Presentation on theme: "More Health for Your Buck: Getting the Most Out of Your NAU Health Benefits While Saving Money."— Presentation transcript:
More Health for Your Buck: Getting the Most Out of Your NAU Health Benefits While Saving Money
Introductions & Overview Presentation Available at http://hr.nau.edu/benefits/max_ben http://hr.nau.edu/benefits/max_ben
More Health for Your Buck: Getting the Most Out of Your Healthcare Benefits While Saving Money Sponsored by NAU’s Human Resources, Employee Assistance and Wellness, and Campus Health Services Departments, with presentations from: Philip Garrod, M.D., Medical Director, Campus Health Employee Assistance and Wellness (EAW) Staff Marc Levy, Ph.D., HR Manager (NAU Benefits) Vicki Penna, Clinical Faculty Member, NAU’s Dental Hygiene Clinic Representatives from Blue Cross/Blue Shield of Arizona
Focus on Wellness (EAW Staff) http://www4.nau.edu/eaw/ Save Money Through Prevention:
Services Short-Term Counseling Critical Incident Response Information and Referral Consultation Seminars and Workshops Wellness at Work Health Screening Program http://www4.nau.edu/eaw/ Employee Assistance & Wellness (EAW)
Upcoming Wellness Programs Family Flu Vaccine Clinic POP (Prostate On-site Project) in Flagstaff! Tour de Rec Tuesdays MOM (Mobile On-Site Mammography) at NAU Relax and Work Well Employee Assistance & Wellness (EAW) For more upcoming programs & details, go to the Calendar of Events at http://www4.nau.edu/eaw/
The HealthyBlue Program of Blue Cross/Blue Shield
The HealthyBlue Program of BCBSAZ An integrated wellness program that provides various resources to live a healthier lifestyle My BluePrint health assessment Health Coaching Programs HealthyBlue Beginnings Nurse on Call Blue365 Disease Management Care Management
Other Important “Perks” from the NAU BCBS Program When traveling you still have access to BCBS network providers. Access to care at “Retail Clinics” (not currently available in Flagstaff). E.g., in Phoenix there are “Minute Clinics” through CVS and “Take Care Clinics” through Walgreens. Others nationally. Preventive services covered at 100%!
Other Important “Perks” from the NAU BCBS Program New Mobile App! Access ID card & benefits, locate Urgent Care Facilities, contact BCBSAZ More features coming: Deductible tracking, BlueNet registration, & more, all from your mobile device!
When Illness/Injury Gets You Anyway: Choosing the Right Treatment Providers (Where to Go When) Saving Money on Your Healthcare
In Terms of Expense… $$$ ER > Urgent Care > Specialist > PCP > Nurse on Call (if questions before going) Saving Money on Your Healthcare
“Emergency Medical Condition” “Acute symptoms of sufficient severity … that the absence of immediate medical attention could… result in – (i) placing the… individual in serious jeopardy, (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any bodily organ or part." What’s an “emergency”??
Where to go for emergencies… CALL 911 or THE EMERGENCY DEPARTMENT
Hospital Emergency Department Urgent Care Center (Consider calling the urgent care center to see if they can handle your problem before going to the emergency department) WHY call ahead?? Not an emergency but still in need of urgent care?
When establishing a provider-patient relationship ask what type of urgent health care needs they are able to handle If you already have a primary care provider ask the same question But wait!... Maybe your PCP offers urgent care!
Questions to ask Do you have x-ray equipment? Can you do laboratory testing in the office? If so, what lab tests can you do? Do you provide wound repair, for ex., stitches? Do you have equipment to treat an asthma attack? Can you hydrate someone who needs IV fluids? Do you take care of possible broken bones? Will you see me late in the day if I have an urgent medical need? How do you handle after hours calls? Urgent Care from your PCP?
If you don’t have an emergency or urgent health care need, who should you see? 1.Primary care provider a.Best to start with this level before going to specialist in most cases b.Better to have someone at the center of your care who can coordinate care across providers. 2.Specialist a.Good for special needs, serious, specific ailments. b.More expensive, esp. for routine/general medical needs.
Primary Care Provider (PCP) It costs you less to see your PCP than it does a specialist. Can evaluate and manage most of your health care needs most of the time. Ask what conditions they manage and which they don’t. Ask if he or she prefers generic or brand name drugs. Ask how often and for what conditions he or she orders lab tests, x-rays, or refer to a specialist. Your PCP is likely to know what specialist to refer you to, if needed. If you are referred to a specialist by your PCP, ask if the referral is for a consultation only or for consultation and management.
Specialist See the specialist if your PCP has referred you and if the specialist asks your to return for follow up. Ask the specialist to communicate with your PCP in a timely manner. Ask the specialist if your PCP can manage your condition with recommendations made by him or her.
Dental Insurance Must re-enroll during this year’s open enrollment period!
Dental Insurance PPO Plan Worldwide Coverage Prepaid Plan In-State Coverage Only Delta Dental of AZ Total Dental Administrators Members in the PPO dental plans can see a provider of their choice. Members enrolled in the prepaid plan must see an in-network dentist to receive a benefit paid on services.
Dental Insurance Per-Pay Period Premiums 2013
Alternative for Routine Cleaning/Diagnostics: NAU’s Very Own Dental Hygiene Clinic Affordable, preventative dental services at NAU’s dental hygiene clinic. Fee-for service (no insurance) Staffed by advanced dental hygiene students supervised by licensed professionals Evening appointments available 208 Pine Knoll Dr. (South Campus) Building 66, room 216 Call 928-523-3500 for appointments Web Page: http://nau.edu/CHHS/DDH/Clinic
Low-Cost, Routine Dental Hygiene Care at NAU
Saving Money on Medications Generics Pill Splitting Over-the-counter Alternatives
Generic Drugs Must meet FDA approval and be bioequivalent to brand name drugs Just as effective as brand names and co-pays are much lower !! If your provider recommends a brand name drug ask if there is a generic in the same class of drugs Reference: http://www.consumerreports.org/health/resources/pdf/best- buy-drugs/money-saving-guides/english/GenericDrugs- FINAL.pdf
Pill Splitting Reduces the number you need to buy First – While many pills can be split to save you money, some pills shouldn’t be split Ask your provider which ones can be split and which ones shouldn’t be You can stretch a one month supply into a two month supply and pay only one co-pay. When splitting pills use a pill-cutter. Don’t use a knife.
Over the Counter (OTC) Drugs Many work just as well as prescription drugs For example, ibuprofen (e.g., Advil, Aleve, or generic) Ask your provider if there is a less expensive OTC that would meet your needs Important: OTC drugs can interact with other OTCs and prescription drugs so ask your provider first! Some interactions can cause serious health risks.
90 day supply via Walgreens Mail Order sent directly to your home Pay only one co-pay for a 3 month supply Mail Order What’s Another GREAT Way to Save $$ on Prescriptions ??
Access by registering for azblue.com. Those needing assistance establishing a login or resetting the password may call E-Solutions at 602-864-4844 Find Compare Rx Drug Costs link and enter the name of the drug you are researching in the Search box. Prescription Cost Calculator What’s Another GREAT Way to Save $$ on Prescriptions ??
Many emergency department visits and hospitalizations directly related to not taking medications correctly or because of unintended medication interactions (Important to tell your provider about all of the prescription and OTC medicines, herbs, and supplements that you take) TAKE YOUR MEDICINES AS DIRECTED BY YOUR PROVIDER What’s Another GREAT Way to Save $$ on Health Care??
Saving Money on Vision Care
Even if you don’t need corrective lenses now (eyeglasses, contact lenses), it is important to care for your eyes. Annual exam important for good health Detect diseases of the eye (cataracts, glaucoma) Detection of other diseases (e.g., diabetes, hi BP) Aid school/work performance Those who spend a lot of time in front of computers may benefit from special corrective lenses
Saving Money on Vision Care Ophthalmologist, Optometrist, or Optician??
Saving Money on Vision Care Ophthalmologist: Total Eye Care (most expensive, like “specialist”) Physicians – Medical doctors with most extensive education and specialization. Important for serious eye problems, need for eye surgery, etc. Optometrist: Vision Care and Eye Care Services (less exp.; like general practitioner for the eye) Diagnose common eye conditions like near- and far-sightedness Also trained to identify cataracts, glaucoma, and retinal disease, and to use some medications to treat eye disease. Optician Trained to fill prescriptions for corrective lenses (glasses or contacts, prescribed by other two)
Saving Money on Vision Care Ophthalmologists > Optometrists > Opticians Not only in education/training/focus, but $$$! Need a minimum of the optometrist level of training for your annual exam, but then can shop around for deals from an optician to fill lens prescription. Typically, most providers in a vision insurance plan are optometrists since treatment for medical conditions of the eye are typically covered under a health plan.
Saving Money on Vision Care Some Online Discount Options http://www.eyebuydirect.com/ http://www.eyeglasses.com/ http://www.discountcontactlenses.com/ Some great deals can be found online, but always look at the “shipping and handling” costs to compare against a trip to a local discount optical store.
Saving Money on Vision Care NAU’s Vision Plan (Avesis) offers a discount card for employees who are not members! Weigh the cost of annual insurance against your typical needs for ongoing eye care, costs of discount programs, and what you get for your money.
Controlling Your Costs by “Partnering” with Your Health Care Provider
How do you “confront” or ask for what you need? You are a customer of this person’s services – if you’re not pleased with the service, you do have the right to ask for something different. You have the right to be treated with respect and as an equal. If something the provider “prescribes” for you doesn’t feel right, explore it with them – sometimes they are just making an educated guess!! Share your whole medical history. Accurate evaluations and recommendations depend on this.
Controlling Your Costs by “Partnering” with Your Health Care Provider You have the right to… check your understanding of what a provider is saying or prescribing for you – ask questions if you don’t understand. understand why diagnostic tests are ordered for you, and what the results mean. express financial concerns about the costs of particular procedures or medicines. Providers are not necessarily looking out for your best financial interest.
Controlling Your Costs by “Partnering” with Your Health Care Provider Shop for “Partner potential” When you meet a new provider: Ask to share in making treatment decisions. Pay attention to how you feel during the visit. Does the doctor listen well? Does the doctor speak to you in terms you can understand? Does the doctor spend enough time with you? Do you think you could build a good working relationship with the doctor?
Controlling Your Costs by “Partnering” with Your Health Care Provider “Partner potential” (cont’d) Is it time for a change? If you are unhappy with how your doctor treats you, it may be time for a change. Before you start looking for a new doctor, talk with your current doctor about how you would like to be treated. Your doctor will probably be pleased to work with you as a partner if you tell him or her that's what you want. If you don't make your wishes known, your doctor may think that you, like many people, want him or her to do all the work.
Flexible Spending Accounts (FSAs) Saving Money on Health Care Expenses Through Tax Savings!
Flexible Spending Accounts A Flexible Spending Account allows you to pay for particular medical or dependent care expenses with pre-tax dollars from your paycheck. You save: Federal Taxes State Taxes Social Security Taxes
Flexible Spending Accounts How they work Two accounts are available: Medical and Dependent Care Monies are pledged annually and deducted on a pre-tax basis. Eligible medical or dependent care expenses are reimbursed to you from your contributions. Contributions are divided evenly over the number of paychecks received during the calendar year.
Flexible Spending Accounts How they work Contributions for mid-year enrollments are deducted over the remaining pay periods in the plan year. Contributions begin the first of the month following enrollment. Administered by ASI. www.asiflex.comwww.asiflex.com Reimbursement very fast when you select direct deposit for FSA.
Flexible Spending Accounts – Administered by ASI Health Care FSA Maximum annual pledge of $2,500 limit for 2013 (per employee/$5,000 per family). Reimbursed up to the total amount of the pledge for the year at any time. Dependent Care FSA Maximum annual pledge of $5,000 (per family). Reimbursed only up to the amount you actually funded through payroll deductions. Debit card is available for ease of payments! NAU covers the debit card fee in 2013!!
Flexible Spending Accounts Enrollment into FSA can be done: Within 90 days of date of hire During FSA open enrollment Must re-enroll each year Within 31 days of some qualified life events (QLEs) Pledge conservatively, amounts not claimed for reimbursement will be lost! Use it or lose it! Much more detail about FSAs available at http://hr.nau.edu/benefits/fsa http://hr.nau.edu/benefits/fsa
Open Enrollment for 2013
Oct. 29, 8 a.m. – Nov. 16, 5:00 p.m. http://hr.nau.edu/open_enrollment_2012 http://hr.nau.edu/open_enrollment_2012 for full details! During Open Enrollment, meet the health care vendors at one of several Benefits Expos! In Flagstaff on October 23 rd Phoenix/Tucson locations: Go to http://hr.nau.edu/open_enrollment_20 12 for dates and locations. http://hr.nau.edu/open_enrollment_20 12
Open Enrollment for 2013 Highlight of Changes: You must re-enroll in dental insurance if you wish to have it for 2013. Dental plans now have four tiers: employee only; employee+child; employee+adult; family Dental premium rates have gone down for all tiers except employee-only. You must re-enroll in medical and dependent FSAs if you wish to have that tax savings FSA medical account limit has been reduced from $5,000 to $2,500.