2020 NMRHCA SWITCH ENROLLMENT BENEFIT PRESENTATION - January 2020 through December 2020
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2020 NMRHCA SWITCH ENROLLMENT
BENEFIT PRESENTATION
January 2020 through December 2020
2
$ Quick Care for More Low or Better Care Everyday Things No-Cost Services Just in case
Quick Care For Everyday Ailments
Access To Care
Appropriate and Affordable Options for Care
5
MyChart:
Be An Active Part of Your Care Team
Presbyterian Health Plan members have secure online access to their
Presbyterian electronic health records.
With MyChart, members can:
• Send and receive messages with their care team.
• Schedule primary care appointments, confirm
or cancel appointments.
• View lab and test results.
• Request prescription renewals.
• View visit summaries, health summary, care plan,
allergies and immunizations.
• Receive health reminders. No fee for members
to access this service.
• Pay doctor and hospital bills.
6
Video Visits
Video Conference with a Healthcare Provider
“Skype” with a healthcare provider 24 hours a day, 365 days a year.
With Video Visits, members can:
• Schedule a Video Visit on any computer, tablet or smart phone.
• Use at home, work or when travelling.
• Get diagnosis and treatment for common health issues
like earaches, cold/flu symptoms and allergies within 1 hour.
• Receive prescriptions to the pharmacy of your choice.
• Receive a text or email summary of your visit.
• View the details of the Video Visit in MyChart. No fee for members
to access this service.
• Receive a doctor’s note for school or work via email.
7
24/7 Urgent and Emergent
Care - PresNow Quick Care
For Everyday
• Unnecessary Emergency Ailments
Care can be 10x more
expensive than Urgent Care
• Lack of 24-hour options
necessitated ER care after
hours and on weekends
• PresNow 24-hour clinics will
remove barriers to low-cost
care during off-times
• Combination clinics will
remove the guesswork of
utilizing urgent healthcare
8
24/7 Care and Improved Cost Outcomes
1
2
PresNow – 4 Locations 4
• Paseo and San Pedro
• Coors and Western Skies – October
2019
• Rio Bravo and Isleta – Coming Soon
• Uptown – Coming Soon 3
9
The Plan That Works For You 24 Hours A Day
However You Need Us, At No Cost
10Growing Statewide Robust Global Emergency
Network National Network Coverage
Nearly one million national In-network emergency
17,000+ providers in care worldwide
providers and facilities
500 locations
Access to Centers of Reimbursement at the
Includes bordering Excellence facilities. same levels as local
communities in Texas emergency care
and Colorado Great for employees,
dependents living out of state Seek care at the closest
Online directory at phs.org/
Always in-network facility with peace of
directory
mind
Visit
www.multiplan.com/presbyterian
for a full listing of providers.
11Secure Digital Access to Your Information
Service for New Mexicans by New Mexicans Only Local Customer Service Team in NM • In-person, walk-in visits available. • Integrated with the delivery system. • Claims, benefits, billing, and general questions. • Patient financial services. 1-888-ASK-PRES • Member Advocates help members locate a PMG provider or facility or one in our nationwide network, as well as schedule their appointments.
Better Health Outcomes, Just In Case
Better Outcomes Lead to National Recognition
Highest Level 3 Recogni7on
for Central NM PMG Primary Care Clinics Top Scoring ProposalYour 2020
benefits
16Changes for 2020
No longer deductible and coinsurance
Effective January 1, 2020
$35 copay Value Care
$30 copay Premier Option
• Physical Therapy
• Occupational Therapy
• Speech Therapy
17Value HMO Plan
Benefit In-Network Out of Network
Annual
Value HMODeductible $1500/ Individual N/A
Out of Pocket $5500/ Individual N/A
Primary - $35
Office Visit N/A
Specialist - $55
Preventive Care (including 100%
mammograms, pap test, N/A
colonoscopy & immunizations) Deductible does not apply
100%
Lab, X-Ray, and
Deductible does not apply N/A
Pathology
Emergency Room $175 $175
Urgent Care $40 N/A
All other covered
services(including inpatient/
outpatient, rehab and MRI, PET & 30% N/A
CT)Premier PPO Plan
Benefit In-Network Out of Network
Premier PPO
Annual Deductible $800/ Individual $800/ Individual
Out of Pocket $4500/ Individual $4500/ Individual
Primary - $30
Office Visit 50%
Specialist - $45
Preventive Care (including 100%
mammograms, pap test, 50%
colonoscopy & immunizations) Deductible does not apply
Lab, X-Ray, and 100%
50%
Pathology Deductible does not apply
Emergency Room $125 $125
Urgent Care $35 50%
All other covered services
(including inpatient/outpatient, 25% 50%
rehab and MRI, PET & CT)You can also read
