We’re sure you have a plate full of New Year’s resolutions to tackle, whether they’re fun (like learning to play the kazoo), or health-related (like getting in better shape, eating right, or training for a marathon).
(For the record, my goals for 2015 are to eat breakfast more regularly and start biking to work again. I’ll take encouragement in the comments, thank you very much.)
While getting your body in optimal shape for 2015 should certainly be high on your priority list, so should getting the most value from your health care plan.
When you have health insurance through Highmark, you don’t just get medical coverage — you also get a host of tools and resources. So to kick off 2015 (in between sets of 200 sit-ups and kazoo lessons), get your health care plan in tip-top shape with these tips for Highmark members:
Whether you need non-urgent health advice, want to review medical claims, want to go “paperless” with health plan communications, or need to manage a transaction for your health spending account, your Highmark member site is the place to do it.
Use the URL on the back of your Highmark member ID card to get started. Once at the site, click the “Register” button in the upper right, and refer to our registration instructions if you need them.
Remember that card we mailed you when you first signed up for your health care plan? Get to know it! Your Highmark member ID card contains lots of vital information about your coverage and also is your ticket to helpful, exclusive resources.
You need your member ID card information when you’re at the doctor’s or pharmacy. But it also contains practical information, including how much you can expect to pay for certain services when you’re getting care or picking up a prescription.
In the event that you’ve recently signed up for a Highmark plan but haven’t gotten your plastic card yet, you can access a virtual member ID card on your Highmark member site. You can look up your virtual member ID card on your smartphone and fax your card information online to a provider. Watch a video to learn more about the virtual member ID card.
You can also use your Highmark member site to tell us how you’d like us to communicate with you. Simply navigate to Account Settings once logged in and explore your communication preferences — here, you can make changes such as enabling paperless/electronic communication over postal mail (available for most types of plan information) and setting your contact phone number.
You’ll also be able to update your contact preferences on the Contact Preferences page on the Highmark site. This is where you can change how you receive your EOBs and claim information, insurance plan updates, member newsletters, and more.
Highmark members in PPO or EPO plans have the option to designate a Physician of Record. A Physician of Record is a physician or practice that you rely on for routine health care services like check-ups, immunizations, and screenings. Typically, this will be an internist, pediatrician, general practitioner, family practitioner, or primary care physician (PCP). A Physician of Record may also coordinate your care among specialists and hospitals and helps Highmark to serve you better.
Identifying a Physician of Record is voluntary and does not affect your coverage, claims, or specialist referrals in any way. But having one may help you better reach your health goals, monitor your health over time, and get routine preventive care every year.
You can designate your Physician of Record in one of three ways:
Health insurance, by nature, is a way of getting an automatic discount on your medical care. But as a Highmark member, you can save in many other ways. By logging into your Member site and then clicking Member Discounts under the Wellness Programs box on the right side of the Home page, you can browse different categories of discounts that you have access to.
Whether you’re looking to save on yoga classes, gym memberships, weight-loss programs, pet health insurance, or even your cell phone bill, your Member Discounts section supports both healthy bodies and healthy bank accounts.
Because of the nature of health insurance, there are some things we have to know: Your name, address, date of birth, and so on. However, there’s other information that we ask our members to supply voluntarily, because it help us improve our service and helps improve the health care system at large.
Since 2006, we’ve asked our members to voluntarily designate their race, ethnicity, language preferences, and educational level. Although this might seem irrelevant in the grand scheme of your health care, it’s actually important for us to have. Filling out this information on your member site helps us develop a big picture of our members: The more we know about the demographics of our customers, the better we can help reduce disparities and inequities in the health care system. The Affordable Care Act actually requires institutions to collect this information for this purpose.
By setting these preferences, we can also ensure effective communication with you and other members under your plan. When you fill out this information, it helps our team assess the need for our members’ interpreter services (if necessary), personalize communications with you, and monitor the quality of care you receive. It also helps us understand our members better!
Finally, if you have a family health plan with Highmark, you can use your member site to update the information we have about the people covered under the plan. After navigating to the site, select Account Settings and then Member Profile. From here, you can review and update your information.
“Double coverage” isn’t just a defensive strategy in football. In health care, sometimes a person might be covered by two policies at once. You and your spouse might both be covered under family plans from both of your employers, for instance, or you might retire from one employer, with benefits, and then get another job that provides you with additional benefits. Regardless of the reason, Highmark can help you coordinate benefits across multiple health plans to make sure that your claims are processed and paid correctly, by the appropriate plan.
It can be tempting to delay coordinating until an issue arises, but being proactive will prevent delays in and problems with your claims processing. Take the time to coordinate overlapping benefits by visiting your member site or calling the member service phone number on the back of your member ID card. (Just be sure to have your other plan’s information on hand before you start.)
Online, navigate to Account Settings and then select Other Insurance. From there, you can fill out a series of yes-or-no questions for yourself and each dependent under your plan.
It’s also good to be aware now – before you’re dealing with an illness or accident, when it’s hard for all of us to think clearly — which facilities are in your network for emergency or urgent care. Choosing in-network pharmacies and emergency/urgent care centers helps you to get the care you need at the lowest out-of-pocket cost
In an Affordable Care Act (ACA) health plan, you get access to essential health benefits: Basic health care services and preventive services that all qualified insurance plans must cover to some degree, under Health Care Reform.
Essential Health Benefits include ambulatory services like primary care and specialist visits, access to Emergency Services, pediatric care, prescription drug coverage, mental health services, and more.
You can explore which preventive health services you and your family members should have at which age by accessing the Preventive Schedule PDF related to your plan on the Highmark member site. (Most but not all members will have this schedule.) Go to the Wellness tab, Healthy Living Topics box, Preventive in the pull-down, and then Preventive Schedule. You can brush up on Essential Health Benefits at DiscoverHighmark.com and at HealthCare.gov.
It’s always a good idea to check with Highmark Member Service before you have care to confirm it’s covered and at what, if any, cost to you — even if you think it probably falls in the preventive care category.
If your Highmark health plan includes a health savings account (HSA), flexible spending account (FSA), or health reimbursement account (HRA), you can manage it on the member site via the Spending tab at the top of the home page when you log in.
Plans with spending accounts give you many benefits, including more control over your health care spending, better visibility of health care costs, the ability to plan ahead and save for future medical expenses, and tax savings.
Since having health insurance with a spending account is still a relatively new experience for many people, Highmark has created a range of educational materials to help explain when to choose a health plan with a spending account, and how to get the most out of an HSA, FSA or HRA once you have one.
You may have already received some of these materials through your employer or in the mail. Online, we provide access to detailed, yet easy-to-understand information about all three spending accounts through our Spending Account Resource Center.
Setting yourself up for a more fluid health care experience is a great way to kick off the new year. But like most things in life, it’s all about the follow-through.
Be sure to regularly check in on the Highmark blog for health advice from medical professionals and even more tips on how to get the most out of your coverage. Knowledge is power, especially when it comes to your own health.
Do you have any health-related New Year’s resolutions? Leave yours (along with any questions about the information above) in the comments below!
If you have a member service question that involves personal health or insurance information, do not use the "comments" feature; please call the number on the back of your Member ID card.