It pays to have one doctor coordinate your care

Your doctor serves as your main contact within the healthcare system. The doctor-patient relationship is unique and likely to be a long one, so finding a doctor that is right for you and your family is important.

Your doctor can provide basic care and:

• Get to know your specific needs and preferences
• Coordinate your preventive care (screenings, shots, well-women exams, physical exams)
• Recommend a specialist when you need one

How do you choose a doctor?

Whether you’re looking for a doctor or dentist, first make sure that the person you choose is in your health plan’s network. If your doctor is out of network, you still receive discounts for your doctor visits but you’ll have to pay more out-of-pocket costs for the same care as an in-network doctor. Second, ask your family and friends for a doctor that they recommend.

Once you have a list of potential doctors, call their office and ask the following questions:

• What are your office hours?
• How long does it take to get an appointment for a routine physical or wellness exam?
• Do you have a nurse practitioner on staff who can handle things like the flu or sinus infections?
• How quickly can a person get an appointment if they are really sick?
• Do you have diagnostic or lab capabilities in-house (x-ray, cholesterol, etc.)
• How many other doctors and nurses are in the office?
• What is the doctor's style?
• What languages does the doctor speak?
• What is the doctor’s position on brand vs. generics prescription drugs?
  

Once you have an appointment, cut down on the time you spend in the waiting room by booking the first appointment of the day, before the schedule can be backed-up.

Save money by lowering your medication costs

With the costs of gas and food rising, you may be looking for ways to cut extra expenses out of your budget. If you suffer from health conditions, however, it’s important that you continue to take medication as needed. To learn what formulary (the list of drugs) that your health insurance covers, refer to the phone number on the back of your ID card.

Save on the cost of medicine without risking your health

Below are a few tips to help you save money at the pharmacy:

Generic medicines are less expensive.

Generics are copies of brand-name medicines. Generic equivalents are made according to the same strict U.S. Food and Drug Administration (FDA) standards as brand-name drugs and therefore have the same quality, strength and purity as more expensive brand-name drugs.

Ask your doctor or pharmacist if you can take a generic equivalent for the brand-name medicine that you take now. Unfortunately, generic equivalents are not available for every brand-name medicine. If there is not an equivalent, ask your doctor if there is a similar medicine in the same class that may be less expensive or that has a generic equivalent.

An example comparison between generic and brand name prescription drugs

Based on example plan. Your coverage may vary. Refer to your enrollment brochure for details or call 1-800-260-9868 for more information about your employer’s Starbridge plan

Shop around for the best deal on medicines.

The retail cost can vary widely from pharmacy to pharmacy. While finding a good deal is important, it’s also important that your pharmacist knows:

• your medical history, including all the drugs—prescription and over-the-counter
• dietary supplements and herbs

That way he or she can provide valuable advice about any potential for drug interactions, side effects, or other problems.

Talk with your doctor about less costly options.

Tell him or her if your prescription costs are a financial hardship.

• Ask if all of your medications are necessary.
• Ask if you are on the correct dose.
• Ask for drugs that are less expensive but just as effective. Often, several medicines can be used to treat the same condition, and your doctor may be able to prescribe the one that is the most economical.
• Often, drug companies give doctors medicine samples free of charge. You might ask your doctor if he or she has medicine samples, especially when you are trying out a new medicine to see whether it will work.

Sign up for prescription coverage.

• If you have ongoing expenses due to health issues, enrolling in health insurance with prescription coverage can make good financial sense.
• Do the math— if you only pay a co-pay at the pharmacy, your out-of-pocket expenses may be lower and more predictable.
• By working together with your doctor, pharmacy and/or your health insurance carrier, you’ll be amazed at how much you can save on your medications.

Over-the-counter drugs (non-prescription drugs)

• Many medications that were once available only by prescription are now available without a prescription.
• Not only are over-the-counter medications convenient (because you don’t need a prescription from your doctor) – they can also save you money.
• Keep in mind that most health plans do not reimburse for over-the-counter medications.

Have you ever wondered how health insurance is paid?

Many Americans get health coverage through their employers. Meet Sophia, a 27-year-old who just started a new job and has access to health insurance through her employer.

Let’s follow the route of Sophia’s health insurance ID card

Once Sophia signed up for coverage, the health insurance company mailed her an ID card. One afternoon, Sophia has abdominal pain and makes a doctor’s appointment. At the doctor’s office, staff members used her ID card to find her enrollment date and the amount of out-of-pocket expenses, such as a co-pay, that Sophia must pay for the visit. After Sophia sees the doctor, the doctor’s office sends a claim to Sophia’s insurer. The claim is basically a bill for the list of services the doctor provided for Sophia.

Knowing more about your health care plan helps you in many ways. When you know more, you can take action to stay healthy and save money.

The health insurer calculates which services are covered under Sophia’s health plan, and pays the doctor for those services. Finally, the insurer sends Sophia an explanation of benefits, or EOB. The EOB is a letter that tells Sophia which costs her plan covered. The EOB is not a bill. If Sophia owes money for doctor’s fees that are not covered, she’ll get a bill from her doctor.

After you look at an EOB, you might be wondering about networks. Your network includes primary care physicians (PCP) along with specialists, clinics, and other health care professionals. Some services that are covered if you go to an in-network doctor may not be covered if you use an out-of-network doctor or hospital. So it’s always best to check your plan first to make sure you will be covered.

Using your additional benefits

Supplemental benefits are offered by some plans as additional coverage or as a stand-alone to the medical plan. Supplemental benefits can offer you:

• Additional options and the flexibility of choice
• Extra protection for things like dental care, life insurance and disability coverage

Dental Coverage

One or two possible options in your health insurance package are separate plans for dental and vision care. If you aren’t offered multiple options, your plan may offer discounts on vision and dental products and services.

Remember that the terms on these policies or discount programs may be different from your regular health benefits. Don’t assume that presenting your ID card is all you need to do. Your vision or dental plan may have unique requirements. Check with your health plan for complete details.

Making the most of your mental health benefits

Often, employers offer an Employee Assistance Program (EAP) for health concerns ranging from caring for your children to alcohol and drug abuse treatment.

Your mental health is just as important as your physical health.

Through your EAP, you have access to professionals who provide confidential assessment and short-term counseling. Your EAP can put you in touch with a counselor 24 hours a day, 7 days a week.