FEHB Enrollment Guide 2021 WE’RE in THIS TOGETHER
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FEHB Enrollment Guide 2021 WE’RE IN THIS TOGETHER. You are at the heart of everything we do. We listen to you and we adapt. Our goal is to provide plans and benefits that work for you and your needs. But it’s not just about providing health plans, we want to help you live a healthy life—the healthiest life possible. It’s our Welcome to SelectHealth. mission and it drives everything from our customer service to our business decisions. In addition to providing the highest quality of care, our focus is A good health plan should be just that—a plan for living centered on providing you the best overall experience. healthier and getting the care you need, where and when We are your trusted partner. This is about YOU. you need it. Use this guide to help you choose the right FEEL THE DIFFERENCE. plan and explore popular benefits like wellness rewards We strive to support you, help you stay healthy, and get and virtual doctor visits. the right benefits for your needs. Plus, who has time for hassles? Insurance doesn’t have to be a pain. We want to save you time and money, all while getting you the care you need, the way you want it. Get a feel for the SelectHealth difference with perks and benefits like: VIRTUAL VIDEO VISITS > Get quality care whenever and wherever you need it with Intermountain Connect Care®—all for $0 out-of-pocket costs per visit. WELLNESS REWARDS > Receive up to a combined total of either $75 per person or $200 per family for completion of qualified wellness events. Contact Member Services at 844-345-FEHB or visit selecthealth.org/fehb for more information. MEDICAL CARE AND INSURANCE IN SYNC > Intermountain Healthcare® and SelectHealth® form one integrated system to ensure you get quality care at the best price. 844-345-FEHB (toll-free) selecthealth.org/fehb Call us weekdays, from 7:00 a.m. to 8:00 p.m. and Saturday, from 9:00 a.m. to 2:00 p.m. 2 | SELECTHEALTH.ORG SELECTHEALTH.ORG | 3 Health Insurance Definitions Your Network SELECTHEALTH MED® We understand health insurance terms can be confusing. We’ll define some commonly used terms that help explain how your health coverage works. SelectHealth Med covers all of Utah’s Intermountain Healthcare hospitals, facilities, and physicians, in addition to thousands of contracted doctors. This Deductible Virtual Doctor Visit network also covers specialty care facilities like Virtual visits allow you to have face-to-face Amount you must pay to doctors and facilities Primary Children’s Hospital and Huntsman Cancer consultations with your provider from home on before your plan pays for covered services. Hospital for cancer treatment. your smart phone, tablet, or computer. Out-of-pocket maximum (OOP) Out-of-Area Dependent Coverage The total amount you may pay for services Health Savings Account (HSA) Dependent children who live outside the service area covered by your plan each year. Things like Think of an HSA as a savings account for will receive in-network benefits for covered services deductibles, coinsurance, and copays may healthcare expenses. If you enroll on a high when they use SelectHealth Med providers in Utah and apply to your out-of-pocket maximum. deductible health plan, you can pair it with an HSA. You can use money in an HSA to pay for preferred network providers outside of Utah. Members Coinsurance medical services—these are called qualified must fill out a Dependent Address Change form if a A percentage of the cost of a covered service medical expenses and are defined by the IRS. dependent lives outside the service area. that you pay after you’ve met your deductible. Some examples of qualified medical expenses National and Worldwide Coverage for Emergency For example, you pay 20%, the plan pays 80%. include doctor’s visits, copays, dental care, and and Urgent Care To schedule an appointment, call 800-832-7733 Copay prescriptions. The tax-free funds in an HSA can Going out of town? No worries! If you get sick or from 8:00 a.m. to 5:00 p.m. (MST). For non-urgent A fixed amount you pay the doctor, pharmacy, be saved from year to year, but only the amount injured while out of state or country, you are covered! questions, send an email to [email protected]. or facility for covered services. For example, that has been contributed so far will be available. Telehealth you might pay $20 for an office visit with your HSA Premium Passthrough BENEFITTING YOU Virtual visits are no additional cost to members for primary care doctor. If you have a high deductible health plan, your Employee Assistance Program (EAP) these covered services: Network health insurance plan will contribute a portion of A network is the combination of doctors and your monthly premium to your HSA or credit a EAP services are available to all SelectHealth FEHB plan > Non-urgent care with participating primary care facilities contracted with us to give you care for specific amount to your Health Reimbursement enrollees. The EAP program provides free counseling for physicians and specialists the best price. When you see a doctor or go to a (HRA) account. issues such as interpersonal conflicts, depression, anxiety, > Urgent care visits using Intermountain facility that is out-of-network, the price for care and other life stressors. The program also includes: Connect Care® will likely be higher and you are responsible to > Elder Care Support – Information, resources, and Note: Deductible does not apply to telehealth services pay the bill. coaching for employees who provide care to a in 2021. spouse or relative who is ill, disabled, or needs Pre-deductible Coverage help with basic activities of daily living. The service provides support for the emotional issues The deductible is waived for the following services: of caregiving and can help identify medical, legal, > Retinopathy screening and Hemoglobin A1c and financial resources that may be available. testing for diabetes > Crisis Response Services – 24/7 crisis services with > Peak flow meter for asthma a licensed mental health professional is available by > International Normalized Ration (INR) testing for calling 800-832-7733. liver disease and/or bleeding disorders > Website – Visit intermountainhealthcare.org/eap > Low-density Lipoprotein (LDL) testing for to sign up for bi-monthly e-tips on living well; heart disease find resources on problem solving, parenting skills, and more; and find office locations and > Certain prescription drugs staff biographies. 4 | SELECTHEALTH.ORG SELECTHEALTH.ORG | 5 In-Network Hospitals In-Network Clinics Salt Lake Area YOU’VE GOT ACCESS! Alta View Hospital As a SelectHealth FEHB member, it’s important to stay in your network. That means, you can go to any Huntsman Cancer Hospital provider that is part of our integrated clinic partner, Intermountain Healthcare, as well as emergency and Intermountain Medical Center urgent care services across the world. Our affiliation with a vast number of providers and clinics across our service areas aims to ensure you are getting the best possible care without having to go far. Logan Regional Hospital LDS Hospital Primary Children’s Hospital Bear River Valley Hospital Going the distance for you, so you don’t have to means we also contract with many additional key Riverton Hospital providers, such as: TOSH®—The Orthopedic Specialty Hospital McKay-Dee Hospital Davis Hospital & Med. Center Layton Hospital Park City Hospital Mountain West Med. Center Ashley Valley Med. Center Heber Valley Hospital American Fork Hospital Orem Community Hospital Uintah Basin Med. Center Utah Valley Hospital Central Valley Med. Center MCH Sanpete Valley Hospital Our members’ most-used services are available through Intermountain Healthcare and our contracted Castleview Hospital affiliate providers. Delta Community Hospital Remember: It’s always a good idea to check the participating status of a healthcare provider before Gunnison Valley Hospital getting care. Fillmore Community Hospital To verify whether a provider is participating on your plan, visit selecthealth.org/findadoctor or call our Member AdvocatesSM line at 800-515-2220 (TTY: 711). Sevier Valley Hospital Milford Valley Memorial Hospital Moab Regional Hospital Beaver Valley Hospital San Juan Hospital Garfield Memorial Hospital Blue Mountain Hospital Cedar City Hospital Dixie Regional Med. Center (400 E. & River Rd. Campuses) Kane County Hospital 6 | SELECTHEALTH.ORG SELECTHEALTH.ORG | 7 YOUR REGULAR WHEN YOU NEED WHEN YOU NEED Our Network. SCHEDULED CARE HELP NOW EXTRA SPECIAL CARE Scheduled care keeps you in tip-top shape There are other options for care when you For times when you need more than just Your Care. and can help detect and correct and issues have questions or you’re feeling under your regular doctor or more timely care, we that come up. Here are a few resources for the weather at times when your PCP isn’t have a broad network of facilities for any regular care. available. Choosing the right care can save kind of treatment you seek. you time and money. PRIMARY CARE PROVIDERS HOSPITALS A Primary Care Provider (PCP) sees patients for INTERMOUNTAIN HEALTH ANSWERS® Intermountain Healthcare hospitals span the state of common medical problems, performs routine exams, Utah, offering a variety of care and services. Think Our nurse line is available 24/7 for any medical questions and helps prevent or treat illness. You can trust a PCP heart care, cancer treatment, transplant services, or concerns you have. Call 844-501-6600 to get help to know your health history, be your partner in women and newborns, and much more—you name it, and talk to a registered nurse for free. preventive care, and help you find other doctors when they can treat it.