Empire Plan enrollees should obtain a booklet called “On the Road with the Empire Plan,” which you can download a copy from the state Department of Civil Service Web site at
www.cs.state.ny.us. Click on “Employee Benefits” and then “Publications & Forms.”
Going on vacation? How well does your health plan travel?
By LORRAINE SIMPKINS
Summer is traditionally the time when most of us take that much-needed vacation. But when you’re planning a trip, don’t overlook the health care needs of you and your family.
Here are some things to consider:
Q: Can you take your benefits with you?
A: HMOs provide benefits for emergency and authorized urgent care worldwide.
Empire Plan enrollees should obtain a booklet called “On the Road with the Empire Plan,” which is available from your health benefits administrator (HBA), who is usually located in the Personnel Office. You can also download a copy from the state Department of Civil Service Web site at
www.cs.state.ny.us. Click on “Employee Benefits” and then “Publications & Forms.” This booklet tells enrollees what they need to know about their health insurance while travelling outside New York state. It’s also useful for enrollees with dependent students who are going to college away from home.
Empire Plan enrollees should verify that their ID cards have a YLS prefix in the lower right corner. Older cards don’t have the YLS prefix. If you travel out of state, a provider may not recognize the card or know where to send bills. You could be billed erroneously for thousands of dollars. If you need a new ID card contact your agency
HBA.
Q: What if I need urgent or emergency care while I’m away from home?
A: Health plans distinguish between emergency and non-emergency, but urgent care. Be sure you know what your plan considers an emergency. A hospital emergency room can be an expensive place to go for non-emergencies. Less costly alternatives include a physician’s office and urgent care facilities.
Empire Plan enrollees can call NurseLine at 1-877-7NYSHIP at any time, any day for health information and advice.
Q: Could I have to pay a big bill for urgent or emergency medical care?
A: Your out-of-pocket expenses, may differ depending on the type of provider and whether or not the provider has an agreement with your health plan to accept the plan’s payment as payment in full. Call your health plan for more information.
Q: Will I be able to find a health provider that participates in my health plan?
A: Empire Plan enrollees have access to participating providers in several states besides New York. To locate a participating provider, call United HealthCare at 1-877-7NYSHIP or go online to
www.cs.state.ny.us and select “Employee Benefits” to link to the Directory of Empire Plan par providers.
To locate a participating pharmacy, call Express Scripts at 1-877-7NYSHIP.
Some HMOs have agreements with other HMOs to allow their enrollees access to each other’s network of providers. Ask your HMO if it has such an agreement with an HMO in the area where you will be on vacation.
Q: What procedures and notification requirements should I follow if a family member or I need medical care while on vacation?
A: Empire Plan enrollees must call Empire Blue Cross at 1-877-7NYSHIP within 48 hours after an emergency or urgent hospital admission. You do not have to call when you are traveling out of the country. Check with your HMO for its procedures and notice requirements in these situations.
Q: Should I check with my doctor before I go on vacation?
A: It’s usually not necessary if you are in good health and only going on a short trip. However, you should call or see your doctor before leaving if you:
• Are going out of the country for an extended period of time;
• Were recently hospitalized for a serious condition or had major surgery;
• Have a chronic medical condition or are taking prescription medicine; or
• Have a minor ailment such as a sore throat or earache.
You also should consider having a dental checkup before leaving if you are going out of the country or will be gone for an extended period of time.
Q: What else might I need to do before I leave?
A: Make sure you have enough prescribed medication to last until you return. Travelers are encouraged to take twice the normal supply needed, carrying half on their person and half in their luggage, to protect against loss or theft.
Consider if the climate or altitude could aggravate an existing medical condition. Do any of your medications increase your sensitivity to the sun?
Will the food meet any special dietary needs you have?
If you’re traveling abroad, you may want to avoid salad, ice, rare meat and raw shellfish. Carry bottled water and/or water-purification products if traveling to an area with questionable water quality. And you may need special immunizations. Be sure to allow yourself enough time to receive all of the immunizations needed and to allow effective immunity to develop.
Q: Is there anything special I should take with me?
A: If you have a serious medical condition, you may need to take medical information about it with you. Be sure to take your health plan’s identification card(s) and telephone numbers, your doctor’s name and phone number, your medication, as well as prescriptions for any additional medication you may need and a first aid kit.
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The
Communicator July/August 04
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