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Current Employee and Pre-Medicare Members
Effective Jan. 1, the HealthChoice High and High Alternative plans
have a $100 pharmacy deductible per person with a $300 maximum per family. This
new deductible applies to pharmacy medications only and must be satisfied
before the pharmacy copay structure applies.
HealthChoice also implemented the HealthChoice Preventive
Medication List Jan. 1 for all non-Medicare plans with a deductible on the
pharmacy benefit, which includes the High, High Alternative, and High
Deductible Health Plans. This is a list of generic medications that are not
subject to the deductible, and you pay the generic copay of up to $10 for a
30-day supply and up to $25 for a 90-day supply. You can access this list at https://www.ok.gov/sib/documents/HCPreventiveMedicationList.pdf.
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Once a year, HealthChoice verifies if you, your enrolled
spouse or enrolled dependents are covered under any other group insurance in
efforts to coordinate benefits with your other plan. Effective Jan. 1,
HealthChoice now requires members to complete a new Verification of Other
Insurance (VOIC) form on a calendar year basis versus an annual basis. Due to
this recent change, as a courtesy, if you provided a VOIC form during July
through December 2016, a new form will not be required from you for 2017.
If you are covering your spouse or dependents and did not
complete the form during July through December 2016, upon receipt of a claim,
HealthChoice will send you a letter requiring you to complete a new
Verification of Other Insurance Coverage form.
To expedite this process and inform HealthChoice now, download
a VOIC form from
the HealthChoice website at www.healthchoiceok.com.
Please do not leave any portion of this form blank. Failure to return this
form in a timely manner can result in the delay or denial of your claims.
If you have any questions about how to complete
the form, please call the medical and dental claims administrator at
405-416-1800 or toll-free 800-782-5218.
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HealthChoice medical and dental
claims Explanations of Benefits (EOBs) are available online through your secure
ClaimLink account.
Access
ClaimLink at www.healthchoiceok.com or directly at www.okhcp-eds.com/hcp/member. When you first visit
ClaimLink, you must register by creating a user ID and password, which are all
you need for future access. You will be notified by email when an EOB is available.
For assistance, call the
medical and dental claims administrator at 405-416-1800 or toll free
800-782-5218. TDD users call 405-416-1525 or toll free 800-941-2160.
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Did you know you have added breast care benefits under
HealthChoice Select if you need a mammogram?
In addition to the HealthChoice preventive mammogram benefit, if
you need follow-up procedures such as a biopsy, puncture aspiration, or
placement of a marker (localization device), you can also receive these at a
Select facility under the Breast care bundle. By utilizing the Select benefit, these
additional services may also be covered at 100 percent under the HealthChoice
Select breast care bundle when received at a participating Select facility.
Specific procedure codes apply.
This program is available to members of the HealthChoice High,
High Alternative, Basic and Basic Alternative health plans and High Deductible
Health Plan (HDHP)*.
You can search for the Select facilities that provide breast
care services and other service types at https://gateway.sib.ok.gov/providersearch/SelectProgram.aspx.
*HDHP members must
first meet their deductible before the plan pays any benefits, other than
for preventive services.
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As of Jan.1, 2017, bariatric surgery is a covered
benefit under the HealthChoice High, High Alternative, Basic and Basic
Alternative health plans and High Deductible Health Plan for members ages 18
and older who have been covered under a HealthChoice health plan for 12
consecutive months prior to the surgery. Members are encouraged to continue
coverage with a HealthChoice health plan for 24 consecutive months after
bariatric surgery. Coverage is limited to bariatric sleeve, bypass and duodenal
switch as well as revision and conversions. All policy provisions, including
deductible and coinsurance, apply.
Bariatric services are subject to certification as set forth by the
certification administrator. All bariatric surgeries must be obtained from an
accredited, network Metabolic Bariatric Surgery Accreditation and Quality
Improvement Program Comprehensive Center. You can search for a network provider
under the specialty, Bariatric Surgery Centers of Excellence, at https://gateway.sib.ok.gov/providersearch/SpecialtySearch.aspx.
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The start of a new year is the perfect time to assess and
organize your medicine cabinet. Leaving expired and unused drugs in your
medicine cabinet can put anyone in your home, including children and pets, at
risk for accidental ingestion, misuse or overdose.
All expired and unused medications should be disposed of
properly. Check all medication labels for an expired date. If unmarked or you
can’t remember what the medication was for, you should dispose of it. Be safe
and dispose of the medication properly.
The following abbreviated guidelines developed by the Food
and Drug Administration (FDA) encourage the proper disposal of medications:
- Take advantage of your local pharmaceutical take-back program. Many police stations have Rx disposal boxes. To find an authorized collector in your area, visit the Oklahoma Bureau of Narcotics and Dangerous Drugs site at https://portal.obn.ok.gov/takeback/default.aspx or call them at 800-522-8031.
- Follow any specific disposal instructions on the medication label. Do not flush medications down the sink or toilet unless disposal information specifically instructs you to do so. The FDA consumer drug information web page has a complete list of flushable medications.
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Remove or destroy all identifying personal information for the medication containers before throwing them away.
- If no disposal information is present on the label and no take-back programs are available in your area, throw the medication in your household trash with these recommendations in mind:
Remove from original container and mix with an objectionable substance, such as kitty litter, dirt or coffee grounds, to make it less appealing to children or animals. Place the mixture in a sealable bag or container to prevent the medication from seeping or breaking out of the garbage bag.
Taking these precautions not only protects our drinking
water, but also reduces the danger of unintentional use, overdose or abuse. For
more information on how to dispose of unused medication, visit http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm.
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