HealthVoice Newsletter January 2020

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Member Newsletter

January 2020


IN THIS ISSUE


Telemedicine – NEW for 2020!

SwiftMD

HealthChoice members and covered dependents are now eligible for consults with SwiftMD doctors by phone and videoconference. With SwiftMD, you can receive a diagnosis and medical advice for common medical conditions at home or on the go. When necessary, they can send a prescription to your preferred local pharmacy where you can pick it up at your convenience. SwiftMD physicians provide consults for many minor illnesses and injuries such as:

  • Allergies and rashes.
  • Bronchitis.
  • Ear infections.
  • Fever and flu.
  • Insect bites and stings.
  • Pink eye.
  • Poison ivy.
  • Sinus infections.
  • Respiratory infections.
  • Urinary tract infections.

SwiftMD doctors are board-certified physicians trained in the U.S., with a minimum 10 years practice experience. They are available 24/7, offering a great alternative to the emergency room, urgent care clinic and even a visit to your primary care doctor for common illnesses and conditions.

For HealthChoice High and Basic members, the first five visits, per covered person per year, are $0 cost. After five visits, there is a $10 charge per visit.

For HealthChoice High Deductible Health Plan members, there is a $45 per visit charge until the annual deductible is met. After the deductible is met, that member will receive five visits for $0 cost. After that, there is a $10 charge for each visit.

Call SwiftMD at 833-980-1442 or log in to SwiftMD to schedule a consultation with a participating physician. Most consultations are completed within 30 minutes of requesting an appointment. Services are not available for Medicare members. For more information, visit SwiftMD.


Introducing the new HealthChoice Benefits app!

HealthChoice Phone App

 

Navigating health benefits and saving money on medical care can be tricky, but HealthChoice makes it easy! The HealthChoice Benefits app can provide information about your benefits and coverage and access to hundreds of potentially free medical services.

The HealthChoice Benefits app has everything you need in one easy place.

  • HealthChoice Select services with $0 out-of-pocket costs – The app makes it easy to access the dedicated Select provider directory.
  • Deductible and out-of-pocket – The app can help you determine how much you have paid for the year.
  • Talk with a doctor – Access your SwiftMD telemedicine service right from the app to talk with a doctor without leaving your house. Doctors, prescriptions and more are available 24/7.
  • Digital insurance card – No more lost or out-of-date insurance cards. Your most current insurance card is always in the app.

Creating an account takes less than 60 seconds – download the HealthChoice Benefits app today from your app store and see how easy navigating and saving can be!


New year reminder about your pharmacy benefit

On Jan. 1, your pharmacy deductible started over.

Current and pre-Medicare members

  • The HealthChoice High, High Alternative, Basic and Basic Alternative plans have a $100 per person pharmacy deductible or a $300 maximum per family deductible before the standard HealthChoice copay structure applies.
  • High Deductible Health Plan members must meet the combined medical and pharmacy deductible ($1,750 individual/$3,500 family) before the standard HealthChoice copay structure applies.
  • The HealthChoice Preventive Medication List is an expanded list of generic medications that are not subject to the deductible and pay at the normal generic copay level of up to $10 for a 30-day supply and up to $25 for a 90-day supply. These medications are available on all non-Medicare plans that have a pharmacy deductible, which includes the High, High Alternative, Basic and Basic Alternative plans and HDHP. View the list at www.healthchoiceconnect.com. Select Pharmacy Benefits under Member Additional Resources.

Prescription ID cards – new or replacement

  • You can request an ID card by calling CVS Caremark toll-free at 877-720-9375 or TTY 711.
  • You can also print a temporary ID card by registering at www.caremark.com. Select Print My Prescription Benefit Card from the drop-down menu under Understand My Plan & Benefits.

Note: Pharmacy ID cards do not list covered dependents.

Medicare members with Part D

Prescription ID card – new or replacement

  • You can request an ID card by calling HealthChoice SilverScript toll-free at 866-275-5253 or TTY 711.
  • You can also print a temporary ID card by registering at www.caremark.com. Select Print My Prescription Benefit Card from the drop-down menu under Understand My Plan & Benefits.

Note: Each individual ID number begins with the letter G.

High Option

  • The HealthChoice SilverScript High Option Medicare Supplement Plan has a $100 per person pharmacy deductible before the standard HealthChoice SilverScript copay structure applies.

Low Option

Please review your 2020 SilverScript Low Option Evidence of Coverage, which you should have received in the mail. It explains what you pay for your Part D prescription drugs and the four cost-sharing tiers.


How to handle a medical emergency

  • An emergency medical condition is a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) so that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in placing the health of the individual (or, concerning a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part.

The following approach is intended to be a helpful guideline but does not substitute for professional intervention or services:

  1. Is there an immediate threat to life, limb or body function (e.g., chest pain, major laceration, major broken bone, acute poisoning, etc.)?
    • Call 911 or proceed directly to hospital emergency department.
  2. Can you handle the problem with a telephone call or are you unsure what to do?
    • Call your primary care physician; keep the number handy (maybe in your cell phone or on the fridge).
  3. If the response to item two is not prompt or is unsatisfactory, a telemedicine option is available.
    • Commercially available vendors are a phone call away. You now have a telemedicine option through SwiftMD. You must register before needing the service.
  4. If the problem is not immediately threatening but needs face-to-face attention with a health care professional:
    • Go to an urgent care facility. Services should be rapid and reasonably priced.
  5. If the problem requires a health care professional and other options are not available or are unsatisfactory:
    • Go to a hospital emergency department.

Unfortunately, emergencies happen at inconvenient times and places. Be prepared – plan ahead and don’t panic. Most emergencies can be handled without undue added stress.


Durable medical equipment fraud

Be wary of phone calls from companies wanting to give you free medical equipment. This equipment is not free. It may be free to you, but in many instances, the company will bill Medicare and HealthChoice for your “free” equipment. Free medical equipment is a scam that primarily targets seniors. The HealthChoice Medicare supplement plans pay the remaining allowed expenses that Medicare does not pay of approved charges.

How the scam works:

You get a call saying you qualify for a piece of medical equipment, and it’s totally free to you because Medicare will pay for it. The caller may claim to be from Medicare or a durable medical equipment company. They repeatedly call until you give in. They may submit an order to your doctor or they may use another physician involved in the scam. You may say no, but the equipment may just appear on your doorstep and Medicare and HealthChoice receive the bill. Once the equipment is received, it is often difficult to return.

How to protect yourself, HealthChoice and Medicare from DME fraud:

• If you receive an unsolicited call, just hang up.
• Refuse all unsolicited offers and report anyone offering free equipment, supplies or services.
• Carefully review your Medicare Summary Notice and HealthChoice explanation of benefits for any charges for equipment you do not need, did not receive or your physician did not order. Review your HealthChoice EOBs at www.healthchoiceconnect.com.
• Protect your Medicare, Medicaid, HealthChoice and Social Security cards by keeping them in a safe place at home. Only get them out when you visit a healthcare provider.
• Report DME fraud to the Medicare fraud hotline at toll-free 800-633-4227 (800-MEDICARE) and to HealthChoice at toll-free 866-381-3815 or email egid.antifraud@omes.ok.gov.


Non-Medicare members, get your flu shot covered under the pharmacy benefit

The Centers for Disease Control and Prevention recommends everyone over the age of 6 months get their flu shot yearly. The HealthChoice High, High Alternative, Basic and Basic Alternative and HDHP plans cover the flu shot at no cost to the members when using a HealthChoice network provider or network pharmacy. The flu shot can help protect women during and after pregnancy and reduce the risk of flu associated hospitalizations along with being extremely important for people with chronic conditions.