FEHB Member Guide 2019 FEDERAL EMPLOYEES— YOU SERVE US, LET US SERVE YOU. TABLE OF CONTENTS 3 Why SelectHealth® 4 We Can Help 7 Wellness Resources 9 SelectHealth MedSM 10 Preventive Care 12 SelectHealth Prescriptions® 13 My Health 14 HDHP Option Benefits 15 Standard Option Benefits 16 High Option Benefits 18 Participating Hospitals 19 InstacareSM and KidscareSM 20 2019 Rate Information Why SelectHealth Our mission is Helping People Live the Healthiest Lives Possible®. For more than 30 years, we’ve been committed to helping members like you stay healthy, offering personalized service, and providing access to high-quality care. Our mission is the foundation of everything we do. Get to know us a little better. WE'RE LOCAL. We live, work, and play in the same communities you do. When you call us, you’re talking to someone who lives in your community—or the one next to yours. We use the same providers and clinics you do. Isn’t it nice to know that the person picking up the phone is a neighbor? WE WORK CLOSELY WITH INTERMOUNTAIN HEALTHCARE®. Our integration with Intermountain gives you access to your favorite doctors and facilities and offers more seamless service from SelectHealth. We're working together to help you live a healthy life. OUR SERVICE IS SUPERIOR. We can answer your toughest questions and help you find the right doctor, clinic, or mental health provider for your needs. We can even schedule an appointment—no referral necessary. When you call us, a real person will pick up the phone in 20 seconds or less. WE'RE PUTTING YOU IN CHARGE. We want you to have the resources to be your own health advocate. Our Medical Cost Estimator can help you plan ahead by telling you how much a service or procedure will cost. And My Health arms you with information about your benefits, year-to-date totals, claims, lab results, appointments, and more. This is a brief description of the features of the SelectHealth® FEHB Plan. Before making a final decision, please read the Plan's Federal brochure (RI-73-865). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees and family members who become Members of the SelectHealth Plan. selecthealth.org/fehb 3 We Can Help Health insurance doesn’t have to be complicated. We can help you with everything from understanding your benefits to finding the right doctor. Our customer service teams are dedicated to providing exceptional service. MEMBER SERVICES We want to help you understand your insurance plan— when you have a question, give us a call. We also realize that life doesn’t always happen between nine and five, so we’re here late. 7 a.m. to 8 p.m., weekdays 9 a.m. to 2 p.m., Saturdays 844-345-FEHB MEMBER ADVOCATES MY HEALTH CUSTOMER SERVICES We can help you find the right doctor for your needs. We’ll find No time for a call? Log in to the closest facility or doctor with the My Health and chat with us or request nearest available appointment, a call back at a time that’s more schedule appointments for you, convenient for you. and help you understand and maximize your benefits. selecthealth.org 800-515-2220 4 selecthealth.org/fehb YOUR FEHB ID CARD You will receive a SelectHealth MedSM ID card that includes your member number, copay information, deductible, prescription drug rates, contact information, and much more. You may be required to show this card at your doctor's office to receive care. For this reason, we recommend carrying this card with you at all times to ensure you get the care you need, when you need it. Your SelectHealth FEHB plan gives you access to the SelectHealth Med network in Utah, and MultiPlan or PHCS networks for emergency or urgent care services while outside of Utah. *Your costs may differ from the sample card image. In-Network Medical Benefits Pharmacy Benefits Medical Deductible: $2000 Formulary: RxSelect BIN: 800008 Preventive Care: 0% Primary Care: $25* Tier 1: $10* MED NETWORK ID: 800000000 Specialty Care: $40* Tier 2: 25%* Connect CareSM: $10* Tier 3: 50%* Urgent Care Clinic: $40* Tier 4: 20%* Emergency Room: $350* Jonathan Doe Tier 5: 20%* *After Medical Deductible SUBSCRIBER Urgent or emergency care outside of Utah: Member Services: 800-538-5038 Find a Doctor: 800-515-2220 Federal P.O. Box 30192, Salt Lake City UT 84130-0192 Employee selecthealth.org Refer to the front of your ID card for your Refer to the back of your ID card for SelectHealth SelectHealth member ID number, copay, deductible, contact information and your FEHB networks. and prescription costs.* INTERMOUNTAIN CONNECT CARE® Healthcare on your schedule—no Connect Care is now lines, no waiting room. Connect only $10 for SelectHealth Care is a convenient way to talk to a provider about urgent medical FEHB Members! issues, no appointment necessary. Only $10 for SelectHealth FEHB Members!* Download the app or visit intermountainconnectcare.org to get started. *Those on a high deductible health plan may pay up to $49 until deductible is met. selecthealth.org/fehb 5 Wellness Resources 6 selecthealth.org/fehb Wellness Resources We want you to live well, so we provide several resources to supplement plan benefits. From discounts to disease management, the SelectHealth Wellness program is designed to help you maintain and enjoy a healthy, happy lifestyle. CARE MANAGEMENT The process is simple—no enrollment forms, fees, or payroll deductions—just great savings when you mention Our registered nurse care managers offer one-time or that you are a SelectHealth member and show your ID ongoing one-on-one support and help coordinate your card. To learn more, visit selecthealth.org/discounts. care. We provide educational materials, newsletters, and follow-up phone calls. For more information, TOBACCO CESSATION call Care Management at 800-442-5305. One of the most significant things a person can do to SELECTHEALTH HEALTHY BEGINNINGS® improve overall health is to quit smoking. We offer a free program called Quit for Life® that allows participants Our prenatal care program provides emotional support to progress at their own pace from home. For more and coaching for expectant mothers from a team of information, call 866-784-8454. nurse care managers. In addition to pregnancy and prenatal education materials and other over-the- THE WEIGH TO HEALTH® phone screenings, the program includes high-risk care Finding a balance of fitness and nutrition that works for management when needed. For more information, call your body is important for a lasting weight management Healthy BeginningsSM at 866-442-5052. program. The Intermountain Weigh to Health program is MEMBER DISCOUNTS for overweight adults who want to lose weight, improve their health, and feel better every day. We know that embracing a healthy lifestyle is easier when it costs less. As a SelectHealth member, you have access to discounts on everyday products and services that aren't generally covered by your plan, including: > Acupuncture > Health clubs > Massage therapy > Hearing aids > LASIK vision surgery selecthealth.org/fehb 7 SelectHealth Med New Layton Hospital 8 selecthealth.org/fehb SelectHealth Med SelectHealth Med covers all of Utah's Intermountain Healthcare® hospitals, facilities, and physicians, in PRIMARY CARE PROVIDERS addition to thousands of contracted doctors. This A Primary Care Provider (PCP) sees patients for network also covers specialty care facilities like Primary common medical problems, performs routine Children’s Hospital and Huntsman Cancer Hospital for exams, and helps prevent or treat illness. You can cancer treatment. Plus, new in 2019 is the brand new trust a PCP to know your health history, be your Intermountain Layton Hospital. partner in preventive care, and help you find other doctors when you need them. Your Complete Care includes specialists, a free nurse line, online telehealth access through Connect Care, and INTERMOUNTAIN CONNECT CARE® pharmacies nationwide. Visit a provider 24/7 via live online video. Many plans cover this service for only $10, and you’ll Wondering whether your current doctor or neighborhood never pay more than $49 for the visit. clinic is part of the SelectHealth Med network? To find out, visit selecthealth.org/providers. Remember to filter INTERMOUNTAIN INSTACARE® your results by choosing SelectHealth Med from the What’s open late and costs less than the ER? network drop-down menu. Our InstaCare℠ and KidsCare℠ clinics. If you need urgent care, these are great options. HOSPITALS PCP Intermountain hospitals span the state of Utah, offering a variety of care and services. Think Health Connect heart care, cancer treatment, transplant services, Answers Care women and newborns, and much more—you name it, they can treat it. YOUR SPECIALISTS When you need more than your PCP, our Emergency InstaCare Care COMPLETE network of specialists and surgeons can help— CARE and there are thousands to choose from. LOCAL CLINICS Intermountain community clinics and contracted Local Hospitals Clinics clinics are in your area, so you never have to drive far to get the care you need. Plus, some Specialists clinics have extended hours! EMERGENCY CARE If you have an emergency, call 911 or go to the nearest hospital—we’ve got you covered anywhere you are. INTERMOUNTAIN HEALTH ANSWERS® Our free nurse line is available 24/7 to ease your mind. Call 844-501-6600 about any condition. selecthealth.org/fehb 9 Preventive Care LITTLE OR NO COST TO YOU Our plans cover preventive care 100%—that means no copay, deductible, or coinsurance. For services to be covered as preventive, your doctor must bill claims with preventive codes.