MEDICAL PLAN OPTIONS

Option 1

This is a traditional PPO medical plan with copays for certain services. If enrolled in the PPO medical plan, you may seek services from both In-Network and Out-ofNetwork providers. If you seek services from In- Network providers your cost will be less than if you see Out-of-Network providers.

Option 2

This is an HMO High Deductible Health Plan (HDHP). If enrolled in the HMO HDHP medical plan, you are eligible to participate in a Health Savings Account (HSA). An HSA is an investment tool that helps you save for healthcare expenses, including deductibles and coinsurance. If enrolled in the HMO HDHP medical plan, you may seek services from In-Network providers only. If you seek services from Out-ofNetwork providers, insurance will not pay towards any cost for services rendered.

Preventive Care Services

Preventive care services are those that are linked to routine wellness exams and screenings. Nonpreventive services are those that are considered diagnostic or treatment for an illness, injury, or other medical condition.

If you go in for a Preventive Screening and a condition is found, it is no longer Preventive and will be billed as Diagnostic (and not covered at 100%).

Preventive care is covered at 100% in-network. The US Preventive Services Task Force maintains a list of preventive services that all Health Care Reform compliant plans should cover at 100% for in-network providers. The following is a list of common services that are included:

• Routine physical exam

• Well baby exams

• Immunizations

• Bone density tests

• Cholesterol screenings

• Mammograms

• Pap smears/pelvic exams

• Colonoscopies

• Prostate test

• Lab procedures

• Screenings for HIV, HPV, and domestic violence

• Breastfeeding supplies

• Contraceptive drugs, devices, and sterilization

• Smoking cessation

Making The Most Of Your Medical Plan

Know where to go – Save the ER for emergencies! Going to the emergency room (ER) or calling 9-1-1 is always the way to go when it’s an emergency. We’ve got you covered for those situations. You are responsible for ER costs when it’s not an emergency. If you need care but it’s not an emergency, try these other options. You can avoid a long wait and the higher costs that come with a non-emergency ER visit.

Call your doctor. Your doctor knows your story.

Your primary care provider usually has easy access to your records, knows the bigger picture of your health, and may offer same-day appointments to meet your needs.

Visit a retail health clinic. Treatment that’s nearby.

Consider this when you have a rash, minor burns, cough, sore throat, minor allergic reactions, bumps, cuts, and scrapes, or when you need shots. Hours of operation vary.

Head to urgent care. Quick after-hours care.

An Urgent Care Center may be the right choice when you have back and joint pain, cough/cold, sinus or ear pain, sprains and strains, or even need x-rays. Flexible hours, including nights and weekends.

Use Virtual Care. Anywhere, anytime online virtual visit.

Speak with a medical practitioner who can diagnosis, treat & prescribe right over the phone 24/7. Great for colds, flus, infections, pink eye, poison ivy & more.

Emergency Room. Only for true life-threatening situations.

There are situations when the ER is the only option. However, it will be the most expensive and take the most time if it is not a life-threatening or severe situation. Use the options listed above to save money and time.