When you have health concerns, you should call your doctor.
But did you know your health insurance company can help you too? Even when you aren’t sick?
Members often call Arkansas Blue Cross and Blue Shield and our affiliates to check on a medical claim or get a new ID card. Did you know our customer service representatives can help you get the most value out of your health plan?
“The way we see it, we exist to help people be as healthy as they can be,” said Erin Maxwell, who leads the customer service team for BlueAdvantage Administrators of Arkansas. “We want to help our members avoid getting sick and to ensure that any health problems they have are caught early. We have programs and services built into our health plans that are designed to do just that. You might not realize what is available to you, but a quick call to our team can direct you to additional benefits and ways we can help.
“If something is going on with your health or a family member’s health, a quick call to find out what services might be available to you or just to give us a ‘heads up’ can help us provide you with the best value from your benefits. Whether it is finding a specialist in your network or connecting you to a nurse case manager, we want to help as early as possible.”
For these reasons and more, we encourage members to contact us (by calling the customer service number on the back of their member ID card) to ensure they are getting the most value from their health plan.
Here are a few situations where a quick call to your health plan could help:
Finding healthcare providers
It’s important to find out before you go to a doctor or hospital whether they are part of your health plan’s network. If you choose a healthcare provider outside your network, it could cost you more out of your pocket. If you want to select a primary care physician who participates in quality-focused initiatives like the Patient-Centered Medical Home (PCMH) program or the Comprehensive Primary Care Plus (CPC+) program, we can also help you find one near you.
Does the medicine your doctor prescribed come in a less-expensive generic form? Does it matter where you get prescriptions filled? Are there supply limits on your medication? Is the medicine eligible for “step therapy?” Do you qualify for financial help for your medicine? We can help answer all of these questions. And those answers could save you big dollars and frustration. Often, the key is asking before that prescription is filled.
Managing a disease/condition
If you struggle with a health condition, you don’t have to manage it alone. Our specially trained nurse case managers are available. They can help with chronic or complex condition management (diabetes, heart disease, asthma, lung disorders, etc.). Our nurses, along with our dedicated social workers, can help you map out a plan. They can teach you about self-care techniques and connect you to helpful support services. But we can’t help unless we know you need help. The first step is to call the customer service number on the back of your card.
Hospital stays/outpatient procedures
A hospital stay or outpatient procedure can lead to a number of healthcare claims. Contacting us beforehand may cut down on confusion about what’s covered and what is your share of the cost. Plus, you may qualify for services like case management. Nurse case managers can help coordinate your care. They can give you tips about what to do before your medical procedure; what to expect during and after your procedure and arrange for home health services; therapies and special equipment to help you have the fastest and fullest recovery possible.
If you’re expecting, our Special Delivery program’s pregnancy-focused nurse case managers are here to help you and your baby have the best pregnancy and delivery journey possible. All Special Delivery moms-to-be receive free educational materials and resources. Moms at a higher risk for complications can have a nurse case manager work with them all the way, monitoring progress and arranging special services when needed. The first step is to contact us and let us know you have a bundle of joy coming.
Wellness visits/health screenings
Your health plan likely covers annual wellness visits or certain health screenings (for conditions like breast cancer, colorectal cancer, diabetes, etc.). If you’re not using the preventive benefits your health plan provides, you could be “leaving money on the table” and opening yourself to the risk that a condition might not be caught early, when it’s easier to treat … or even cure.
If you’re looking to be healthier, call us! Chances are your health plan includes health-and-wellness benefits like discounts on health-and-fitness products. Other benefits include services like smoking-cessation assistance, nutritional counseling, educational resources and tools for healthy living. We can help explain what your health plan offers and get you connected.
Your health plan may include coverage for services related to your behavioral/emotional health. If you need to know what’s covered, we can help.
Your health plan website has a lot of information about the services available to you and how you can access them. But if you still have questions or just want to talk it through with someone, call the customer service number on the back of your member ID card. There’s a friendly voice on the other end who is eager to help.