Flu Shots, do they really work?

Log into myuhc.com  Benefit Awareness News | September 2017 Do flu shots really work? Yes! Here’s how What to do next Don’t wait. Get your flu shot from a network provider as soon as it’s available. Here’s how to find a flu shot near you. Be sure to bring your health plan ID card with you. And tell your provider the flu shot is covered under your medical benefits, not your pharmacy benefits. Also in this edition Do flu shots really work? Yes! Here’s how Did your child catch something at school? Try a Virtual Visit Is your hospital safe? Discover a healthier you with Rally® Is it a cold or the flu? Colds and the flu have some similar symptoms. So it isn’t always easy to know which one you have. With a Virtual Visit, you can see a doctor from the comfort of your home or on the go. Connect with a doctor from your mobile device or computer 24/7. *Check your benefit plan to see what services may be covered. Benefit Awareness News sends articles based on topics of general interest to our readers. They are not targeted to individual members, nor are they individually customized. We do not have access to members’ personal health information. Therefore, we cannot send articles to members based on that information. Sources: Centers for Disease Control and Prevention; U.S. Food and Drug Administration © 2017 United HealthCare Services, Inc. 9700 Health Care Lane, Minnetonka, MN 55343 USA. Privacy policy

Open Enrollment

It’s your choice: Take advantage of open enrollment

*REPOST* Brought to you by UHC:

https://www.uhc.com/newsletters/september-2016/take-advantage-of-open-enrollment?srcName=smf-ban

If your employer offers health benefits, you may start hearing soon that it’s time for open enrollment. This is the time of year when you can make choices about your coverage for the next year. Open enrollment is sometimes called annual enrollment or benefits enrollment.

Before you know it, it will be time to choose your coverage. So take a moment to review these tips and tools that may help you prepare.

Seven questions to ask

Your employer may offer one health plan or multiple options for health coverage. When deciding what’s right for you and your family, keep these questions in mind:

1. Is my doctor in the network?

If you have doctors or specialists you like, be sure they’re in the network of the plan you choose. Why? Your costs are usually lower when you use a network doctor.

Visit myuhc.com® to find out if your doctor is in the plan’s network. You can also find a doctor with theUnitedHealthcare Health4Me® mobile app.

2. Is my medicine covered?

Most plans have a list that shows which prescription medicines are covered. It’s called a formulary or Prescription Drug List (PDL).

To see which medicines are on your plan’s list, go to myuhc.com — and click on “Pharmacies & Prescriptions.”

3. Who else needs to be on my plan?

Some plans offer coverage for your spouse, partner or children. These are your dependents. If the plan offers dependent coverage, children under age 26 without their own health coverage can be on your plan.

4. What type of health coverage is right for me?

You may be offered a choice between a “traditional” copay health plan and a high-deductible health plan. With a traditional copay plan, your monthly premium will be higher — and you will pay a fixed copay amount, such as $25, for each doctor visit. With a high-deductible plan, your monthly premium may be lower. But you may have a higher share of out-of-pocket costs.

How do you decide what’s right for you? Think about what health care services you and each family member might need in the coming year. For example:

• Are there medications you take routinely?
• Are you planning to have surgery?
• Do you see a doctor regularly for a health condition?
• Are you planning to have a baby?

5. What other costs should I plan for?

In addition to the premium and deductible, you may also have copays or coinsurance. To learn more about the difference, see this infographic.

Then try this worksheet to help you plan for your potential costs.

6. Will I have access to an HSA, HRA or FSA?

Check with your employer to see if a health savings account (HSA), health reimbursement account (HRA) or flexible spending account (FSA) is available to you.

These are all ways to use tax-free money to help pay for medical expenses. But there are differences. Learn more in this infographic.

7. What other benefits does my employer offer?

Carefully read the information your employer sends you. Some health plans include incentives for healthy living. And your employer may offer dental, vision or disability benefits too.

What to do next

Start planning for your health care costs in the coming year:

• Fill out this helpful health costs worksheet.
• Watch for emails from your employer about open enrollment dates.
• Take time to consider your options — so you can choose a plan that’s right for you.

© 2016 United HealthCare Services, Inc.

2016 || Part D Donut Hole

Medicare Coverage & Costs | Tue, Apr 26, 2016 @ 09:00 AM

The Medicare Part D Donut Hole: Going…Going…Not Quite Gone

Posted by Medicare Made Clear

The prescription drug donut hole is a gap in Medicare Part D’s prescription drug coverage.

Once you and your Medicare Part D plan have spent a certain amount on covered prescription drugs during a calendar year ($3,310 in 2016), you reach the coverage gap. You are now in the Part D donut hole.

You pay a larger percentage of your prescription drug costs while you’re in the donut hole until another dollar limit ($7,062.50 in 2016) is reached. Then Medicare Part D coverage kicks in again.

Closing the Part D Donut Hole

The good news is the donut hole isn’t as big as it used to be. When Medicare Part D launched in 2006, Medicare beneficiaries had to pay 100% of their prescription drug costs during this gap in coverage. With the passage of the Affordable Care Act, that percentage started to drop.

In 2016, you pay 45% of the cost of brand-name prescription drugs and 58% for generics while in the donut hole. These percentages are scheduled to decrease every year, bottoming out at 25% for both brand-name and generic drugs in 2020.

This will effectively close the donut hole, putting costs on par with what you pay between the time you meet your deductible (if you have one) and when you hit your out-of-pocket spending limit.

Getting Into and Out Of the Donut Hole

It’s important to note that it’s not just your share of your prescription drug costs that get you into and out of the donut hole. The amount your plan pays also counts towards the first milestone that puts you into the donut hole.

Drug companies may help pay your way, too. They provide a 50% discount on brand-name drugs purchased while in the donut hole.

The drug company discount counts toward the second dollar limit, the one that marks the end of your passage through the coverage gap. For generic drugs, only the amount you pay out-of-pocket applies to your spending limit.

Conclusion

This will all get simpler in 2020 when the donut hole closes. Until then, following these tips may help you climb out of it more quickly – or keep you from falling into it in the first place:

• Stick with your plan’s formulary whenever possible. Only medications on the formulary, or for which you get an approved exception from the plan, count toward your spending limit.
• Make sure to get your drugs from a network pharmacy. Prescriptions you fill outside your network pharmacy don’t apply to your spending limit.
• Opt for generics if your doctor thinks they’re appropriate. The lower costs for generics may be enough to keep you from slipping into the donut hole.