Taking steps to lower your medical costs not only keeps money in your own wallet, but also keeps the Fund’s costs down—which benefits you in the long run. As noted before, the PPO plan is self-funded, which means the Fund pays the claims, not Anthem or Zenith American Solutions. So when claims are high, the Fund’s costs go up. If costs run too high, the Fund may have to raise the monthly contributions you pay and/or increase how much you pay for medical services.
Take Advantage of Free Preventive Care
We encourage all members to get preventive care services. Early detection is often key to treatment of many diseases and conditions that cause serious illness or even death. Spending a relatively small amount of time now can save you a lot of time, money, and discomfort in the future.
Both the PPO and HMO plans cover preventive care for you and your family at no charge to you, as long as you see in-network providers. This includes services such as physical exams, certain immunizations, and preventive screenings and services based on your age and risk factors—such as a flu shot, colonoscopy, PSA test for men, or mammogram or pap smear for women. For a list of covered preventive care services, visit anthem.com for the PPO plan or myhpnonline.com for the HMO plan.
Manage Your Weight
If you’re overweight, you may be at higher risk for health problems such as heart disease, stroke, high blood pressure, diabetes, and more. These problems not only affect your quality of life, but can lead to higher medical expenses for you and the Fund. Take advantage of your plan’s health and wellness resources to improve your eating habits and become more physically active.
Talk with Your Doctor
According to the Department of Health and Human Services, the most important thing you can do to get the best care at the lowest cost is to have honest, open conversations with your doctor. For example, when your doctor recommends a test, procedure or prescription, ask:
- Do I really need this?
- Do I need it now or can I wait?
- What are my alternatives?
- How much does it cost?
Use Your Resources
- If you have problems or questions about your coverage, visit the Zenith American Solutions website at zenith-american.com or call 702-734-8601. The Fund also has a Nurse Advocate who can help further with medical or prescription questions, hospital visits, transition care, and pregnancy questions. You can contact the Nurse Advocate through Zenith American’s customer service line.
- If you’re in the PPO plan, visit Health and Wellness Resources at anthem.com for a variety of healthy tools and programs. If you’re in the HMO plan, visit myhpnonline.com for health education resources and wellness classes.