Preventive care

During Flu Season, Prevention is King

Right now, many of our clients are concerned about getting the flu—especially H1N1 (Swine Flu). The answer to the question on most people’s minds is “yes,” the H1N1 vaccine is going to be covered by your insurance in most cases, but it’s still being given out on a priority basis.

We’re glad people are asking about vaccines because preventative care is an extremely important tool in staying healthy and avoiding potentially costly insurance charges related to illness. And most high-deductible plans have excellent preventative care features at no charge or that don’t apply to your annual deductible.

In addition to vaccines, regular wellness visits, covered screening exams, exercise and proper diet are a powerful ways to keep the body strong and to nip health issues in the bud.

We’re also aware that there are a significant number of people out there who are uncomfortable taking vaccinations for various reasons. In those cases, keeping the immune system strong through preventative measures is especially important to staying healthy and avoiding illnesses such as H1N1. Talk to your doctor, nutritionist or acupuncturist about the best ways to keep your immune system at peak performance to stave off seasonal flu and H1N1.

If you’re confused about what’s covered and what’s not, your broker should be a resource in answering your questions and directing you toward covered preventative care. You’re paying the premium costs for your insurance, so we want to make sure you’re getting the most out of that coverage and really leveraging it to support your good health.

When a virus runs rampant such as H1N1, it can be scary. People who need to be in public for work and life get understandably worried that they could be exposed and be the next to get sick. We as brokers hope that through covered preventative measures and good, clear information, our clients can feel more empowered … and more healthy.

Note: Every insurance carrier and every plan operates a little bit differently. As a reminder, always check with your doctor or carrier to confirm covered benefits and what qualifies as in-network services. Out-of-network services may cost more or have different coverage levels.

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Taking Full Advantage of Your High-deductible Plan: Preventive Care

The most frequently talked-about reason for switching to a high-deductible health care plan is the premium savings. But there is also another element to these high-deductible plans that’s highly desirable: rich, useful and comprehensive preventive care benefits.

These services are covered at 100 percent and plan deductibles and HSA dollars don’t apply. So long as you go to an in-network provider and stay within the allowed frequency (some services are annual, etc.), these exceptional benefits are totally free.

Well-baby and well-child preventive care includes vision, hearing and lead exposure screenings as well as a host of free immunizations.

Adult preventive care includes vision, hearing and routine blood and urine screenings. But it also includes “less obvious” free services such as cholesterol and lipid level screenings, blood glucose tests for detecting diabetes, prostate cancer screenings, HIV tests, bone density scans and colonoscopies. There are also breast exams, mammography screenings, pelvic exams, pap tests and contraceptive management for females.

Just always be sure to check in with your doctor first so that you get the coverage to which you’re entitled. Call ahead, give the office your insurance information and ask if the services that interest you are covered in full at that time.

When you schedule a routine office visit, that’s a great opportunity to request additional preventive care services covered under your plan. Just always confirm that those benefits fall under your free preventive care.

Preventive Care Services: What’s In It for Them?

So, why are all of the major carriers offering all these no-charge preventive services with their high-deductible plans? Because they’re counting on these services keeping people healthier and detecting health issues before they become costly catastrophic problems down the road. A healthier America for them translates into fewer insurance claims. A healthier America for you means less time ultimately receiving medical care and a better-conditioned body to live the life you want.

These preventive care services are recommended by everyone from the American Cancer Society to the U.S. Preventive Services Task Force, but people aren’t utilizing these benefits nearly as much as you’d think.

On one hand, that’s because people aren’t used to services of this breadth and scope being truly 100 percent covered. They expect copays and deductibles and other charges to apply, so they stay away unless it’s absolutely medically necessary.

On the other hand, many people simply aren’t aware they’re entitled to these free preventive services with a high-deductible plan or aren’t clear enough about their benefits to feel confident using them.

We picked up a new client the other day that had super-rich preventive benefits as part of their existing plan, but they had no idea so much was covered for free because their last broker didn’t do any reviews with them. They had fantastic insurance but nobody in the group knew how to utilize it or when they could use it.

That’s why the role of the insurance broker is such a critical part of the process. A good broker is a good partner—reviewing or reminding clients about plan benefits and informing employees exactly how to best utilize their plan.

The goal is that hopefully you’re healthy and you don’t need to use you plan services very often, but when something comes up, you need to know what benefits you’re entitled to. It’s the broker’s role to keep people up to speed on how to best take advantage of their insurance.

Whether it’s on a quarterly, semi-annual or annual basis, our role as brokers is to continuously review with groups what benefits they have. That can be a quick highlight summary or a lunch-and-learn refresher meeting. Reeducating groups on little things such as plan usage plays a big role and goes a long way … and you’d be surprised how many people don’t realize or completely forgot what rich benefits are included and free with their insurance plan.

The more the broker can stay in front of people, the easier it is for those individuals to ask questions and find a comfort level. That’s our job as brokers: to be as available and proactive as is necessary to make sure people understand their benefits. And quite frankly, that’s a lost art in this business.

Remember that with employee benefits, the key word is “benefit.” Don’t hesitate to take advantage of what’s included in your plan.

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