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SPECIALIZING IN HEALTH INSURANCE BENEFITS FALL 2007
Getting the Mo$t From Your In$urance Think Pink! Will You Be Flu-Free This Season? How Does Your Health Plan Rate Open Enrollment Reminder We use this space to focus on ways to help you use your health insurance for maximum benefit at minimum cost. Don’t wait until you need your coverage to learn how it works. That could leave you with thousands of dollars in medical bills.
One of the most important things you can do is – Play By The Rules! All insurance carriers have specific rules and requirements. For example – you might go to the hospital for an operation that is covered by your insurance, but you don’t realize that one of the attending doctors is NOT part of your health plan. That could leave you on the financial hook for more than you expected.
Here are some key words and questions to keep in mind:
Pre-authorization – do you need it and does your doctor have it in hand?
Referrals – do you have to get it from your primary-care doctor? Even after that, do any treatments require pre-authorization?
Limitations – both benefits and payments have limitations and if so, what are they?
Deadlines – know what the specific time frame you have to dispute a denial of a claim or the amount of an insurance payment. Otherwise you could lose an appeal just by missing a deadline.
Deductibles – understand how much your deductible is, and what it applies to. For example – a preventative checkup may be covered even if you have not met your deductible. But a subsequent treatment the doctor prescribes during that checkup may not be.
R. Kashmiry and Associates, Inc. is always ready to help you get the most from your health insurance.
Health Insurance BenefitsR. Kashmiry & Associates is a certified broker for Anthem Blue Cross and Blue Shield in handling the Medicare Advantage and Blue MedicareRx plans.
We believe all employers and employees ought to be able to get the same quality health care benefits and affordable rates available to big companies. R. Kashmiry & Associates, Inc. has the tools to do it. We've designed a framework of strength, flexibility and affordability that offers a real health care solution for small and large businesses.
We are a complete employee benefit design company located in Boardman, Ohio. In addition to working with various state associations, we provide service to over 1,000 out of state clients.
If you have questions or comments, drop us an email, info@rkashmiry.com,
or phone, 800. 860.6295.Visit our website at www.rkashmiry.com
Welcome!
R. Kashmiry and Associates, Inc. is always keeping our clients’ needs in mind. To that end, we recently updated our website www.rkashmiry.com to make it more accessible and easier to use. Under Member Services – there is a quick link to www.anthem.com where you can download helpful tools to better manage your healthcare plan or find a provider covered under your plan. And those are just two of the options there. Administrative Forms is another handy category for Employer/Employee Applications, Change Forms, and Prescription Drug Card Enrollment – to name only a few options. The top line index will easily guide you.R. Kashmiry and Associates, Inc has more exciting, money-saving changes coming soon. The first is the “new” “HBA/BIA of Ohio Healthcare Alliance”. We will be e-mailing you a complete explanation of the “Alliance” within the next few weeks. Also coming up – our “new” “Blue Access® Hospital Surgical” plan with savings up to 70% off a full range PPO plan. Both could be big assets to your bottom line.
Think Pink!
October is Breast Cancer Awareness Month! Here are some quick facts: 1 out of every 8 women will get breast cancer during her lifetime. And 80% of women diagnosed with breast cancer will survive more than 10 years.
The key is early detection and treatment. Mammograms are an important weapon in this battle. Anthem covers them with a co-pay. Medical Mutual of Ohio pays 80% of mammograms after meeting your deductible on Individual Plans. Under Medical Mutual Group Plans, one routine mammogram per benefit period is 100% covered if done in a physicians’ office or at an independent lab.
If you have any questions, please call R. Kashmiry and Associates at 1.877.860.6295. Don’t let coverage uncertainty be an excuse to not getting what could be a life-saving mammogram!
How Does Your Health Plan Rate?
R. Kashmiry and Associates, Inc. is proud of its long-standing relationships with its select list of Insurance Providers. But how do they rate in comparison with others on a national basis? The September 2007 issue of Consumer Reports provides the results of an exhaustive survey of 37, 000 of its readers.In short – Anthem Blue Cross/Blue Shield of Ohio rated an overall 75 points out of 100 – with a score of 80 meaning enrollees were very satisfied on average with their coverage. Consumer Reports advised that differences of less than six points are “not meaningful”. The ratings of two of our other select providers were a 76 for Medical Mutual of Ohio and a 74 for United Healthcare. So all three are within the “very satisfied” range. Other survey questions ranged from billing to choice of, care from, and access to doctors. On those, Anthem was straight down the middle on a scale ranging from “better” to “worse”. Medical Mutual of Ohio and United Healthcare ranked slightly lower on the question of billing problems.
Thanks!
We hope we offered a few helpful tidbits today. Our goal is to say what we mean -- and mean what we say.If you have questions or comments, drop us an email, info@rkashmiry.com, or phone, 877.860.6295. Please feel free to forward this eNewsletter to anyone who might find it useful.
Remember, it's all
"Just For The Health Of It!"
