Using Your Benefits Wisely
Our goal is to offer comprehensive, high quality, low cost health care coverage. Health care costs continue to be a significant issue for many, so it is important to understand how to maximize the benefits available to you. To help, we’ve compiled a list of tips that can help you make the most of your benefits – no matter which health plan your employer offers.
Participants with Preferred Provider Organization (PPO) Plans
- Cigna & CareFirst BCBS
- Use network providers. Your insurance company has negotiated with in-network providers so that they charge a set cost for their services. In order to minimize out of pocket costs, use network providers for your medical care. When you use an in-network provider, you’ll know beforehand what you’re required to pay and there won’t be any surprise bills.
Participants with Health Maintenance Organization (HMO) Plans
- Kelsey Seybold - Houston
- Use Kelsey Seybold Medical Centers & Cigna In-Network Facilities. Non-emergency outpatient services are only covered at Kelsey Seybold medical centers. Inpatient services are only covered at Cigna in-network facilities with a referral from Kelsey.
- Union Health Service - Chicago
- Use Union Health Service Facilities. Non-emergency outpatient service are only covered at United Health Service (UHS). Outpatient services that are not available at UHS and inpatient services are covered by Blue Cross Blue Shield of Illinois only with a referral from UHS.
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- Take advantage of preventive care services. Seeing your doctor for routine physical exams and annual screenings can help give you a clear picture of your overall health – and alert you to any potential health issues. It can also help save you money: many preventive care services are offered at no cost to you if you see a network provider.
- Visit urgent care centers instead of the ER. While there is no substitute for the ER in an emergency, you can save time and money by visiting urgent and convenient care centers for non-emergency medical conditions, such as a fever, sprain or earache.
- Take generics. A generic medication contains the same chemical ingredients as its brand name equivalent. You will pay a lower co-pay for using generic medication. Participants with Caremark CVS coverage can obtain a 90 day supply of maintenance medication through a CVS retail or mail order pharmacy.
- Review your Explanation of Benefits (EOB). Don’t just file away – or throw out – your Explanation of Benefits. An EOB is the document that comes in the mail after you receive medical care. Review the EOB carefully to make sure it accurately reflects the care you received. Errors can happen and you and/or the Fund should not pay for services your provider did not provide. Contact the Fund office if you believe there is an error with your EOB.
To learn more about your specific coverage (like deductibles, co-pay amounts and network information), click here to search by your employer.