Here in New York, the cold weather is finally upon us. You may be planning a trip somewhere warm to escape, or if you’re someone who moves south for the winter, you are probably already settled in to your warmer climate. Hopefully you have taken care of all of the items associated with being away from home, but in case you are still ironing out your health care needs, we put together some helpful tips to assist you. Using your health care away from home requires some research and planning.
Where to Buy Your Insurance Plan If You Have Another Residence
You should buy coverage in the state where you officially reside. New York considers you a resident if you intend to make it your permanent home. If you’re a so-called snowbird, you may own a second home and/or live part of the year in another state, but your official state of residence is where you spend most of the year. (It’s also where you pay taxes, register your cars, and are registered to vote.)
Know Your Network
Here’s a very important question – will you be able to find doctors while traveling that are in-network? The answer is yes, but in order to do so, you’ll want to make sure you are looking at a health insurance plan that has a national provider network, so you’re able to find a doctor year-round – no matter where you are. Of course, you could also look at plans that offer out-of-network coverage, and determine whether that level of coverage would be sufficient.
If your plan has a regional or limited network plan, you may face restrictions when trying to seek routine medical care while you’re out of state.
Most CDPHP® commercial plans include a national network with more than 725,000 providers across the U.S. to choose from. If you’re a CDPHP member, there’s a handy tool for accessing a list of providers in our national network. Simply use Find-A-Doc, or download My CDPHP Mobile on your smartphone. In addition, if your plan has a national network, your member ID card should indicate that, and it means that you have more in-network providers to choose from, and you are less likely to deal with out-of-network costs.
Knowing how out-of-network care is covered is critical. Look at the various benefits categories (i.e., testing, mental health benefits, provider office visits, medical devices) and, be sure to look at if, and how, out-of-network care is covered in each. More than likely, it will not be the same across the board. In general, HMOs and EPOs will not cover out-of-network care. PPOs typically do, but you will pay more out-of-pocket.
Understand Emergency Care
If you are insured through a major insurance carrier, chances are that you will be covered should you need emergency medical treatment while out of state. This holds true whether you have an HMO, EPO, or PPO plan, and whether you arrive at the medical facility via ambulance or on your own.
Each insurance carrier has a unique set of rules you must follow in order to ensure you get the proper coverage. If you are a CDPHP member, you can check your member contract by logging into the secure member site. If you require further assistance, you can make a simple phone call so that you understand what your health insurer’s rules are before an emergency happens, which can help you to avoid a rush of medical bills.
If you take regular medications, establish yourself with a national pharmacy chain. Choose a chain that has a strong local presence in your hometown as well as your out of state location. No matter where you are, you won’t have to worry about transferring or calling in new prescriptions, as all of your prescription and insurance information will be readily available.
Also, get the lowdown on prescription refills. Will you be able to refill prescriptions at a network pharmacy when you are away from your home state? Do you have the option to refill them by mail order, or receive a few months’ supply in advance? If you do, this is a good avenue to explore, as it is one less thing you’ll have to worry about so you can enjoy your warmer climate!
Always be sure to travel with complete and up-to-date contact information for family, friends, and any professionals you depend upon. If you are a CDPHP member, carry your ID cards with you at all times, and call the number listed if you have specific questions about your plan. Remember, your ID card can be as close as your smartphone if you download the My CDPHP Mobile app! If you have questions about your prescription drug coverage, you can call CVS/caremark at 1-800-552-8159. Safe and happy travels!
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