select PPO Provider Lookup and click QualCare for New Jersey or SuperMed for Ohio. You will be taken to their website where you can locate providers. In southwestern Missouri, CoxHealth providers have been added to the network. The Coventry National Network no longer contracts with St. John s Health Systems in this area. CoxHealth providers are listed in the electronic directory. In Texas and California, the Coventry National Network has been expanded to include all Tenet Healthcare Corporation hospitals, outpatient and ambulatory centers. If you have questions about these changes, contact us anytime at or visit where you can your questions to us or use our Live Chat feature to get assistance while you are online. The Mail Handlers Benefit Plan P.O. Box 8402 London, KY If requesting a change of address by mail or , please be sure to include both the old and the new address. Please note that only the enrollee or an authorized representative of the enrollee may request an address change. Don t Forget Moving at the speed of life means there will certainly be times when we forget to do things. As another year of health benefits gets underway, you can use this checklist to make sure you have completed important tasks to ensure yourself a smooth benefits experience: o To ensure prompt processing of your claims, please complete the Coordination of Benefits form whether or not you have other coverage. The COB form can be found at select Member Services from the home page and click Forms. o In accordance to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), MHBP cannot share any information that s considered protected health information (PHI) with any person or entity without your express written consent. Please complete the Release of Information and Authorized Representative forms, located at to authorize MHBP to share your and covered dependents PHI with anyone other than those involved in treatment, payment, health care operations or certain other areas. You may also call us at to obtain these forms. (continued on page 4)

4 HealthBenefitPlanner (continued from page 3) o If you are taking advantage of the savings and convenience our mail-order pharmacy program offers, now would be a good time to check your remaining refills. You can order refills by phone, Internet or mail. Call or visit to use automated ordering. Order approximately three weeks before your current prescription runs out to allow for processing and mailing time. o If you are looking for dental and vision benefits, but you did not sign up for these during Open Season it s not too late. MHBP offers dental and vision supplemental plans that you can enroll in year round. Contact us today at or visit to get your dental or vision coverage started right away. Your coverage starts the first day of the month following your enrollment (e.g. if you enroll on 3/15/08, your coverage would start 4/1/08). How is Your Hearing? Could you repeat that? What did you say? Can you speak up? When communicating, you may find that you are constantly asking these questions. You wonder if the person with whom you are trying to communicate is not speaking clearly or loud enough. It s important to have your hearing checked regularly to make sure your hearing is normal, or if you are experiencing hearing loss or deficiency you can get help at the earliest point possible. MHBP provides coverage for hearing exams and hearing aids and offers a hearing discount program. Hearing Facts: Approximately 28 million Americans have a hearing impairment. Hearing loss is greater in men. Only 1 out of 5 people who could benefit from a hearing aid actually wears one. Hearing loss affects approximately 17 in 1,000 children under age 18. The rate increases with age: Approximately 314 in 1,000 people over age 65 have hearing loss and 40 to 50 percent of people 75 and older have a hearing loss. Source: National Institute on Deafness and Other Communication Disorders (NIDCD) website: Your MHBP benefits allow for one routine hearing exam for all members once per calendar year and coverage for one hearing aid per ear for all members. Benefits are limited to a maximum of $200 per hearing aid. Through the HearPO discount program, you can get discounts on testing performed by licensed hearing care professionals, access to over 250 hearing aid choices starting as low as $549 per aid, comprehensive follow-up services at no charge for one year, and discounts on hearing aid repairs. To access your hearing benefit from HearPO, or for a listing of HearPO providers in your area, call HearPO at HEARING ( ). Please remember to identify yourself as an MHBP member. For more information about hearing discounts and benefits, please refer to the official Plan brochure, or call us anytime at

5 10 Ways to Maximize Your Benefits There is a lot that you can do to get the most out of your benefits and stretch your health care dollars further: 1. Lower your out-of-pocket costs by using PPO network doctors and hospitals whenever possible. 2. Obtain preventive care screenings, immunizations, and annual physical exams from PPO providers. Preventive care is not covered if not provided by a participating PPO provider. 3. If you have Medicare, use physicians who participate with Medicare. They are only allowed to bill up to the Medicare-allowed amount, which can reduce your out-of-pocket costs. 4. Use network pharmacies and make sure your claims are filed electronically. When you use non-network pharmacies or submit paper claims, no benefits apply. You are responsible for all charges. For emergency admissions you must notify us within two business days after the admission even if you have already been discharged from the hospital. 9. Consider using an Urgent Care Center for minor illnesses and injuries such as sprains, ear infections and minor cuts instead of the hospital emergency room to save you money. You can locate an urgent care center near you by checking the electronic provider directory on our website, In case of a true emergency, seek care at the nearest emergency room. 10. Compare cost and quality information for participating PPO doctors and hospitals before you make an appointment when you use our Network Fee Lookup, My Cost of Care and Hospital Comparison tools located at Refer to the official Plan brochure for complete details about your MHBP benefits. 5. Use our mail-order pharmacy. You can get up to a 90-day supply of maintenance prescription drugs delivered to your home. 6. Share the Rx Drug Guide with your physician so he/she can prescribe cost-effective medication alternatives for you when possible. Request generic medications to save you more money. 7. Take advantage of your 100% benefit for covered non-emergency outpatient lab tests when you use the Lab Savings Program through Quest Diagnostics. 8. Call us if you must be admitted to a hospital. To avoid benefit reductions and a $500 penalty, you, your doctor or the hospital must notify us at least two days before the admission except for a maternity admission for a routine delivery. LASIK Discount Program Name Change Amerisight to QualSight In the fall edition of The Planner, we introduced our new LASIK discount program. This program has changed its name from Amerisight to QualSight. The services and savings offered by this program remain the same, only the name has changed. To learn more about the QualSight discount program visit select the Dental/Vision/ Lab and More Benefits link from the home page and click the QualSight LASIK link. 5

6 P.O. Box 8402 London, KY Contact Us MHBP Member Services TDD/TTY MHBP Supplemental Dental & Vision Plans Mail Order Pharmacy Refill Service U.S. Laser Network (laser vision correction) EyeMed Vision Care HearPO Network Information (888-HEARING) Quest Laboratory Overseas Enrollees QualSight (laser vision correction) 2008 Coventry Health Care. All rights reserved. All product and/or service names and logos are (registered) trademarks of their respective owners. This is a summary of the Mail Handlers Benefit Plan. For a complete description of all benefits, please see the official Plan brochure (RI ). All benefits are subject to definitions, limitations and exclusions set forth in the official Plan brochure. 6