Comprehensive Overview of 2021 IBEW System Council #6 Medical Benefits
Key information on the 2021 medical benefits offered by IBEW System Council #6, including plan details, coverage options, emergency care provisions, and the importance of preventive exams for early detection and treatment. The plan includes two options - Managed Medical Care Plan (MMCP) and Comprehensive Healthcare Benefit (CHCB). Each plan has specific deductibles, co-insurance rates, and coverage for emergency services, surgeries, and hospital expenses. Access to preventive services and screenings is emphasized for proactive health management.
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2021 Medical Benefits IBEW System Council #6 June 9, 2021
Key Information Regarding Your Plan - Runs on a Calendar Year - No limitations for pre- existing conditions - No lifetime maximums - No referrals needed to visit a specialist - All preventive services covered at 100% - Service Enhancements: - Teladoc - Health Advocate
Two Plan Options: Managed Medical Care Plan (MMCP) In-network deductible = $350 per individual and $700 per family In-network coinsurance = 90% (you are responsible for 10% of the allowed amount for your services once you reach your deductible) Office visit copays: PCP: $25 Specialist: $40 Urgent Care: $25 ER: $100 Comprehensive Healthcare Benefit (CHCB) In-network deductible = $350 per individual and $700 per family In-network coinsurance = 80% (you are responsible for 20% of the allowed amount for your services once you reach your deductible) No copays Office visits are subject to your deductible and coinsurance
Key Benefit Information In need of emergency care?: If you are enrolled in the MMCP: Emergency Services Emergency Room Services - Emergency Ambulance 100% after $100 copay (waived if admitted) In-network: 90% after deductible Out-of-network: 70% after deductible If you are enrolled in the CHCB: Emergency Services Emergency Room Services 80% after deductible Ambulance 80% after deductible Having surgery?: If you are enrolled in the MMCP: Hospital and Medical / Surgical Expenses In-network: 90% after deductible In-network: 90% after deductible Hospital Inpatient Hospital Outpatient Out-of-network: 70% after deductible Out-of-network: 70% after deductible If you are enrolled in the CHCB: Hospital and Medical / Surgical Expenses Hospital Inpatient Hospital Outpatient 80% after deductible 80% after deductible
Get a Preventive Exam A preventive exam, also known as a routine checkup gives you and your doctor a full picture of your health. It helps identify problems earlier, when they re easier to treat. It considers your family history and conditions you already have. It even looks at your lifestyle behaviors. Cancer Prevention and Screenings Cancer screenings, from colonoscopies to mammograms are key to cancer detection. Screening tests can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier, to treat or cure. By the time symptoms appear, the cancer may have grown and spread and can make the cancer harder to treat or cure. Tips to Preventive Care Remember when you see an in-network provider, preventive services are 100% covered under your plan. Physical Exams Immunizations Routine Gynecological Exam Routine Pap Smear Mammograms, Annual Routine Diagnostic Services and Procedures 100% (deductible does not apply) 100% (deductible does not apply) 100% (deductible does not apply) 100% (deductible does not apply) 100% (deductible does not apply) 100% (deductible does not apply)
The Importance of Preventive Care -- Biometric Screening Know your numbers! Provides a snapshot on personal health Uncovers potential health issues Confirmshealth improvements Facilitates conversation with health careproviders 1 in 3 adults in America have prediabetes but 90% don t know it 25 % of adults with diabetes don t know they have it 1 in 5Americans have a behavioral health condition 2/3 of those also have a chronic condition 50% of adults inAmerica have one chronic condition, 25% have multiple chronic conditions 7
Telemedicine Teladoc teladoc.com See a doctor on your computer, tablet, or smartphone 24/7 convenient and easy. Great for non-emergency conditions, such as sinus infections, bronchitis, pink eye, sore throats, cough, etc.
Connect with your Dedicated Service Team Questions on your benefits, claims, finding doctors and more? Medical Benefits: Highmark: 1-866-267-3320 UHC: National Plan Members : 1-800-842-9905 UTU Members: 1-888-445-4379 Aetna: National Plan Members: 1-800-842-4044 UTU Members: 1-888-332-8742 Prescription Drugs: Express Scripts at 1-800-842-0070 Dental: Aetna at 1-877-277-3368 Vision: EyeMed at 1-855-212-6003 Health Flexible Spending Account: UHC at 1-888-298-9754 Behavioral Health: United Behavioral Health at 1-866-850-6212 Websites: a www.highmarkbcbs.com www.aetna.com www.myuhc.com member.eyemedvisioncare.com/railroad/en www.express-scripts.com
Other Helpful Resources Health Advocate Your Track to Health Your go to resource for Health and Welfare benefits Support for a wide range of health and insurance related issues. Scheduling appointments Transferring medical records Coordinate treatment for complex diagnoses Provider Search Cost Transparency Tools Discount Programs Health and Wellness Resources
