How To Choose A MCHCP Medical Plan Benefit Basics Webinar

Benefit Basics Webinar
Series
How To Choose A
MCHCP Medical Plan
For Non-Medicare Retirees
Online
www.mchcp.org
Phone
800-487-0771
573-751-0771
Address
832 Weathered Rock Court
Jefferson City, MO 65101
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–MCHCP Member Services
 800-487-0771
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Today’s Presenter
Lisa Campbell
Communication Specialist
Missouri Consolidated
Health Care Plan
www.mchcp.org
800-487-0771
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Agenda
Things to Consider
Calculations
Informed Enrollment Tool
Open Enrollment
Things to Consider
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Things to Consider
Medical Claims
- Past
- Future
Prescriptions
- Generic
- Brand
- Non-Formulary
- Health Savings Account
(HSA)
- Spouse
- Children
Incentives
Available Funds
- Personal
Dependents Enrolled
Plan Premiums
- Tobacco Free
- Partnership
- Disease Management
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Medical Claims
Preventive:
100% covered
Major Services:
Well Child
Hospitalization
Well Woman
Surgery
Immunizations
Radiology
Cancer Screenings
Routine Services:
Office Visits
Labs
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Medical Claims
Procedure
Total #
You
Child
Total
Outpatient
Surgery
1
$350
$0
$350
Office Visits
6
$240
$80
$320
Radiology
6
$125
$50
$175
Preventive
2
$0
$0
$0
Chiropractor
10
$400
$0
$400
Therapy
5
$200
$0
$200
List anticipated services for upcoming year
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Medical Claims
Log in to myMCHCP
Select UMR or Coventry logo
Claims
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Medical Claims
Select individual
whose claims
you want to
view
The individual’s information will appear at the top of the
screen
Select claim that you would like to
view to determine what the billed
amount, allowed amount, and what
you paid.
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Prescriptions
Prescription
Tier
Network
Discounted Rate
Co-Pay
Amoxicillin
Generic
$18.21
$8
*Sertraline
Generic
$1,290.64
$8
*Montelukast
Generic
$25.66
$8
Assumptions:
All costs are based on generic alternative.
All prescriptions are for 30 day supply at retail.
*Generic alternatives for Zoloft and Singulair.
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Prescriptions
Log in to myMCHCP
Select Express Scripts logo
Manage Prescriptions
Price a Medication
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Prescriptions
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Prescriptions
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Prescriptions
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Prescriptions
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Dependents Enrolled
Who will be covered on your plan?
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Available Funds
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Available Funds
Contributions
Subscriber Only
Subscriber + Dependent(s)
MCHCP
$300
$600
Employee has option to add personal funds
pre-tax to HSA.
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Premiums
*Partnership Premium for Employee Only Coverage
PPO 300
PPO 600
• $70 month*
• $840 year
• $41 month*
• $492 year
HDHP
• $0 month*
• $0 year
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Annual Premiums
PPO 300
PPO 600
$840
HDHP
$492
$0
$492
difference
$792 with
HSA
contribution
$348
difference
$840 difference
$1140 with HSA
contribution
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Incentives
Disease Management Rx
Reduced Copayment
$55 vs $100
$110 vs $200
$137.50 vs $300
Partnership
$25 subscriber only
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Calculations
Service
Allowed
Amount
PPO 300
PPO 600
HDHP
Annual Physical $0
$0
$0
$0
*Office Visit
-Sinus
$100
$25
$100
$100
Generic
Antibiotic
$12
$8
$8
$12
**Annual
Premium
----
$840
$492
$0
State HSA
Contributions
----
-----
-----
($300)
Total Member
Cost
----
$873
$600
$+188
*Office visit is with primary care physician with no lab work.
**Member earns incentives.
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Calculations
Service
Allowed
Amount
PPO 300
PPO 600
HDHP
$0
$0
$0
$0
*Office Visit
-Sinus
-Influenza
-Psychiatrist
$100
$150
$125
$25
$25 + $50 = $75
$40
$100
$150
$125
$100
$150
$125
Prescriptions
-2 Generic
-Brand Name
$12 + 10 = $22
$40
$16
$35
$16
$35
$22
$40
$150
$20 x 3 = $60
$150
$150
**Annual
Premium
----
$840
$492
$0
State HSA
Contributions
----
-----
-----
($300)
Annual Physical
Chiropractor x 3
Total Member
---$1,091
$1,068
$587 - $300 =
Cost
$287
*Office visit is with primary care physician with one lab work.
**Member earns incentives.
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Informed Enrollment Tool
myMCHCP
Informed
Enrollment
Adjust utilization
Medical and
Pharmacy
Claims loaded
Adjust
dependents
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Open Enrollment
Plan Options
Premiums
Incentives
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Contact Information
MCHCP
800-487-0771
www.mchcp.org
myMCHCP
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Eligibility/Enrollment
Premiums
Change of address
Name change
General benefit questions
Other Contact
UMR 888-200-1167
www.umr.com
Coventry 855-234-6191
www.chckansas.com
ESI 866-544-6963
www.express-scripts.com
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Benefits
Claims
Providers
ID Cards
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