- Nov
- 2
- 2018
Know how to save when utilizing your Northwell benefit plans
It’s that time of year again—when you and your loved ones have the opportunity to enroll in Northwell Health’s benefit plans. 2019 benefits open enrollment will be live on mySelfService Monday, November 26 through Friday, December 7, with valuable offerings including medical and prescription, dental, vision, as well as Healthcare and Dependent Care Flexible Spending Accounts. You’ll also have access to disability and life insurance options.
Whichever benefit plan you chose to enroll in consider the potential savings if you utilize in-system health care providers, facilities and services. In-system refers to providers and facilities that are within the Northwell Health’s Clinical Integration Independent Physician Association (CIIPA, or IPA for short). The association consists of approximately 8,000+ employed and community-based physicians throughout New York, who have agreed to take the Northwell employee benefit plans and to deliver quality care to all our plan participants.
Considering the following when utilizing your Northwell benefit plans:
Preventive care: Use in-system services and providers and you will have 100% coverage for preventive care services, such as annual exams and immunizations. Using in-UHC or out-of-network services will cost you a deductible and coinsurance as of January 1, 2019 (scroll to the bottom for further explanation).
Specialty care: Use in-system orthopedic and cardiac services and you will pay the low copay of $40. Using in-UHC or out-of-network services will cost you a deductible and coinsurance as of July 1, 2018 when going outside the CIIPA network for your orthopedic and/or cardiac care.
Urgent care: Use one of our four in-system urgent care centers and your copay will only be $20: GoHealth, ProHEALTH, PM Pediatrics and CareMount Urgent Care. Using other centers outside our system will cost you $60 per visit. A trip to the emergency room is $200.
Maternity care: Use in-system and your maternity care will be 100% covered.
Lab work, diagnostics, and physical, speech, occupational therapy: Use in-system, like the Northwell Core Labs and Rehabilitation Services, and you will be 100% covered.
Wellness Credit Program: Complete four healthy actions in 2019 and you’ll receive the maximum amount of credit in 2020 paycheck credits ($1,040). Read More
Dental: Cigna offers two plans that provide access to affordable and quality dental care. Stay in the Cigna Advantage network and you will pay the least out-of-pocket for your care.
To further clarify:
What is a copay? A copay is your defined cost for a medical service. When enrolled in either one of the UnitedHealthcare plans – your copay for an in-system urgent care visit will be only $20, a compared to a $60 copay for in-network or out-of-network.
What is a deductible? A deductible is a set amount of money the plan requires you to spend out-of-pocket before you can be reimbursed for in-network and out-of-network medical care. This means, you are responsible for paying a deductible if you do not use in-system physicians or other clinical providers, or if you use non-system facilities. Remember: If you stay in-system and in the CIIPA network, you avoid paying any out-of-pocket expenses other than a copay.
What is in-UHC network? In-UHC network means the physician, hospital or facility is in the UnitedHealthcare national network.
We hope these tips from Northwell Health will help you save on your health care needs in the future!
This information excludes union-represented employees, as well as non-union per-diems and part-time employees scheduled to work less hours than 50% full-time. Northwell’s retirement plans excludes employees from Peconic Bay, Northern Westchester and Phelps.
An In-System provider should inform the patient prior to or when his/her lab work needs to be sent out to a “non-in-system” lab like Lab Corp. This would avoid a surprise bill to the patient who is assuming that the lab work would be sent to the In-System Northwell Lab.
Twila – I absolutely agree with you, but this does not always happen. If you have questions about who and what is in-system, visit Northwell.edu/insystem.