How to Use Your Health Insurance
These tips and resources will help you get the most from your BCBSWY plan. You can find all the details about your insurance coverage in the Benefit Document.
Your plan includes preventive care benefits that may include screenings, well-patient care and immunizations. Typically, when you receive those services through a network provider, you won't have to pay any out of pocket costs.
Depending on your age, you might have access to:
- Free blood pressure, diabetes and cholesterol tests
- Mammograms, colonoscopies, pap smears and other cancer screenings
- Flu and pneumonia shots
- Well-child visits from newborn to age 21
Ask your physician to write prescriptions permitting substitution of a generic drug, if available. Taking generic drugs is one of the most important things you can do to control costs. Not only do generics save you money at the pharmacy (sometimes more than 90%), but they help hold down your insurance premiums long-term as well.
If a brand is required, physicians are encouraged to consider medications listed in the Preferred Drug List (PDL). The PDL, or Formulary, represents recommendations of our Pharmacy and Therapeutics (P&T) Committee. The P&T Committee includes practicing physicians and pharmacists dedicated to identifying high-quality, cost-effective drug therapy. All medications are reviewed and selected after consideration of safety, effectiveness, uniqueness and cost. The Preferred Drug List is updated quarterly and can be located at: bcbswy.com/pharmacy/. Then click "Preferred Drug List (Formulary)".
Use a doctor who has a participation agreement with BCBSWY. You'll pay less for the service and it helps keep insurance premiums down. Staying in network shouldn't be difficult. BCBSWY has the largest network in Wyoming; more than 90% of the state's providers participate with BCBSWY.
Check with your tax preparer about tax deductions for healthcare expenses that might apply to you.
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Consume healthcare as thoughtfully as you would any other large purchase.
- Be aware of the true cost of medical care
- Respectfully question tests and procedures-ask what they are for, what you'll learn or if there is an alternative; get a second opinion when appropriate
Most of us don't really know the true cost of the care we receive. That's because we do not directly pay the full bill, but rather just our portion (copayment, deductible, coinsurance), which is usually just a percentage of the actual cost. Consequently, we're sometimes not as careful about how the money is spent.
A Blue Plan member recently reported buying a wheelchair and told us the store listed two prices: $2,000 if paying out of pocket; $4,000 if going through insurance.
Marking up an item simply because insurance will pay is fraud and it needs to be addressed. Everybody pays the price through increased premiums. We need to work together to stop it, so please report any suspicious activity to Member Services at 800-442-2376.
The U.S. Healthcare Benchmarks, Trends and Observations report says if Americans could cut out healthcare fraud and abuse, we would save the U.S. healthcare system between $100 billion and $175 billion.1
1 Source: Robert Kelley, Vice President, Healthcare Analytics, Thomson Reuters, 'Where Can $700 Billion in Waste Be Cut Annually From the U.S. Healthcare.
Learn more about healthcare costs and savings at the Blue Cross and Blue Shield Association site.
If you have an Individual or Family plan, a change in your life could make a difference to the healthcare coverage you have and may change your eligibility for cost assistance from the federal government. A life event can include gaining a new dependent as a result of getting married or having a baby, or it can mean losing other health coverage due to divorce or death of a spouse. Your benefit document provides specific details about what is considered a life event. If you have a life changing event, be sure to contact your sales representative for assistance. If you have healthcare coverage through your work, be sure to contact your employer with information about your life changing event.