When to go to the ER or doctor’s office

You’re not feeling well and have decided to seek medical attention. But where you should go? Should you go to the local hospital’s emergency room, visit your personal doctor, or go to an urgent care center?

The answer depends on your specific situation. It’s important to go to the right medical setting so you can get the best type of care for your medical needs.

Here are some tips to help you decide where to go when you require medical care.

If you think it is a life-threatening emergency, immediately go to the ER or call 911. Do not delay.

Emergency rooms are designed to handle these urgent medical situations.

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Some examples of emergency situations include:

  • Heart attack
  • Difficulty breathing
  • Severe burns
  • Head injury
  • Major injuries or severe bleeding

If it is not an emergency, try visiting your doctor or an urgent care center. That way you will avoid a long wait, and will likely avoid more expensive medical bills. It’s important to save the hospital emergency room for true emergencies. Visiting the emergency room for a common illness or minor injury delays care for someone who is experiencing a true emergency and drives up the cost of health care.

If you are feeling sick, but it’s not an emergency, you should visit your primary care doctor first. Your doctor is familiar with you and your medical history. Your doctor will be able to help diagnose your condition, and will let you know if you need to seek additional care.

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Some examples of generally non-emergency situations:

  • Sore throat
  • Ankle sprain
  • Rash
  • Immunization
  • Sports physical
  • Chronic conditions, such as asthma or diabetes

If you feel sick or have an injury that doesn’t require immediate emergency treatment, but you can’t wait to visit your doctor, you may want to consider visit an urgent care center or walk-in clinic. Many cities have urgent care centers that help patients in these types of situations.

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Urgent care centers are often open later at night than general doctor’s office hours, and visiting an urgent care center often leads to shorter waits and less expensive out-of-pocket medical expenses than visiting the ER. You should check to make sure the urgent care center is part of your plan’s insurance network, however.

Some examples of potential reasons to visit urgent care include:

  • Spiking high fever
  • Painful possible ear infection
  • Broken wrist
  • Injury requiring stitches
  • Painful urination

These are just some general suggestions. Please consult a medical professional to help diagnose your condition and the necessary medical care you should seek.

Please call the phone number listed on the back of your Blue Cross Blue Shield of North Dakota ID card for questions about your insurance coverage.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Medicare celebrates 50th anniversary of bill signing

Fifty years ago, Americans were sharply divided on the bill that would provide health insurance to the elderly. Some groups thought it would cost too much. While others thought it didn’t do enough. And some groups feared the possibility of socialized medicine.  This bill was as hotly debated in its day as the Affordable Care Act was in 2010.

On July 30, 1965, President Lyndon B. Johnson signed Medicare into law.
On July 30, 1965, President Lyndon B. Johnson signed Medicare into law.

At that time, most in Congress believed the need was real. The number of Americans older than age 65 had increased from 3 million in 1900 to 15 million in 1950, according to the U.S. Census Bureau. Sadly, this group was the nation’s poorest, with two-thirds having an income of less than $1,000 a year

Only one in eight of America’s elderly could afford health insurance.

This generation had started working during the Great Depression, when 70 percent of North Dakotans received some form of public assistance. They endured the hardships of World War II. Many of them had no big nest eggs.  A hospital stay could wipe out their financial savings.

Many physicians weren’t paid for services to the elderly because the elderly didn’t have the money. Even so, the American Medical Association fiercely fought the legislation, fearing socialized medicine.

On July 30, 1965, President Lyndon B. Johnson signed Medicare into law. As a result, elderly Americans, including many North Dakotans, were now able to receive health insurance that they previously could not afford.

Uncertainty prevailed. Physicians and hospitals in North Dakota and nationwide wondered how the new law would affect them, how they would be paid and how long it would take to receive payment. With Medicare, they were now expected to submit insurance claims and needed to add staff to handle the paperwork. They, in turn, passed that cost to their patients through higher charges.

BCBSND was selected to administer Medicare in North Dakota and proudly processed North Dakota’s first Medicare claim in 1966. The work was labor and paper intensive. Staff processed claims once a week by key-punching them. Notes were painstakingly copied from one piece of paper to the next. A total of 14,568 claims were processed in fiscal year 1966. Thanks to advances in technology, the process improved throughout the years. In 2001, BCBSND formed a subsidiary, now known as Noridian Healthcare Solutions, to handle the Medicare workload.

No doubt, Medicare has helped people 65 and older to get the health care they need throughout the years. Today, more than 110,000 North Dakotans receive health care services through Medicare.

You can learn more about the Medicare controversy in the 2004 article titled “Medicare: A look back to 1965” published in BCBSND’s Healthcare Discussions magazine.  

Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Upper body stretches you can do at your desk

Sitting too much can be hazardous to your health. Some have even compared the health impacts of sitting for long periods of time to smoking.

Unless you have a newfangled treadmill desk or have converted your workspace into a standing desk, you likely are required to sit at a desk for hours a day.

But just because you work at a desk, doesn’t mean you can’t move around during the day, or get up and stretch a little.

Here are some quick microburst videos showing how you can stretch different parts of your body during short breaks at your desk. Most of these videos are between 30 and 45 seconds long. The complete 10-video playlist is available on our YouTube channel.

Here are some upper body stretches you can do at your desk:

Neck stretches

Upper back stretch

Chest stretch

Wrist stretches

You can also stretch out your legs and do some upper body exercises while seated.

Here are some more deskercises, or exercises you can do at your desk.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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How health insurance works

Health insurance can be confusing. We’re here to help.

People often ask us how health insurance works. We’ll try to explain.

Here’s an example. Say you cut your hand and needed stitches. You went to the hospital and showed them your health insurance card.

First you were asked to pay a COPAYMENT, or copay, at the time of service. Copay amounts vary depending upon your specific plan. Some plans have different copay amounts for doctor’s visits and ER visits. You then got stitched up and left the hospital.

Watch the video to find out more.

When you received the bill from the hospital and your insurance company’s Explanation of Benefits in the mail, this is what you found:

Copay (you pay) -$10
Deductible (you pay) -$500
Coinsurance (you pay) -$98
Coinsurance (insurer pays) -$392

In this example, your plan had a $10 copay, a $500 deductible and 80/20 coinsurance (insurance pays 80 percent after deductible, you pay the other 20 percent).

After paying a copay, if applicable, you must pay the amount of your DEDUCTIBLE during your plan year before your insurance company will begin sharing costs with you. In this example, your deductible is $500.

After your copay and deductible have been paid, the remaining balance is $490 in the example. Of this amount, you are responsible for your COINSURANCE percentage. In this example, your insurance company pays 80 percent ($392), and you pay the other 20 percent of what’s left ($98 in this example). Keep in mind this is only an example. Cost sharing amounts vary depending upon your specific plan.

After reaching your full deductible for the year, you will not have to pay this the next time to seek care, you will only have to worry about your copay and paying your coinsurance amount.

Please call the phone number on the back of your ID card if you have any questions.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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How health insurance premiums are used

People often ask us what happens to the health insurance premiums our members pay. Here is an explanation.

Blue Cross Blue Shield of North Dakota charges premiums in exchange for providing our members with health insurance coverage. If you get insurance through your job, your premiums may be deducted from your paycheck or direct deposit.

Here is a look at how BCBSND premium dollars were used in 2014.

2014 BCBSND Dollar Breakdown UPDATED (reserves)

For every premium dollar BCBSND members paid:

  • 87.2 cents went to cover the costs of medical care members received.
  • 7.2 cents were used for operating expenses, including processing member claims, technology, and wellness programs to benefit members.
  • 2.3 cents were paid to the federal government in taxes and fees mandated by the Affordable Care Act.
  • 1.2 cents were paid in premium taxes.
  • 2.1 cents, the remaining balance, went into reserves to provide a necessary safety net in case member medical claims outpace premiums collected from members.

We have been asked if premium increases help us post hefty profits and where that money goes. As a nonprofit member-owned company, when there is anything left over after paying for members’ medical claims and our bills, it is kept in reserves — not distributed as profits to benefit shareholders.

Premiums don’t cover the full cost of members’ health care costs, but help to keep costs down, and give members discounts for covered services. Health insurance provides a safety net by capping the amount of out-of-pocket expenses members are billed by hospitals and clinics for expensive medical procedures. Those without insurance are billed directly by medical facilities and are not eligible for the discounts that our members receive. Health care costs are the primary driver of health insurance premiums.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Practice food safety during the summer

The aroma of burgers on the grill. The delight of a red slice of watermelon dripping with juice. There’s nothing like eating outdoors in the summer. 

Practice food safety at your picnic.When you cook outdoors, you’re often away from your kitchen sink, refrigerator and kitchen thermometer. Even so, cooking outdoors is no pass to forgo food safety. After all, no one wants to get sick from foodborne illnesses.


You can make your gathering safe by following these tips when packing your cooler:

  • Keep cold food cold by using ice or frozen gel packs. Aim to keep coolers at 40°F or colder to prevent bacterial growth, and consider packing meats, poultry and seafood into coolers while still frozen.
  • Organize, putting beverages in one cooler and perishables in another, so as guests reopen the beverage cooler to replenish drinks, perishable foods aren’t exposed to warm air.
  • Limit the number of times perishable food coolers are opened. Replenish ice as needed.

All year, food safety starts with clean hands, utensils and platters. For summer picnics and other outdoor meals, follow these steps:

  • Always wash your hands with warm water and soap for at least 20 seconds before and after handling food. No access to running water at a park? Use a water jug, soap and towel. Or use moist disposable wipes.
  • Clean all picnic tables and other setting surfaces before you set out foods and utensils.

Remember foodborne illness is no laughing matter. Each year, roughly one of every six Americans gets sick from foodborne illnesses. That’s 48 million cases that are completely preventable.

Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.


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Tax credits continue on North Dakota insurance marketplace

Twitter_Our members can rest assured coverage remains in place

We understand that you may have questions or concerns about the impact of today’s ruling by the U.S. Supreme Court on your health insurance coverage. We would like all members to know that their Blue Cross Blue Shield of North Dakota insurance coverage remains in effect.

Today’s ruling allows North Dakotans who qualify to continue receiving tax credit financial assistance when purchasing plans on the North Dakota marketplace.

The ruling allows state insurance marketplaces established by the federal government in North Dakota and 35 other states to offer those who qualify tax credits to help them afford the costs of insurance premiums. The tax credits are only available to those who purchase plans on marketplaces in states for individual and family plans set up by the Affordable Care Act health reform law. The next enrollment period to purchase insurance on the North Dakota marketplace begins in November for January 2016 coverage.

The ruling does not impact those who receive health insurance through an employer, a government program such as Medicare or Medicaid, or those who purchase insurance directly from an insurance company. It only affects those who receive financial assistance when purchasing plans on the North Dakota marketplace at www.healthcare.gov.

Today’s ruling helps ensure that we can continue to provide the security and stability of Blue Cross Blue Shield health insurance to all of our members, regardless of who they are or how they purchase coverage.

There is still much work to be done to help make health care more affordable. We are partnering with patients, doctors and hospitals to help create a health care system that is better coordinated, provides quality care and helps patients get healthy faster and stay healthy longer.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Employees support the United Way of Cass-Clay

What could be better than a walk in the park?

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At Blue Cross Blue Shield of North Dakota, we believe in promoting physical activity and supporting the United Way of Cass-Clay.

Our employees, retirees and their families gathered on June 18 at Lindenwood Park in Fargo to do just that. Kids enjoyed the kids’ dash, and others pushed strollers, walked, jogged or ran the 5K.

Through employee registration fees for the event, we raised $2,500 to support the United Way of Cass-Clay!

Our Employees’ Committee came up with the great idea to host the walk as a new way to raise funds for the United Way. The event provided employees, retirees and their families an opportunity to enjoy an evening together — while helping others. More than 325 people signed up for the event.2015 06 18_kids dash


Travis Christopher of the United Way of Cass-Clay dubbed the event the unofficial kick-off to the 2015 United Way campaign. “You dialed up the best weather of the spring and summer,” he told the crowd gathered in the park. “You are leaders. This isn’t just a fun run; it’s the unofficial kick-off of our next campaign.”

Employee Josh Malnourie was one of the many employees who brought family to the event. “The company 5k is a great event for employees to invest in our community through the United Way, while having a fun time with our coworkers,” Josh said.

Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Understanding migraines



Headaches are one of the most common pain-related health problems for adults and kids. While some headaches can be mild, others land people in the emergency room.

Some headaches are known as migraines. Migraines are painful, throbbing headaches that last from four hours up to three days. Migraine pain can prevent people from participating in work, school and other activities.

While different people may have different symptoms, the main migraine symptom is a throbbing headache on one side of your head. Other symptoms may include:

  • Nausea and/or vomiting
  • Pain aggravated by activity, light, noise or odors
  • Seeing temporary spots, wavy lines or flashing lights before the start of a headache

More than 10 percent of Americans suffer from migraines. Migraines tend to run in families and rank in the top 20 of the world’s most disabling medical illnesses.

Your health care provider can create a treatment plan for your headaches, based on your type of pain. Try to answer these questions and bring this information to your appointment with your health care provider:

  • How long have you had headaches?
  • Where does it hurt?
  • What type of pain is it?
  • When do you get headaches?
  • What seems to trigger your headaches (foods, drinks, timing, activities, seasons)?
  • How long do they last?
  • Do you get other symptoms?
  • What does help (sleep, over-the-counter medications, rest, exercise)?
  • What have you tried to treat headaches?
  • Does anyone else in your family have headaches?

Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Health care access in 50 states, 200 countries


Are you or your family planning a summer vacation?

If you or your family gets sick while traveling, we’ve got you covered — even if you’re outside the state or in another country.

Blue Cross Blue Shield of North Dakota (BCBSND) offers the most accepted health insurance in North Dakota, with access to more than 99 percent of doctors and hospitals in the state.

As a BCBSND member, you also have access to a robust national and international network, allowing you to seek care when traveling, on vacation or studying abroad. Our members have access to more than 90 percent of the nation’s doctors and specialists in all 50 states through BlueCard partnerships between Blue Cross and Blue Shield plans. Members also have access to health care services in 200 countries through BlueCard Worldwide agreements.

Need medical care when out of the state? You’re covered. Specific coverage details may vary. Coverage is generally not available for elective services, but is covered for emergency or medically necessary care.

BlueCard access provides you and your family coverage in all 50 states.

College students on their parents’ insurance, and students on BCBSND plans can receive medical care when traveling outside the state and country.

For more information, please call the phone number on the back of your BCBSND ID card, or visit online member services.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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