HEALTHBEAT NEWS for MEMBERS of UK-HMO

Transcription

1 HEALTHBEAT NEWS for MEMBERS of UK-HMO OPEN ENROLLMENT EDITION Special issue for all UK benefits-eligible employees SPRING 2017 Changes to the UK-HMO Plan for Adding Out-of-Area Urgent Care to the UK-HMO Plan Effective July 1, 2017, UK-HMO is adding out-of-area urgent care as a covered benefit for the UK-HMO plan. This means that any time you are traveling outside the UK-HMO counties, you will now be able to seek treatment at an urgent treatment center for out-of-area urgent care. In the past, when UK-HMO members were out of area, the only thing they were covered for was emergent care. However, while you are inside the UK-HMO counties, you still must be seen at the current participating urgent treatment centers for urgent care. Those will be the only participating facilities within the UK-HMO counties unless you are having an emergency. You can find a list of UK-HMO Participating Urgent Care Centers on the UK-HMO website at edu/ukhmo. Choose **UK-HMO Participating Urgent Care Centers** from the menu on the left. UK-HMO Open Enrollment The UK Health Benefit Open Enrollment period that allows UK employees to sign up or switch their health benefits will be held April 24, 2017 through May 12, Changes made during the Open Enrollment period will go into effect July 1, If you have any questions regarding your plan, contact the following numbers: UK-HMO Customer Service (toll free) UK Human Resources Benefit Office , Choose option 3, then choose option 1 Urgent care option near Wilmore UK Health Plan members who live in or near Wilmore, Ky., now have an additional in-network option for urgent care close to home. The Phyllis D. Corbitt Community Health Center in Wilmore, operated by the UK College of Nursing, sees patients 2 years of age and older for all basic urgent-care needs. Illnesses commonly treated include: Colds and sinus infections Fevers Ear infections Bladder infections Minor injuries including sprains, insect bites, and minor cuts and burns. The center, located at 317 E. Main St., is open 10 a.m. to 6 p.m. Monday Friday, and features seven nurse practitioners, each board-certified in their specialty. No appointment is necessary. Call for more information.

2 Highlights of UK-HMO Health Plans Effective July 1, 2017 Medical Services Choice of Physician Choice of hospital UK-HMO UK-HMO Participating Provider (Go to and choose Find a Doctor on right of page. Enter your ID # or alpha prefix (ULS for UK-HMO) and choose continue. UK Albert B. Chandler Hospital, Kentucky Children s Hospital, and UK Good Samaritan Hospital Emergency/accident (or urgent) care $100 co-payment per emergency department visit, waived if admitted to hospital as inpatient or observation stay. $25 co-payment at Concentra UTC - Lexington (Boardwalk, Dove Run and Sir Barton Way); and Nicholasville UTC (Bellaire Drive). Berea Urgent Care (Brenwood St.); Frankfort Urgent Care (Kings Daughters Drive); Georgetown Urgent Care (Osbourne Way, Suite 1); and Lexington Urgent Care (Nicholasville Road). $15 co-payment at UK Twilight Children s Clinic $10 co-payment at UK Health Plan Urgent Care Clinic (University Health Service Building, first floor) Preventive care routine Pap smears, mammograms, PSA, screening colonoscopy and sigmoidoscopy 100% covered Routine child care and immunizations (through age 18) Routine adult physical exam (19 years and above) Physician (primary care) office visits for diagnosis and treatment Physician (specialist) office visits for diagnosis and treatment Allergy injections Maternity care (physician) Prescription drugs Chiropractic; physical therapy; occupational therapy; acupuncture; pool therapy/exercise therapy; cardiac rehabilitation; pulmonary rehabilitation; music therapy; speech therapy Autism Outpatient mental/nervous care or substance abuse care rendered by licensed psychiatrists and psychologists Inpatient mental/nervous care or substance abuse care (acute care) Outpatient diagnostic tests, lab and X-ray, and other diagnostic tests (excluding HIGH COST below) $10 co-pay (except allergy injections, see below) $30 co-pay $10 co-pay 100% covered. Inpatient co-pay will apply upon admission. Prescription drugs are covered under a separate plan through Express Scripts and UK Employee Benefits. $15 co-pay 45 visits per plan year for all therapies combined If a member completes at least 24 cardiac or 24 pulmonary rehab visits, UK-HMO will reimburse them 50% of the co-pays for that specific service. Autism is covered at 100% after $15 therapy co-pay for children 2 to 21 years of age for therapeutic, respite and rehabilitative care (unless receiving ABA therapy). Respite care covered at 50%. $30 co-pay 100% covered after $200 co-pay 100% covered Ambulatory hospital Ambulance (including Air Ambulance) Outpatient diagnostic testing (HIGH COST - MRI, MRA, CT, SPECT and PET scans) Outpatient surgery Hospital services, including semi-private room and board Hospital services, observation stay Skilled nursing Tobacco cessation counseling Durable medical equipment (DME), prosthetics, orthotics Durable medical equipment (DME), prosthetics, orthotics $75 co-pay. Non-emergent ambulance will only be paid when transported to UK Chandler or UK Good Samaritan hospitals. $75 co-pay $200 co-pay per admission $100 co-pay per observation stay 100% covered, 30-day limit 100% covered 20% co-insurance ($500 maximum out-of-pocket per plan year for these services combined, then covered in full) 20% co-insurance ($500 maximum out-of-pocket per plan year for these services combined, then covered in full) This is a partial listing and summary of benefits and services. For complete details of covered services, exclusions and benefit limitations, refer to the Benefits Booklet, which can be viewed at For the latest Open Enrollment information, including open house dates, times and locations, see the UK Employee Benefits website at

3 Benefits open house information Building Location Date Time Good Samaritan Hospital 310 S. Limestone, Conference Room A & B Monday, April a.m. University Health Service Building 830 S. Limestone, 1st floor Tuesday, April a.m. 2 p.m. Peterson Service Building 411 S. Limestone, Loading Dock Wednesday, April 26 7:30 11 a.m. Coldstream Research Campus 1500 Bull Lea Rd., Conference Room 101 Thursday, April p.m. Chandler Hospital 800 Rose St., North Lobby Thursday, April a.m. 1:30 p.m. Chandler Hospital 800 Rose St., North Lobby Tuesday, May 2 6:30-8:30 a.m. UK HealthCare at Turfland 2195 Harrodsburg Road Family Medicine Conference Room A & B Tuesday, May p.m. UK HealthCare Sterlington Road 2317 Alumni Park Plaza, 1st Floor Lobby Wednesday, May 3 11 a.m. 1:30 p.m. University Health Services Building 830 S. Limestone, 1st Floor Thursday, May 4 7:30 10:30 a.m. College of Ag Good Barn 1451 University Drive Thursday, May p.m. Main Building 410 Administration Drive Lexmark Room Friday, May 5 11 a.m. 1 p.m. Good Samaritan Hospital 310 S. Limestone, Conference Room A & B Monday, May p.m. Eastern State Hospital 1350 Bull Lea Road, Rooms 1A05, 1A11 and 1A17 Tuesday, May a.m. Scovell Hall Lawn 670 S. Limestone Friday, May a.m. 2 p.m. Are you seeing UK-HMO participating providers? It is always important to make sure that your providers you are utilizing are UK-HMO participating providers. Even though a provider sends you to another provider or suggests that you obtain your physical therapy at a certain location, as the member, it is your responsibility to make sure you are utilizing participating providers. With all of the different insurances that are out there, the providers cannot be expected to know what providers are participating with every insurance plan. To check to see whether a provider participates in your plan, visit anthem.com. Check the menu icon, then choose Find a doctor from the Care column. Log in with your username and password, or, if you have UK-HMO insurance, simply enter ULS in the box for alpha prefix, and click Continue. Choose the type of provider you are looking for, their specialty and enter your ZIP code. If you are looking for a particular provider, you can enter that person s name in the Whose name is: box. Click Search and you will be given a list of participating providers who meet your specifications. If you are a UK-HMO member and you are out of the area and need to locate an emergency room, there is a number on the back of your ID card for a 24/7 NurseLine. You can always call this number and speak directly with a nurse to determine the need to seek emergent care and find a provider. Unless you have an emergency situation, it is better to check ahead of time and make sure your providers are participating because if they are not, you will be responsible financially for the bills. You can also call the member services number on the back of your ID card, (toll-free), and they can assist you with determining if your provider is a participating provider.

4 How do I enroll in UK benefits? 1. Enroll online You may enroll from your office computer or in the comfort of your own home with your own computer. It s easy! Visit myuk Employee Self-Service online at uky.edu/irj/portal. Enter your Link Blue user ID and password and click sign on. (This is the ID/password you use to log into your Exchange account or in some cases to log into SAP. For assistance with your ID or password, contact Information Technology at HELP (4357). Then follow the Quickstart Guide, sites/ EnrollQuickStart.pdf, for those benefit plans you need to update. online benefits enrollment Quick Start Guide Getting Started: Sign in to myuk online, visit Employee Self-Service Log in to the myuk Web site ( with your link blue user ID/password. Click the Employee Self-Service tab in the dark blue bar. Then click Benefits and Payment. Update & Enroll Step #1 Personal Profile Review your address(es) and click Edit Personal Profile to update as needed. Step #2 Dependents & Beneficiaries Review current information and click Edit Dependents & Beneficiaries to update as needed. Add a dependent or beneficiary, save their updated details & be sure to enter an effective date. Step #3 Current Benefits Summary No action needed; review your current details and click Next. Step #4 Medical, Dental, & Vision Plans Add benefits by clicking Add beside a desired plan and attaching dependents. Step #5 Other Plans Repeat Step #4 above for the remaining plan options: Select the desired plans, assign beneficiaries and choose Next to proceed. If you do not choose to enroll in a plan, simply click Next. Step #6 Important! Review & Save On this final screen, you will view all of your enrollment selections. Be sure to click Save at the top of the screen to save all of the choices you have made. The option to print your new selections, return to enrollment or review current and future selections will be available upon saving. Access UK-HMO website Please visit the UK-HMO website at ukhmo to find answers to all of your UK-HMO health plan questions. The UK-HMO website provides access to all of the following information: Benefit information including your Benefits Booklet. A link to the UK-HMO Provider Directory online search, which allows you to locate participating providers. A link to Anthem, which allows you to view your claims and authorizations and access healthcare information. Frequently asked questions (FAQs) regarding UK-HMO. Primary Care Access, which includes information about access to the Primary Care Practice options available for UK-HMO members. Information about and links to the other health services available at the University of Kentucky. UK-HMO current and past newsletters. UK-HMO pre-authorization lists. In the News UK-HMO information updates. Please be sure to visit the UK-HMO website regularly for updated information. 2. Paper option Enroll using paper forms. Pick up forms at 112 Scovell Hall or access printer-friendly forms at the URLs below: Employee Health/Dental/Vision insurance enrollment form: Life and AD&D insurance form: benefits/forms/life-insurance-and-add-enrollmentform Flexible Spending Account form (health and/or dependent care): Retiree Health/Dental/Vision insurance form: uky.edu/hr/benefits/forms/retiree-healthdentalvisionform Changes you can make anytime throughout the year You can make the following changes anytime throughout the year: Decrease optional life insurance coverage. Adjust voluntary retirement contributions. Check out UK discounts on auto or home insurance. Change beneficiaries for your life insurance or retirement plan. UK Chandler named one of the 100 Great Hospitals in America UK Albert B. Chandler Hospital has been named among the 100 Great Hospitals in America by Becker s Hospital Review, a monthly publication offering business and legal news and analysis relating to hospitals and health systems. The hospitals included on this list are renowned for excellence. They are industry leaders in innovation, quality patient care and clinical research, and have received recognition across various publications and accrediting organizations. Becker s Hospital Review has published a version of this list since The Becker s Hospital Review editorial team selected hospitals for inclusion based on analysis of several ranking and award agencies, including U.S. News and World Report s Honor Roll and specialty rankings, CMS star ratings, Leapfrog grades, Truven Health Analytics top hospitals, Most Wired hospitals and Magnet accreditation. The full list of organizations presented in alphabetical order can be read at lists/100-great-hospitals-in-america-2017.

5 New UK health plans primary care clinic opening in late 2017 We re working to make it easier for you to see a primary care provider. We have heard from you that it can sometimes require a lengthy wait to get an appointment with a UK HealthCare provider. In response, UK HealthCare is developing the Team Blue Primary Care Clinic, a clinic dedicated to serving only UK employees and their adult family members who are on a UK health plan. We re aiming to open this clinic at Kentucky Clinic South, just off Harrodsburg Road near New Circle, in late Initially, the non-teaching clinic will have a dedicated doctor and advanced practice providers. Employees and their family members who are covered by a UK health plan can access the clinic for their routine primary care needs as well as same-day appointments when they re sick. Our Health & Wellness team will also be onsite to guide you toward any of our health and well-being services you might find beneficial. We re excited to offer this clinic just for you. Watch for more information later this year as we prepare to open the clinic, which is in addition to the urgent care clinic at University Health Service available to employees and their covered family members seeking same-day care. In the short term, we have expanded our contract with Concentra. UK-HMO members who do not already have a primary care provider can visit a Concentra care center for primary care. For more information, visit concentra. Access your medical records online My UKHealthCare is a secure online portal that allows our patients to: Request prescription renewals when it s convenient for you, not just when our offices are open. Request, cancel or reschedule appointments. View lab test results, radiology reports and office visit summaries. Get health maintenance reminders. View your immunization record and allergies. View your hospital discharge instructions. You can even send secure messages (like an , only more secure) to your physician s care team. If you don t yet have access to My UKHealthCare patient portal account, visit myukhealthcare.org to learn more and to request an account. You can also request an invitation next time you visit your provider s office. For questions or help with portal operation, call or (toll free) 9 a.m. - 8 p.m. Be a quitter! Tips for finally conquering your smoking addiction If you re a smoker, you probably already know it s not a healthy habit. The benefits of not smoking are vast, but the bottom line is this: if you stop smoking now, you ll have a better quality of life and more years to live it. We know that quitting smoking isn t easy, but we re here to help. We ve put together a list of tips and resources that can help you or someone you know start on the path toward success. Check them out and pass them along to family and friends. Learn about smoking-cessation aids. Quitting cold turkey isn t the best option for everyone, and aids like nicotine patches, nicotine gum and medicines for withdrawal symptoms can help make quitting easier. At UK HealthCare, low-cost nicotine replacement products are available in our pharmacies and gift shops. Make it through the hardest part. It s often said that if you can make it through your first week of not smoking, when withdrawal symptoms are at their worst, you ll be on your way to success. Consider your triggers. Different triggers make different people reach for a cigarette. Plan ahead for the things that cause you to smoke and come up with an alternative plan. Avoid smoke at all costs. Ask people not to smoke around you, and avoid those who do. Realize that a relapse isn t the end of the world. Don t beat yourself up if you have a cigarette after quitting. Relapse is a common occurrence and nothing to be ashamed of. Understanding why you chose to smoke is often the key to preventing it from happening again. Treat a relapse like an emergency: Figure out what caused it, and come up with strategies to keep it from happening again. Remind yourself why you re quitting. Consider writing all your reasons on a piece of paper and keeping it in your purse or wallet. My kids. My husband. My health. Feeling more energetic. Looking younger. Keeping my breath fresh List as many reasons as you can think of, then pull the card out when you re craving a cigarette to remind yourself of your motivation.

6 University of Kentucky Health Care Plans 2333 Alumni Park Plaza, Suite 200 Lexington KY HealthBeat is published by the UK Health Care Plans office. The information is intended to educate members of UK-HMO about subjects pertinent to their health and health coverage, not as a substitute for consultation with a personal physician. Writing, editing and design for HealthBeat provided by UK HealthCare Digital and Brand Strategy. Don t forget to update your address when moving When you move, it is important that you fill out an updated health benefits enrollment form with your new address and forward it to: University of Kentucky Employee Benefits Office 115 Scovell Hall Lexington KY The staff will forward the information to UK-HMO, and this will enable us to ensure that you receive important information during the plan year. The health benefits enrollment form is available to you at www. uky.edu/hr/forms/benefits. If you are moving outside the UK-HMO service area, you must notify the UK Employee Benefits office and make arrangements for health insurance coverage within 30 days of your move date. Otherwise, you may find yourself with an unnecessary lapse in health insurance coverage and at financial risk for all of your healthcare expenses. You can also change your address by going to and logging in using your Link Blue username and password. Choose your Personal Information and change your address. This will transfer this change of address information to the UK Benefits office and then on to Anthem. If you move out of the area and need to change insurance plans, it is a good idea to contact the UK Benefits office at , option 3 and option 1 to discuss this with them. UK-HMO Monthly rates Employee eligible for university contribution Employee NOT eligible for university contribution Employee Only Employee + Child(ren) Coverage levels Employee + Spouse Employee + Family [Spouse & Child(ren)] $28 $134 $261 $385 $523 $783 $1,044 $1,307 (See UK Benefits website for retiree rates at University of Kentucky UK-HMO and UK-RHP (Region A and B) Ballard McCracken Carlisle Graves Hickman Gallatin Pendleton Bracken Carroll Grant Mason Trimble Lewis Greenup Owen Harrison REGION B Henry Oldham Fleming Nicholas Carter Boyd Scott Franklin Bour bon Shelby Bath Rowan Jefferson Elliott Lawrence Spencer Fayette Bullitt Anderson HMOClark Menifee Morgan Meade Johnson Hancock Powell Martin Nelson Mercer Wolfe Magoffin Henderson Breckenridge Washington Madison Estill Daviess Hardin Union Boyle Garrard Lee Floyd Larue Marion Breathitt Pike Webster McLean Lincoln Grayson Jackson Owsley Ohio Knott Rockcastle Crittendon Taylor Perry Hart Casey Hopkins Livingston Butler Green Clay Edmonson Leslie Muhlenberg Letcher Pulaski Lau rel Caldwell Adair Lyon Warren Barren Metcalfe Russell Knox Harlan Marshall Christian Todd Logan Cum berland Wayne Trigg Whitley Allen Bell Simpson Monroe Clinton McCreary Boone Woo dford Kenton Jessamine Campbell Robertson Montgomery Fulton Calloway REGION A