HOW TO USE YOUR MEDICAL PLAN

HOW TO USE YOUR MEDICAL PLAN

With just a little bit of effort, you can get the care that’s right for you and keep your costs down.

  • Use Free Telehealth: Feeling sick and think you might need a prescription? All of the medical plan options come with telehealth available 24/7 – Texas Health Aetna Anytime-MD or UHC Virtual Visits. Before choosing care that may cost you more, consider if telehealth will meet your needs.
    • Note: If you have a regular office visit with your physician and they provide an option to conduct the visit virtually, your normal costs still applyThis is different from the Telehealth options described above.  
  • Get care in the comfort of your own home: If you’re in an eligible zip code, get urgent care in the convenience of your own home. DispatchHealth is available 8 a.m. to 10 p.m., 365 days a year and costs the same as an urgent care visit. Connect with DispatchHealth by calling 214-377-1791, visiting their website, or downloading the app.
  • Take advantage of Be Healthy programs: The best way to lower your medical costs is to take great care of yourself. Whether you want to improve your diet, lose weight, become more active, or manage a chronic condition, there’s a Be Healthy program that can help.
  • Check if prior authorization is needed: Some procedures and surgeries require prior authorization, which means your carrier has to approve coverage before you get the service. Check with your medical carrier before you schedule any procedure.
  • Ask Your Medical Carrier: Anytime your doctor requests additional procedures or services outside of your doctor’s office, call your medical carrier before you get the service to verify how much the plan will pay. Most of the time, your doctor’s office doesn’t know which services are covered under your plan.
  • Choose in-network doctors and facilities. Under all medical options only in-network doctors and facilities are covered.
    • If you’re enrolled in Texas Health Aetna, to see a list of network doctors and hospitals:
      1. Visit texashealthaetna.com
      2. Select “Click here to find a doctor” under the Find a Doctor section
      3. Enter your home location (zip, city, county, or state) and click “Search”
      4. Under Select a Plan, choose “Employer Plan — Open Access EPO Plus” as your plan and click “Continue”
    • If you’re enrolled in UnitedHealthcare, to see a list of network doctors and hospitals:
      1. Visit WhyUHC.com/thr
      2. Click Health Plans
      3. Select a plan option 
  • Getting Lab Work: if your doctor requires you to get lab work done, the labs that are in network are Lab Corp and Quest Labs. Getting lab work done elsewhere will mean higher costs for you.
    • NOTE: For any plan option, if you choose to use the Lab option to get your Wellness Credit Screening, you will go to Quest Lab ONLY. Find out more about that here.
  • Check your hospital bill. When you go to a hospital for a procedure (such as surgery or childbirth), you may receive services from hospital-based physicians that you are not aware you have received. For example, if you have an MRI, you typically will not meet the radiologist who interprets the results. For most patients with insurance, charges are often considered out-of-network for services provided by radiologists, anesthesiologists, pathologists and emergency physicians. Under all medical plan options, when you use an in-network hospital, Texas Health saves you money by covering hospital-based physician services as in-network. Because most plans do not offer this same advantage, these claims are often processed incorrectly. When you receive your explanation of benefits from your medical carrier, you should carefully check your hospital charges to be sure you are not being charged out-of-network rates for these services. If you believe your bill is inaccurate, call your carrier (Texas Health Aetna or UHC) and ask for a review of the claim.