My Account: Sign in Register Home Shop Plans & Services Already a Member? For Brokers For Providers News & Tips About Making the Most of Your Benefits January 1, 2020 Healthcare can be confusing — and costly. Here are some ways you can make the most of your health insurance benefits. Master these points to stay healthy and save on your healthcare costs! Stay In-Network Your benefits will be paid at a lower rate if the doctor or other healthcare provider is not in your network. Make sure all doctors and other experts involved in your care are in your specific network. This means specialists (such as anesthesiologists), medical equipment and lab or X-ray testing. Out-of-network care will cost you more. Using a QualChoice National Network (QCNN) provider for emergency services when traveling will help limit your out-of-pocket costs. For a list of QCNN healthcare providers, call the toll-free number on your ID card. If your health issue is not an emergency, care at an ER will not be covered. Get Pre-authorization, if Needed To be covered, some services require pre-authorization. Find out ahead of time if the services you need require a pre-auth. Your claim could be denied if pre-authorization was needed and you didn’t get it before you received care. Services Needing Pre-authorization See Your PCP Instead of a Specialist See your Primary Care Physician (PCP) first for most medical needs. Because he or she knows you and your health history, you’ll get personalized advice. Together, you can make the right decisions for you. Why do you need a PCP? Know What’s Covered in an Office Visit Certain routine treatments are covered under the office visit copayment. But other more complex ones may be applied to your deductible (the amount you must pay before your insurance company starts to pay your claims) or coinsurance (your share of the cost of the service, such as 20%). Always check your official plan documents for the cost sharing amount for specific services. Ask for Generic Drugs Ask your doctor if a less expensive generic form of a prescription drug will work as well as a name brand for you. Your cost share will be lower with a generic. Use Your Preventive Care Benefits Routine preventive care like screenings, check-ups and counseling to prevent sickness, disease or other health problems are covered by most plans at no cost to you. Use these benefits for age-appropriate annual pap tests, mammograms, health exams, flu shots and more. Check your plan for details. At your yearly wellness exam, make sure any tests done are included in the U.S. Preventive Services Task Force A and B Recommendations. Download a list of screenings covered under the QualChoice preventive care benefit. Tags: Using Your Benefits, Save on Healthcare Costs Categories: Members | Employers Categories Brokers Employers General Members Providers Recent posts Preventing Flu Nov 9, 2021 08:24 Children Can Outgrow Weight Problems— With Some Healthy Changes Sep 21, 2021 11:04 Know Your Family’s Health History Jun 22, 2021 10:10 Protecting Dad's Health Jun 15, 2021 06:12 Best If Used By: Spring Cleaning Your Fridge May 25, 2021 10:38 View By Topic Affordable Care Act (ACA) - (3) Announcements - (34) Benefit Reminder - (7) COVID-19 - (9) CPC Plus - (8) Diabetes - (4) Group Plans - (6) Health IQ Challenge - (4) Health Tips - (105) Heart Health - (1) Immunization - (7) Improving Healthcare - (13) Individual Plans - (4) Maternity - (2) Medical Coverage Policy - (3) Medicare - (1) My Account - (11) News Release - (2) Open Enrollment - (4) Opioids - (1) PCMH - (7) Pharmacy and Drug Coverage - (4) Pre-authorization - (12) Prevention - (20) QCARE - (32) QualChoice in the Community - (1) QuicRewards - (6) Save on Healthcare Costs - (13) Security - (1) Stopping Tobacco and Nicotine Use - (14) Using Your Benefits - (13) Video - (35) QualChoice is committed to giving great customer service! Legal Notices Privacy Terms of Use Medicare Part D Notice Member Rights Your Right to Appeal Non-discrimination & Language Help About QualChoice About Us Contact Us Copyright © 2021 QualChoice. All rights reserved. | Site Map