New Medical Insurance

Benefit

Becky Goins

UAMS Human Resources

“I wish UAMS gave a cost break to employees for coming here for healthcare.”

It’s here!

Started January 1, 2012

What is UAMS SmartCare?

• Incentive for you to come to a UAMS facility for your healthcare

• New benefit under our medical insurance • Applies to UAMS employees and family covered under

our medical insurance • Reduces what you pay out of pocket after insurance

pays

Come home to UAMS.

facilities include:

UAMS Hospital

UAMS Outpatient Clinics

New UAMS clinic in west Little Rock

AHEC Family Medical Centers

UAMS physicians who bill through UAMS MCPG but are located at Freeway Medical, UAMS CARTI or Baptist Inpatient Rehab (which are not SmartCare facilities)

Ark. Children’s Hospital

Pediatricians not practicing at a UAMS SmartCare facility

CARTI

Baptist Rehab Institute for outpatient therapy

Baptist Psychiatric Facility

Freeway Dialysis Services

VA and NLR VA Hospitals

NW Ark Centers for Children (Lowell)

Does not include:

How well do you understand how our medical insurance

benefits work?

Let’s review so you see how

SmartCare will save you money.

What’s the name of our medical insurance plan?

QualChoice

University of Arkansas Health Plan Remember, we’re self-insured and self-funded.

QualChoice is our third party administrator.

What’s the difference between Classic and Point of Service?

Classic... You must go in-network, similar to an HMO. Only exception are true emergencies (or for medical

services not available in-network and QualChoice has authorized, in advance, for you to go out-of-network)

POS…

Same in-network benefits as Classic. But also have coverage if you go out-of-network (although higher cost sharing).

What does “in-network” mean?

• A doctor, hospital or other health care provider listed in the QualChoice network for U of A Members

• Provider search at www.qualchoice.com (look for providers with “SC” notation)

• “Find a Doc” from www.uamshealth.com

Which LR hospitals are in-network?

UAMS

St. Vincent

Ark. Children’s Hospital

Baptist

Heart Hospital

What do you pay if you go in-network for preventive care?

Annual physical

Well baby/child visits & immunizations through age 18

Flu immunizations

Routine screening mammograms (age 40)

Pap smears

Prostate antigen testing (PSAT)

Colorectal cancer screening (age 50)

Bone density screening (age 65)

Insulin (under QCARE)

Hypertension meds (generic, under QCARE)

Blood pressure monitor (under QCARE)

Kick the Nic (under QCARE)

Rest of your covered medical care falls into two “what I pay” categories

Your share of the cost is a COPAY

and/or

Your share of the cost is subject to annual DEDUCTIBLE and COINSURANCE

What is your cost for in-network doctor office visit?

Your PCP Specialists, other network doctors

$25

$40

$10

$25

Save $15

Copay

What do you pay for outpatient procedure (surgery, MRI) in-network?

Deductible 20% Coinsurance (up to annual max)

$ 750

$2,000

$2,750

$ 250

$1,000

$1,250

Save $1,500

What do you pay for hospital admission?

Inpatient copay

Deductible

20% Coinsurance (up to annual max)

$ 250

$ 750

$2,000 $3,000

$ 150

$ 250

$1,000 $1,400

Save $1,600

What do you pay for maternity?

Deductible

20% Coinsurance (up to annual max)

$ 25 $ 250

$ 750

$2,000 $3,025

$ 10 $ 150

$ 250

$1,000 $1,410

Save up to $1,615

Inpatient copay

1st prenatal office visit

Former $1,000 UAMS OB discount replaced by better savings under SmartCare.

More on Deductible/Coinsurance

UAMS SmartCare ded/coins counts towards other regular in-network ded/coins… and vice versa. One bucket. Amount you have to pay in before insurance starts paying depends on where you’re receiving care at that moment. UAMS SmartCare? Or elsewhere in the network?

It’s easy!

• Nothing to sign up to access SmartCare… as long as you’re enrolled in UA medical plan

• Simply choose to come to UAMS for your care; you’ll automatically pay less out of your pocket.

• You maintain the choice of where you want to go for your care. But now there’s an extra incentive to come home to UAMS.

• Be sure to show your QualChoice card showing you’re in the UAMS group and have SmartCare.

What you should consider…

• If my PCP is not at UAMS, should I switch?

• If I have other coverage, should I/can I switch to UA health plan?

Not until open enrollment is offered. Or may enroll within 30 days of a “qualifying event” such as marriage, birth of child, loss of coverage through spouse due to job loss or divorce.

SmartCare is just for UAMS employees. Not available to UALR, UAF or employees at other UA campuses .

• How much to put in my healthcare FSA?

But wait… there’s more to

Patre Allen UAMS SmartCare Concierge for Employees

(501) 686-8749

My primary role will be to assist and facilitate employee access to care at UAMS. This includes:

Facilitating the coordination of appointments

Facilitating communication between participants and clinic staff/ physicians regarding test results and special needs while maintaining complete confidentiality

Collaborating with clinic management and staff to enhance the patient experience and eliminate barriers to care

How can I facilitate your UAMS SmartCare appointment?

Email your request to: smartcare@uams.edu

(“Smart Care Appointments” under Global)

Please include: • Patient’s Name • Date of Birth • Address and phone number • Insurance Policy Number • Clinic Name • Physician Name

Or call

(501) 686-8749

This is a dedicated number

just for UAMS employees.

More resources

• For more information about SmartCare, visit http://www.uamshealth.com/smartcare. Links to this page are on the UAMS intranet and Human Resources home pages.

• Benefit questions? Contact HR Employee Services. • Ground floor Central Building, across from old ER • 686-5650, AskHR@uams.edu

• Please be aware that the flexibility to move in and out of SmartCare by

selecting your provider and place of service also adds complexity to the billing process. If you receive services at UAMS and your bill does not appear to reflect the SmartCart savings, please contact QualChoice at 219-5133 (toll free 1-888-795-6810).