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Information coming soon to help you prepare to use your 2016 medical benefits

by on December 18, 2015

Employees and pre-65 retirees recently participated in the annual enrollment process for 2016 insurance benefits. In the next several weeks, employees and pre-65 retirees will receive information that is essential to using their new medical plans.

Please review the list below of frequently asked questions as you prepare to use your medical benefits. You can also visit the AEP Health Hub to access detailed information on our plan offerings and a new section, Plug In to Benefit, that will become available January 1.

Q: When can I expect to receive my new insurance and/or healthcare account cards?

A: Medical ID cards are currently being generated by Anthem and will be mailed near the end of December.  Beginning January 1, 2016, you will be able to register as a member at www.Anthem.com , which will provide you with electronic access to your (printable) ID card. Healthcare providers can contact Anthem at any time to verify your 2016 medical benefits coverage.

If you elected a Health Savings Account or Flexible Spending Account with HealthEquity, you can anticipate receiving your welcome kit and debit card(s) prior to January 1.

Be sure to present your new insurance identification when you visit a doctor or pharmacy, so that they can update your insurance information.

Q: My doctor is not within the Anthem network. What are my options?

A: AEP’s partnership with Anthem provides access to one of the largest networks of doctors and hospitals in the country.  Click here to verify that your providers are considered in-network with Anthem.

In case that your doctor does not participate in the Anthem Network, you have a few options to consider:

  • Under certain circumstances, you may qualify for Transition Assistance, which allows members to continue to see a doctor who is out-of-network with Anthem, while only paying in-network charges (for a period of time). Qualification is based on your course of treatment for a serious health condition; however, it can include conditions such as pregnancy, cancer, behavioral health, terminal illness, etc.  Completion of a Continuation of Care form is required and can be obtained by contacting Anthem at 877-585-9572.
  • The AEP medical plans provide for access to out-of-network providers. If you choose to see an out-of-network doctor, the charges associated with your visit and your financial responsibility for those charges will be higher than if you access a doctor within the Anthem network. See the detailed benefit plan descriptions for coverage information regarding out-of-network doctors.
  • You can nominate your doctor for participation in the Anthem network by contacting Anthem at 877-585-9572. Anthem will contact your doctor to discuss the possibility of joining the Anthem network.  This process may take between weeks or months, and there is no guarantee that your doctor will become an in-network provider.

NOTE: Individuals currently seeking behavioral services should confirm your doctor’s network status with Magellan beginning Jan. 1, 2016. If your current doctor does not participate in Magellan’s network, you can receive a Transition Benefit, which enables you to receive in-network coverage for your current doctor for up to 90 days. This will enable you to transition to an in-network doctor. To check on your doctor’s network status and to register your current care for the Transition Benefit, contact Magellan at 877-705-4357.

Q: I currently have an Aetna medical plan and have been speaking with a Health Advocate/Coach to help me manage my health condition. How can I go about finding someone similar with Anthem?

A: If you currently interact with a Health Advocate associated with Aetna, you have the opportunity to continue support with an Anthem Registered Nurse. That nurse may provide support with the management of a chronic condition or assistance with understanding what to expect if you spend time in the hospital. In January, Anthem will be reaching out to all employees who currently interact with a Health Advocate to explain the support available to you. Additionally, you may reach out to Anthem any time after January 1 and ask to be connected to a Registered Nurse.

Q: How do I get access to the Health Navigator that I heard about during the benefit meetings?

A: Health Navigator is an online tool that lets you track your medical spending, and helps you shop for medical services, prescriptions, and providers in your network. Health Navigator is provided free of charge to all employees, their spouses/domestic partners, and adult dependents enrolled in a company medical plan and will be available beginning January 2016. Pre-register today at MyCastlight.com.

From → Benefits

One Comment
  1. whitimot6 permalink

    Rebeccawhite1952@gmail.com

    Sent via the Samsung GALAXY S® 5, an AT&T 4G LTE smartphone

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