MD11Fr8Dog

Uh, you've had it already, for more than a year!

https://pilot.fedex.com/contract/cba/sec27/sec27g.shtml

fdx727pilot

Same here. Came in the mail Friday.

CPDLC

Haven't gotten the benefits letter yet up in ANC but thanks for the reminder that they're in the contract FR8Dog.

groggy

got mine in ANC on saturday (yesterday)

rolling thunder

In the base medical plan will we have to pay full price to see a doctor until we use our deductible? Or will the copay be in use even if we have not met the deductible?

Jetjok

It appears that right out of the gate (the first of the year), if you have an office visit, IN NETWORK, you have a $20 copay. Once you've met the annual deductible limits, then there is no more copay. At least that's how I interpret the Medical Plan Options -- Benefits at a Glance sheet.

groggy

Great question, how best do we find the answer, I cannot find it on pfc.
The assumption I would agree is copay first....but I can't fathom how once the deductible is reached, you are free to see the doc and pay nothing? I would Assume that copays still apply. So what good is the deductible?

Perhaps you pay the doc 100% until deductible is met, then start using copay benefits?

fdx727pilot

From my letter, it looks like simple Dr visits have the copay. Hospital visits or major treatments, you pay at 100% till the deductible is met, then insurance covers 80%. I don't have the letter in front of me, but that was my impression.

KnightFlyer

Just did the enrollment. Fairly easy. Has an annual cost comparison calculator for Base vs Buy Up that you can use based on your dependents and their medical needs. Went with the Buy Up plans for medical and dental for employee and family.

Jetjok

So this is what I found out today, with calls to Anthem Customer Service as well as to my Internist, all relative to the new Medical Plan and its options. I'll only address the Buy Up Plan, because for anyone with a family, that is the plan to take (imho of course.) However, the coverages for the Base Plan and the Buy Up Plan are very similar, with some exceptions.

There are two types of service providers to consider: they are IN NETWORK, and OUT-OF-NETWORK. Each one is a little different, as they cost you more or less, depending on the service and its affiliation with Anthem.

Starting with the Annual Deductible - if you use IN-NETWORK providers, there is NO annual deductible, whereas if you go OUT-OF-NETWORK, then each person in your family has a $250 per calender year deductible, up to a family maximum of $750.

Out-Of-Pocket (OOP) is similar to the Annual Deductible, in that if you use IN-NETWORK providers there is on OOP, while if you go OUT-OF-NETWORK, you have a $3,250 individual expense with a family limit of $9,750.

Co-Payments also take into account whether you're using IN-NETWORK or OUT-OF-NETWORK providers. As an example, let's use Office Visits, because we all understand going to the doctors. While all the other services are similar, with the co-pays differing, depending on type of service, ie, specialist, lab work, etc. If I see my doctor (office visit) and he's an IN-NETWORK provider, I don't have any Annual Deductible requirement, but I do have a co-payment of $20 per visit. If I'm seeing a specialist (oncologist, cardiologist, etc, etc) the co-pay is $40 per visit. Using the same examples, if my providers are OUT-OF-NETWORK, then I do have an Annual Deductible of $250/per person (up the family limit of $750). I also have to pay 30% (note this is 30 percent) of the cost of the visit, not $30, and that is after I've paid my Annual Deductible. So at the beginning of the year I make as an example, 5 visits to the doctor, and he bills me $100 per visit. He's an IN-NETWORK provider so I end up paying a total of $100 for the 5 visits ($20 x 5 visits). If he's an OUT-OF-NETWORK provider I end up paying $250 (Annual Deductible), paid during the first 3 visits, then an additional $75 co-pay (2&1/2 visits at 30% of the $100 fee or $30x2 visits plus $15, which is 30% of $50 for the third visit, after you've met your deductible.

Now for the interesting part. If you have a secondary insurance, like Tri-care for you military pukes, or from your wife's workplace, then they should pick up the vast majority, if not all, of your co-payments. I called my internist today and asked how they dealt with Anthem and a secondary carrier, and they told me that they don't ask for payment from the patient (that would be me or you), because it would just create a horror show when the secondary insurer paid the co-pay, with Anthem already having paid their portion, because the doctors office would then have to write you a check to reimburse you for the co-pay amount (that the secondary insurer paid.)

Anyway, that's what I learned today by reading the Medical Plans Options; talking with Anthem Customer Service; and finally my doctor's office (using them as a representative office for co-payments.)

1. I hope you can understand what I've written, 2. I hope this helps you. And 3. Unless you're single or are about to file for bankruptcy protection, and living paycheck to paycheck, I'd not even think about taking anything less than the Buy Up Plan.

Regards,

JJ