Where Will You Go if You Need Urgent Medical Care?
When someone in your family needs medical care now, it can be hard to think straight. Whether you’re worried about a family member or leaving work early with a high fever, you don’t want to frantically search for the nearest in-network urgent care center.
While you can’t predict an illness or injury, you can plan ahead of time so you know where to go when the unexpected happens.
Take some time this week to identify where you can go when you need immediate care. Look for locations near your home, workplace, and other places you frequent, like your gym or church.
Make a list of the locations you find or bookmark them in your maps app—don’t forget to note their operating hours. Next time you or your family needs immediate medical attention, you’ll have a plan in place.
Urgent Care
To make sure these locations are in your medical network, visit your insurance provider’s website. While you can visit out-of-network urgent care centers, you’ll probably end up paying more for your care.
Emergency Room
Only visit the emergency room in the case of a true emergency. If you do have a life- or limb-threatening emergency, your visit will be covered as in-network even if the facility isn’t in your medical network.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
A Guide to Mid-Year Benefit Changes
Navigating your employee benefits can sometimes feel overwhelming, especially when life throws change your way.
Usually, your benefits like health insurance, dental coverage and flexible spending accounts are locked in for the entire plan year once open enrollment ends. However, the IRS allows some exceptions if you (or your dependent) experience a Qualifying Life Event (QLE).
Check out the chart for some examples of QLEs. If you’re not sure whether your life event qualifies, contact Human Resources.
Important Note
If you experience a QLE and want to adjust your coverage, you must notify Human Resources and provide relevant documentation within 30 days.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
Are You Making the Most of Your Health Savings Account?
Health savings accounts (HSAs) are a great tool for helping manage your out-of-pocket healthcare expenses. They offer triple tax benefits—meaning you put your money in tax-free, it gains interest tax-free and you can withdraw it tax-free for qualified medical expenses. Follow the strategies below to make sure you are getting the most out of your HSA account.
Contribute as much as you can.
To boost your savings for future medical expenses, contribute as much as you can up to the HSA contribution limit.
In 2025, the individual limit is $4,300 while the family limit is $8,550. If you’re age 55+, you can contribute an additional $1,000 per year!
Remember, there’s no limit to how much money you can roll over into the next year.
Review your eligible expenses.
You may be surprised by how many items and services you can pay for with your HSA. Eligible expenses may include bathroom scales, massage guns, nebulizers and baby monitors, plus more common items like sunscreen, pregnancy tests and vitamins. Review more eligible expenses at HSAStore.com.
Be sure to keep your receipts.
If you aren’t using an HSA debit card and instead plan on reimbursing yourself for eligible expenses later, make sure you keep your receipts. The IRS may request documentation to prove that these were eligible expenses.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
An Ounce of Prevention Is Worth a Pound of Cure!
Even if you’re feeling healthy now, do your future self a favor by getting a wellness checkup this year. Most medical plans cover certain preventive services—like screenings, tests and immunizations—at no cost to you.*
What is preventive care?
Preventive care includes a variety of healthcare services focused on helping you maintain good health. While regular medical care focuses on treating illness, preventive care aims to keep you from getting sick in the first place.
Why should you get preventive care?
With preventive care, you and your family could catch signs of health issues before they become more serious. Don’t wait until it’s too late—contact your doctor today to discuss your preventive care options.
*Your medical plan may charge a fee if you receive services from an out-of-network provider or if the preventive service is not the primary purpose of your office visit.
These Services May Include
- Annual checkups
- Health screenings
- Lab tests
- Immunizations
- Counseling
Tip
Visit odphp.health.gov/myhealthfinder to find out what tests and screenings are recommended for your age.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
EAPs Are More Than Just Counseling!
Personal problems can affect your life both at home and at work. Whether you’re facing a specific challenge or just want some ideas for improving your work-life balance, remember that you have access to our Employee Assistance Program, or EAP.
EAPs give you and your family access to resources, including professional counselors, at no additional cost. The fact that you used the EAP and any information disclosed will remain completely confidential.
EAPs are more than just counseling! They typically also include access to online resources and articles to help you deal with problems you may be facing, like family relationships, legal assistance, emotional well-being, substance use disorder, and more.
While EAPs are designed for short-term care, you might want to build a long-term relationship with a therapist instead.
To find an in-network mental health provider, visit our insurance provider’s website.
For more information on our EAP, contact Human Resources.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
Is Your Prescription Too Expensive? Ask These Questions!
If you’re prescribed a medication that doesn’t fit your budget, you have options.
Whether you’ve been taking a medication for years or were just prescribed a new one, you may be able to save some money by asking your doctor or pharmacist these questions.
1
Is there a generic equivalent to this medication?
Many medications have a generic equivalent that’s less expensive than the drugs you see advertised on TV, but just as effective.
2
Is there a similar medication that costs less?
Even if there’s no generic equivalent to your medication, you might be able to save money by switching to a similar drug. For example, maybe Medication A isn’t covered by your formulary, but Medication B can have the same effects and is covered by your formulary.
3
Can I have the medication mailed to my house?
If you're on a maintenance medication, you may be able to save time and money by having your medication shipped to your house.
!
What’s a formulary?
A formulary is a list of drugs, both brand-name and generic, covered by your prescription plan. Your plan’s formulary may change as new drugs and research become available.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
Back-to-School Benefits Tips for Parents
Here are some benefit-related tips for parents to keep in mind as your family prepares for the back-to-school season.
1
Schedule annual check-ups and immunizations
Make sure your children are current on their vaccinations, including flu shots and other routine immunizations like measles, mumps, and rubella (MMR) and HPV (for older children). Early scheduling helps avoid last-minute rushes and ensures all health requirements are met.
2
Complete sports physicals and health forms
Many schools require a recent sports physical exam before allowing students to participate in athletics. Check with the school to find out if physical exams are required and whether there are specific forms that need to be filled out by a doctor.
3
Plan for medications and allergies
If your child takes prescription medication for a chronic condition (such as asthma or ADHD), ensure that you have enough for the start of the school year. You might also want to check if your child’s school has policies for administering medications during the day. For children with allergies, make sure that the school has the necessary emergency medications (such as EpiPens) and is aware of any triggers.
4
Review your coverage for mental health resources and support
The start of school can be stressful, so check with your health insurance provider to see what mental health services are available, including counseling or therapy options. If telehealth services are available, that could be an easier option for kids as they adjust to the school year.
5
Access parenting and work-life support through your Employee Assistance Program
Many Employee Assistance Programs (EAP) provide resources to help with parenting, stress management, and work-life balance.
Some EAPs offer short-term counseling services, legal advice, and even assistance with finding childcare, all at no cost to you.
6
Schedule dental and vision care appointments
Routine check-ups for eye health and dental hygiene are essential and can help prevent issues that may interfere with your kids’ learning or daily activities. If your child wears glasses or contacts, consider updating prescriptions before the school year begins.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
How Much Life Insurance Do You Need?
Life insurance isn’t a fun thing to think about, and it may seem like an unnecessary expense. But if you have people who depend on you for financial support, then life insurance is really about protecting them in case something happens to you—your designated beneficiary would collect a financial benefit upon your death.
Even if you already have a life insurance policy in addition to the policy we provide, it’s important to ask yourself:
“Do I have the protection I need to cover all my financial responsibilities?”
Many people decide how much life insurance to purchase based on an income replacement calculation—between 5 and 10 times the amount of your current income. Think about your personal circumstances.
Is yours the sole income in your household? Are there other expenses, such as college tuition, that may arise in the future? Don’t forget to include potential medical and funeral costs. Above everything, you want to be sure your family does not get stuck with bills, debts or expenses that they cannot afford.
If you decide to increase your life insurance, you can do so at the next open enrollment period (restrictions may apply).
Guarantee Issue
A guarantee issue amount is the amount of coverage you can be approved for without completing a health questionnaire—commonly referred to as Evidence of Insurability (EOI). Guarantee issue amounts typically only apply during your initial enrollment period when you’re first hired.
If you want to enroll in the voluntary life plan or increase your coverage after your initial eligibility period, you may be required to complete the EOI.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
What Happens When You Meet Your Deductible?
If you’ve recently met your medical deductible or out-of-pocket maximum, you may be wondering how that affects your benefit coverage.
Check out the information below for a refresher on the differences between deductibles and out-of-pocket maximums and how they might affect your plan.
DEDUCTIBLE VS OUT-OF-POCKET MAXIMUM
Additional considerations:
- If your plan covers out-of-network care, you may have a separate out-of-network deductible and OOPM.
- Some plans have a separate deductible or OOPM for prescriptions.
- If you have family coverage, your deductible and OOPM might be embedded or non-embedded.
- Embedded means that there is an individual amount embedded—or built into—the family amount. All family member expenses combine to meet the full family deductible/OOPM, but each individual only has to meet the individual amount on their own.
- Non-embedded plans only have one family deductible/OOPM level. The full deductible must be met by one or more family members before the plan will pay.
Helpful definitions
Copayments (copays): A flat fee you pay for a covered healthcare service. You will typically pay your copay at the time of service, and then the plan will pay any remaining amount.
Coinsurance: The percentage of the cost you pay for covered services after you meet your deductible.
Network: The doctors, hospitals, and other healthcare providers your insurance company has contracted with to provide services at discounted rates. You will pay less when you use in-network providers. Some plans will not cover the care you get outside of the network.
Premium: Also called contributions or rates, a premium is your share of the cost of maintaining your health insurance coverage. Typically, an employer pays part of the premium, and your contribution is deducted from your paycheck before taxes.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
Be a Benefits Pro! How to Prepare for Open Enrollment
Open enrollment is your annual opportunity to review and change your benefits. You can only change your benefits outside of open enrollment if you experience an IRS-qualified life event, so it’s important to take advantage of open enrollment.
There’s a lot to think about when selecting healthcare benefits, and taking time to consider your medical needs ahead of time can help ensure you choose the best options for you and your family.
Consider the ideas below to help set yourself up for success this open enrollment.
Review your current benefits and elections.
Consult with your spouse or partner about your current benefits, all known medical needs, and any potential changes or requirements when selecting a new plan. If your spouse’s employer offers benefits, compare their benefits with yours so you can choose the best option for your family (restrictions may apply).
Confirm your beneficiaries are current and accurate.
Make a list of your primary care physicians, specialists, mental health professionals and prescriptions.
Calculate your total medical costs for the current year, including copays, coinsurance, deductibles and premiums.
Create a list of all major life changes since last year’s open enrollment, such as major life events (e.g., marriage, birth of a child, death, divorce), health changes (e.g., a new diagnosis, new prescriptions), address changes and income changes.
List all known medical needs for the upcoming year, including elective surgeries, childbirths, blood work and routine preventive care visits.
Consider tax-advantaged accounts. Flexible Spending Accounts and Health Savings Accounts can help save you money on expenses you’re already paying.
Determine whether you or your spouse are eligible for Medicare. If you or your spouse are approaching age 65, consider whether you want to enroll in Medicare. You may have to pay a fee if you decide to enroll in Medicare after your initial eligibility.
This checklist is merely a guideline. It is neither meant to be exhaustive nor meant to be construed as legal advice.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
How to Spot Errors on Your Medical Bill
Do you check your medical bills for errors? It’s easy for billing mistakes to happen, which is one of the reasons it’s crucial to look over your bill thoroughly before paying.
Checking your medical bills is easier than you may think, and it can potentially save you a substantial amount of money in the long run. Consider these tips for spotting errors on your medical bill.
Request an Itemized Bill
The bill you receive in the mail from your doctor is typically just a summary, meaning you won’t be able to see what each charge was for and how much. An itemized bill allows you to see specific medical codes showing what the charges apply to. You can request an itemized bill through your billing office.
Review Your Itemized Bill
Reviewing your itemized bill allows you to confirm each charge you’re paying for is a service you received. While reviewing your itemized bill, you can also look up any medical codes you’re unsure of.
Verify Dates of Service
Ensure all personal information, such as date of birth and insurance information, is correct. Double-check your dates of service. This detail can impact how your insurance coverage assists your payments or how much of your bill counts towards your deductible.
Compare the Explanation of Benefits (EOB) to the Bill
Every bill you receive should come with an EOB summary from your insurance provider. An EOB shows what percentage of each charge on your medical bill was covered by your insurer versus how much you owe. If you notice a mistake or have questions about your EOB, reach out to your provider.
Check for Upcoding
Upcoding is when there is a charge for a more expensive service than you received. If the charge seems too high or out of the ordinary, mark it as a potential error.
Be Sure There Aren’t Any Canceled Services
Doctor’s offices are busy, and sometimes a service that has been canceled is still accidentally billed to patients. If you see a charge you’re not sure you received a service for, reach out to your provider to confirm.
Call the Billing Office
Billing representatives are there to answer questions you have about your medical bill. Once you’ve reviewed your bill and flagged any issues, it can be beneficial to set aside time to talk with a representative to be sure your bill is accurate.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
Your Year-End Benefits Checklist
1. Check your deductible and out-of-pocket maximum (OOPM).
If you have any upcoming procedures or appointments, you might want to complete them this month so that you get the highest level of coverage before your deductible and OOPM reset on Jan. 1.
2. Refill your prescriptions.
Make sure you have the prescriptions you need, especially if you’re changing insurance companies.
3. Review your contact information.
Make sure HR has up-to-date contact information ahead of W-2 distribution.
4. Have your medical, dental and vision ID cards handy.
Whether you keep your ID cards in your wallet or on the app, make sure you have them easily accessible. If you get a new ID card in the mail, you can dispose of the old one.
5. Make sure your providers are in your network.
Networks can change or be renegotiated, so you should regularly double check that your medical, mental healthcare, dental and vision providers are still in your plan’s network so you can make sure you’re getting the best quality and cost of service.
6. Spend down your FSA balance by Dec. 31.
FSAs are “use it or lose it” accounts, which means you forfeit any unused money in your account at the end of the year*.
7. Submit your FSA receipts for reimbursement.
If you need to submit eligible FSA expenses for reimbursement, do so by the end of the year. Make sure you have receipts and documentation that include the patient’s name, provider’s name, date and type of service, and cost. Tip: Visit FSAstore.com/fsa-eligibility-list to double check if your purchases are eligible for reimbursement.
*If your plan has a grace period or rollover provision, you may have extra time to spend your FSA balance or get to roll over a certain amount into the next year. Visit your FSA website or contact HR to learn more.
This content is for informational purposes only. Contact your physician and/or insurance provider for information specific to you and your benefits.
