farm bureau wellmark health insurance

8/16/2019 Farm Bureau Wellmark Health Insurance

1/16

E D U C A T t

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F A R M B U R E A U

I N D I V I D U L

A N D F A M I L Y P L A N S


2/16


3/16

GET THE EST OF OTH

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)ellmar #ealt Plan o* $oa, $nc.

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*aml

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costs. ecomin+ a membero* te $oa

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accessto insuranceserviceo/tions, alon

it discounts on entertainment and

travel. Findout ooucan arnesste

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4/16

D E C O D I N G T H E ! A R G O N

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9 eductible - 'e amount ou oe *or ealt care

s

ervices

tat our /lan covers be*oreour

e a

t /lan be+insto /a.

Some /lansaive te deductible *or certain services, ic

- meansour bene*its ic in immediatel.

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>ut-o*-/ocet maimum 5>P=- 'e mostou /adurin+ a

/olic/eriod5usualla earbe*oreourealt /lan be+insto

/a 100 /ercent o* te alloed amount. 'is doesnt include

our /remium or te cost *or ealt care our ealt /lan

doesnt cover.

9

Personal

doctor-

'e /rovider ou cooseas our /ersonal

*ami /sicianat te t ime ou enroll in our)ellmar

e a

t

/lan.Coosin+a /ersonaldoctor can leadto better e a

t

outcomes because e7senosour *amil istor, oversees

all treatments , mana+escronic conditions, nosour

/rescri/tions, el/sou avea ealt li*estle andassists

it coordinatin+ care.

9

Primar care /rovider 5PCP

-

; t/e o* /rovider tat delivers

/rimar care. PCPs include*amil /ractitioners,+eneral

/ractitioners, internal medicine /ractitioners,

obstetr

cians7

+necolo+ists,/ediatricians,/sicianassistantsand advanced

re+istered nurse/ractitioners.

9

=etallic tiers - ueto te ;**ordable Care;ct 5;C;,te

*ederal +overnment created *our cate+orieso* covera+eor

"metallic tiers." Plansare assi+ned a metallic tier 5 ronBe,

S lver, oldor Platinumbasedon te /ortion o* claims/aid b

te insurer.=etallic tiers mae it easier*or ou to com/are

/lansand, t/icall, te morecovera+ea

/

an o**ers, te more

oull /a

in

/remiums. ;t)ellmar, e ave/lans*or

individuals and *amilies

in

te ronBe,Silverand oldtiers.

9

$n-netor

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;n

in

-netor /rovider

is

oneo asan

a+reementit )ellmar to /rovide services to members*or a

ne+otiatedrate. (s in+ /roviderstat are in -netor meansoull

/a lessout o* our on /ocet *or care, savin+oumone.

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>ut-o*-netor

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;n out

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ana+reementit)ellmarto /rovide servicesto membersat

a ne+otiated rate. $* ou useanout-o*-netor /rovider,

ou

ll

/amoreout-o*-/ocet *or services tan i* ou usedan

in-netor /rovider.@ou maalsobe res/onsible *or /ain+

te di**erence beteen te amount a /rovider car+es *or te

service and te maimum amount tat )ellmarill /a *or

tat /rocedure or service

9

ene*it ear -

;

12-mont /eriod o* bene*its covera+eunder

our ealt /lan. For individual and *amil /lans, tis runs

P=

accumulations. ;mounts ous/end ou

t

-o*-/ocet *or

a//licable covered items and services *rom P=.

9

>/en !nrollment Period 5>!P- 'e>!P

is

te earl time

/erioden ou can maeadustments to our ealt

covera+e*or te net ear.

9 S/ecial !nrollment Period 5S!P- ;n

S!P

is a indoo* time

enoucan a//l *or ealtcovera+eor maea can+eto

our current covera+edueto a Auali*in+ li*e event.?uali*in+

li*e eventsaremaorcan+eslie+ettin+ married, avin+a bab

or losin+covera+etrou+ a moveor ob loss . 'eonlaou

cancan+eour covera+eoutside o* te>!Pis trou+ anS!P.

) # ; ' S ; % # S; :

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5/16

N A R R O " I N G Y O U R O P T I O N S

C 1 0 5 + & 4

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)en looin+at our /lan o/tions, rememberto notonl considerour /otential costs *or toda,but also*uture costs. &emembertat

costsaremore tan ust our montl /remium.>ut-o*-/ocet e/ensescome *rom tin+s liedeductible amounts, co/aments and

coinsurance*or doctor visits, os/ital stas, labor, /rescri/tion dru+s, andemer+encroomvisits.

o )at ind o* netor best *its our needs:)it)ellmar,

ou *eel /rotected noin+ ou can +et te covera+eou need

en and ere ou need it. @oucan coose*rom tree t/es

o* netorsD

9

)ellmar lue PP>S= /lans +iveou te *reedom and

convenience to +et ealt care *rom an /rovidero

/artici/ates it a lueCross lue Sield /lan. ee/

in

mind, coosin+ a netor /roviderill reduceour outH

o*-/ocet costs.

> )ellmar lue #=os=/lanscover care ere in $oa.

100 /ercent o* os/itals and 6 /ercent o* doctors *rom

$oaare in te netor. ont orr - ou can still +et

out-o*-state covera+e

in

emer+enc and accidental

inur situations.

9

)ellmar lue&eardsP>SS= /lans letoucooseoto

useit evertime ou needcare.'eamount ou /aout-o*H

/ocet

is

determined bte tier our /rovider

is

in, andoull

/alessb seein+ lue&eards/roviders. 'e)ellmar

lue &eards

P> S

netor /lans are uniAue to)ellmar

and evenalloouto earn reards*or ealt beavior.

o ;reour /rescri/tions covered at te cost-sare l eve l ouant

to /a:!ver/lancovers/rescri/tion dru+s

a

little di**erentl.

e*orecoosin+

a

/lan, besure to understand te di**erent tiers

o*te lue & !ssentialsEdru+/lan.Fora Auic overvieo* te

tiers, turn to /a+e 10 o* tis +uide.

@ou

canalsoeasilsearc*or

our s/eci*ic /rescri/tion dru+ on)ellmar.com.P

but souldbeconsidereden /icin+

a

ealt/lan.

9 eductibles *or in-netor andout-o*-netor services

are anoter /art o* our total costs.

;

/lanit a i+er

deductible ma saveou mone in montl /remiums, bu

ou ma aveto cover a lar+er /ortion o* o ur ealt care

services be*ore bene*its be+in.

9

>P=salsoa**ect our costs. '/icall,te i+erte >P=

te loerte montl /remium.

o ;reou interested

in

/otentiall savin+moneon our taes

savin+

*or

our retirement:Coosin+a i+-deductible eal

/lanand /uttin+ dollars in a ta-advanta+edealt savin+s

account 5#S;to /a*or Auali*iedmedical e/ensesis one

to ee/our /remiumdon. Plus,te *unds ou /ut into ou

#S;are+enerallta-deductible.

"' / # 4 - * 2 5

9 1 6

( ' '

5 ' % 6 4 ' t * 4 1 6 ) * t * ' : 8 * # t

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@oumabe ealt toda, but at a//ens i* ou ave

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ealt issuetomorro:

)enconsiderin+ a /lan *rom )ellmar, maesureoure com*ortable it o

muc ou maaveto /aout-o*-/ocet *or ealt care costs i* te "at i*"

a//ens. !itera,)ellmars /lans el/ou *eel con*ident noin+ oull beable

to +et te ealt care ou needen and ere ou need it.

?uic 'i/D (sete Auestions on /a+e13 to assessour needs *or toda and tomorro.

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6/16

F A R M B U R E A U E ; C L U S I V E C O P A Y P L A N S

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Plan C om /aris on uide 2 01 6 $


8/16

F A R M B U R E A U E ; C L U S I V E H I G H = D E D U C T I B L E H E A L T H P L A N S

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