¨ Make sure your insurance ID card is in your possession at all times. This does include running to the beach in only a bikini, or going for an early morning run around the block in only shorts and tee-shirt. Find a place and keep it with you at all times. It will also serve as ID, but more importantly, will make receiving medical care much easier should you need to be taken to the emergency room quickly for some reason.
¨ ….And speaking of the emergency room, it is the most expensive place to receive medical treatment. If you have a true medical emergency, by all means get to the emergency room as quickly as possible. However, if this is not a life threatening medical emergency, you may find it more economical to contact your physician first to determine where he wants you to go for the care that you require. Emergency room visits which do not result in an overnight hospital stay now impose a $50 State mandated co-pay.
¨ If you do end up in the hospital or in the emergency room, check your insurance ID card to see if it is necessary to call an 800 #, notifying your insurance company that you are in a hospital. Failure to do so can reduce drastically the insurance payment and can cost you unnecessary money out of your pocket. As we preach continually in this column, knowing how your benefits work can save you time, aggravation, and money!
¨ For those of you vacationing abroad this summer, depending on your destination, you may need certain immunizations. Your insurance may or may not pay for these immunizations. Medicare will not pay because Medicare does not cover routine services and an immunization is considered routine.
¨ Keep in mind you may need to get advanced refills on prescriptions if you will be away for any length of time. Many insurance companies will not cover prescriptions refilled before a certain date. Therefore, you may need to jump through a few hoops and prove you will be away from home to have the rx’s advanced. Do not wait until you are en route to the airport to do this.
¨ If you are covered by the traditional Medicare program and remain within the fifty United States, Medicare will cover any bonafide claim that you have. The claim must be submitted, by the provider, to the Medicare carrier for the state in which you received the medical care.
¨ If you are covered by the traditional Medicare plan and leave the United States, Medicare does not pay for any medical service rendered outside of the country, regardless of the reason. Medicare is only good in the United States. Hopefully, you have other health insurance besides Medicare. Check with them to see if they cover any foreign travel. If you have a Medicare supplement that is identified with the alphabet letters C through J, you do have foreign travel emergency coverage. There is a $250 deductible and then your expenses are paid at 80 percent up to a lifetime maximum of $50,000. Note that this is just for emergencies – illness or injury while you are abroad. If you are going to a foreign country for medical care, it will not be covered. For example, some people may wish to try a cancer treatment in Mexico or in Europe and travel there regularly for such care, because the care is not available in the United States. This will not be covered by your Medicare supplemental insurance.
¨ Check with your HMO if you leave the immediate area. Find out just what it will cover in the event you become ill. Most HMO’s cover medical emergencies no matter where you are. Find out also what happens if you become ill, but it is not an emergency.
¨ If you give birth this summer, remember to add the baby to your health insurance plan. It will be necessary to complete an application within thirty days of birth. Your insurance agent or Employee Benefits Department can help you with this.
Best wishes from all of us at MIC Insurance Services for a happy, healthy, relaxed summer!
If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, or visit our web site at www.micinsurance.com.
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