5 ways to become your own health care boss

While your doctor is the medical expert,  you are your own best advocate. Practicing these five things will help put you in the driver’s seat of your health care.

1. Make health care choices based on information, not fear. When your doctor recommends a procedure or medication, you should find out more. What are the pros and cons of the procedure? Is it truly necessary? Is this procedure covered by my insurance? Are there other ways to accomplish the same goal? What is the cost? Insurance costs are a direct reflection of medical costs, so being a wise consumer helps with your out-of-pocket expenses and ultimately your insurance costs. Make sure you are informed on the benefits and risks of all your health care decisions, even the ones that seem obvious.

2. Use medications responsibly. If you have been prescribed long-term medications, make sure to use them as prescribed. When starting a new drug, ask your doctor if a generic alternative is available. You can also ask about a pill-splitting option to decrease your out-of-pocket medication costs. Americans incur $200 billion worth of care per year for illnesses and hospitalizations that could have been avoided if medications were taken as prescribed.

3. Understand your health insurance policy. Health insurance is complicated. But the more you know your plan, the better you will be able to understand what is covered and how much you will have to pay out of pocket. Many preventive services are covered under your plan. Check to see which services are covered. Preventive services can help prevent high costs later. In addition, when scheduling appointments, ask the provider if they participate with a Blue Cross Blue Shield plan. You will be responsible for additional costs if you see a provider who is not participating.

4. Exercise. Eat. Sleep. Repeat. Yes, prevention is still the best medicine. Controlling your weight with a healthy diet, regular exercise and enough sleep can help prevent the onset of diabetes, heart conditions and cognitive deficits. Even if you are young, making healthy decisions today will positively impact your health in the future decades. Controlling diet, weight and healthy habits will save you lots of money in the future.

5. Choose the right care at the right time. When assessing an illness or injury, ask yourself if it constitutes an emergency department visit, a walk-in clinic visit, or if you can hold off for a less-expensive office visit. Some providers offer a free nurse helpline, which may be helpful to get resolution. According to the Agency for Healthcare Research and Quality, the average cost of a visit to the doctor is about $199; a visit to the ER costs about $922. About 25 percent of those visits are unnecessary.

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

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Find out if you’re eligible to buy 2015 insurance after February 15 deadline

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February 15 was the deadline for North Dakotans to sign up for new Blue Cross Blue Shield of North Dakota individual or family plans to receive 2015 coverage. Most Americans are required to have health insurance this year, or they will face a tax penalty from the federal government.

Even if you didn’t buy your plan by February 15, you still might be able to get a new health insurance plan in 2015:

  • If you have a significant life change such as getting married, divorced, the birth or adoption of a child, or even some income changes after February 15. You may be eligible for a special enrollment period to sign up for 2015 coverage. Please call us at 1-800-280-BLUE (2583) to find out if you are eligible.
  • If you qualify for Medicaid, you can enroll at any time at healthcare.gov.
  • If you lose health insurance through an employer after February 15, you can sign up for 2015 health insurance.
  • If you meet certain age requirements and other circumstances you may qualify for Medicare.

The next enrollment period for health insurance begins on October 1, 2015, for coverage starting on January 1, 2016.

What if I have health insurance?
If you currently receive health insurance through your employer or through a government program like Medicare or Medicaid, the February 15 deadline does not apply to you. If you have insurance now, but you lose your coverage during 2015, you may qualify for a special enrollment period to select a new insurance plan.

If you are a current BCBSND member and have an individual or family plan, and your plan is being discontinued in 2015 you will be automatically transferred to a new plan unless you contact your local independent agent or call us at 1-800-280-BLUE (2583) and we’ll help you.

More information about health reform is available on our website.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.
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Longer customer service phone line wait times

Our customer service representatives are currently receiving twice as many phone calls as usual. As a result, the wait times that our members are experiencing when customer service are increasing as well.

We pride ourselves on delivering world class customer service and we are doing our best to help all our members as quickly as possible. If call volume is especially heavy and we aren’t able to help everyone at a certain time, you may hear a recorded message asking you to call back later.

One reason for the high call volume is the February 15, 2015 deadline to enroll in health insurance coverage for 2015. We expect the wait times to decrease after the deadline and we are doing everything we can to add more resources to help members during this time. We appreciate your patience.

Tips to reduce your wait time
Here are some tips to avoid waiting on hold when calling customer service:

  • You can call the phone number listed on the back of your ID card. Our customer service phone line is answered Monday through Friday, from 8 a.m. to 4:30 p.m. Central time. We usually receive fewer calls in the early morning, so you can try then, if possible.
  • When calling in if you have your ID card with you, enter it in on your phone’s keypad when prompted to help speed up your call.
  • You can also use our Online Member Services tool on our website to ask your question, perform tasks like checking your claims, finding out what has been paid by insurance and updating your address.

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

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Get an online quote, shop for a plan on our website

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Did you know that you can get a health insurance quote before signing up for a plan?

All you need to do is visit www.BCBSND.com/shop and shop for insurance for individuals or families. You can click on the “Get a Quote” button to shop and compare insurance plans.

The open enrollment period for 2015 coverage runs through February 15, 2015. After that you must have a qualifying life event, such as getting married or the birth of a child, to be able to get 2015 insurance.

If you want to see if you qualify for a federal tax credit to lower your premiums on the Health Insurance Marketplace, we have a handy calculator to help you see if you might qualify. If not, you just need to enter some basic info about yourself and your spouse or any dependents you want to add to your plan.

Then you can start shopping and comparing plans to find one that works best for you and your situation.

Let us know if you have any questions. You can also call us at 1-800-280-BLUE (2583) for help enrolling in a plan.

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

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What you need to know about new IRS tax filing requirement

You are now required to report your health insurance coverage when filing a federal tax return.

For the first time this tax season, you must report to the Internal Revenue Service if you, your spouse or dependents had qualifying health insurance coverage during 2014.

We mailed a statement outlining members’ health insurance coverage in early February. That statement will help you with a new requirement of the Affordable Care Act.

If you have individual coverage from us …

We mailed a statement of coverage to members to help them prepare their 2014 tax return.

  • If you purchased a qualified health plan on the Health Insurance Marketplace at www.HealthCare.gov, you can call 1-800-318-2596 to receive this information.

Please use it when doing your taxes, or share it with your tax preparer.

If you get insurance through your employer from us …

  • Your statement of coverage will come directly from us, provided the company you work for is a fully insured group.
  • You will need to get the information from your employer if the company you work for is a self-funded group or trust.
  • Please contact your HR department if you have questions on the type of group insurance your employer offers.

Can we help?
If you have more questions, please call 1-800-280-BLUE (2583).

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

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What is a copay?

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Health insurance can be confusing. We’re here to help. Here’s an explanation of an often misunderstood health insurance term and what it means.

A COPAYMENT, or a copay, is a set amount you pay when receiving medical care. Patients are often asked to pay a copay when arriving for a doctor’s appointment, or seeking other medical care.

HOW COPAYS WORK
The amount of your copay is listed on your Blue Cross Blue Shield of North Dakota ID card. Copay amounts vary depending on the type of service received and the specifics of your health insurance plan. For example, some members have a different copay amount for doctor’s appointment than for visits to the emergency room.

After paying your copay, you may still be required to pay a deductible and coinsurance (or a percentage of the remaining balance).

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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February 15 is deadline to enroll in 2015 health insurance

If you don’t have health insurance, you have until Sunday, February 15, to enroll in 2015 coverage.

If you miss the deadline, you will need to wait until this fall to enroll in coverage that won’t take begin until 2016.

Ways to enroll in coverage from us:

  • Go to www.BCBSND.com/shop
  • Call 1-800-280-BLUE (2583)
  • Work with your independent insurance agent
  • Visit one of our nine offices located throughout North Dakota

We will have staff taking phone calls the weekend of February 14-15 to help those seeking assistance enrolling by the deadline.

Sunday, February 15, is also the last day you can enroll in a new health insurance plan through the federal Health Insurance Marketplace at www.healthcare.gov. Our plans are offered on the Marketplace. You can select “North Dakota” as the state to shop for coverage at healthcare.gov.

Here’s what you need to know:

  • You must enroll by February 15 to have coverage in 2015.
  • You only need to enroll through the Marketplace if you plan to apply for a federal tax credit to help pay for your insurance. You can visit BCBSND’s Tax Credit Calculator to see if you might qualify.
  • If you don’t want to apply for a tax credit, you can enroll in coverage directly from us at www.BCBSND.com/shop, or by calling 1-800-280-BLUE (2583).
  • If you change jobs, move to a new state, experience the birth of a child, a change in marital status or another major life event after the deadline, you may qualify for a special enrollment period to purchase coverage.
  • When filing your federal income taxes for the 2015 tax year you will be required to show proof that you had qualifying health insurance in 2015 to avoid paying a tax penalty.

Questions?

We are here to help.

If you have questions, please call one of our health benefits consultants at 1-800-280-BLUE (2583), talk to your local independent agent, or visit one of our offices during regular business hours.

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

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Screening for HPV can help detect cervical cancer

Doctors now believe that human papillomavirus, HPV, is the most common cause of cervical cancer, according to the American Cancer Society.

January is Cervical Cancer Awareness Month. According to the Centers for Disease Control and Prevention, each year 21,000 HPV-related cancers can be caught and treated early with proper testing. While HPV can cause cervical cancer, it can also create cancer cells in other areas of the male and female genitals.

Other risk factors include:

  • Family history
  • Smoking
  • Chlamydia
  • Diet low in fruits and vegetables
  • Being overweight
  • Being pregnant before age 17
  • Immunosuppression, such as that which occurs with HIV or AIDS
  • Long-term use of birth control pills and intrauterine devices (IUDs)

Cervical cancer is most treatable when caught early, in a stage doctors call “pre-cancer.” This stage shows that there are cancer cells in the cervix but they have not invaded the surface, which can cause the cancer to spread to other parts of the body.

The great news is that testing is much improved, which means early detection and prevention is better than ever! The best way to prevent cervical cancer is to get tested regularly, especially if you are sexually active.

Your doctor may perform a traditional Pap smear alone or in combination with an HPV test.

  • A Pap smear is a test where doctors take a small bit of tissue from the cervix and have it tested in a lab for signs of cancerous cells.
  • An HPV test can be done using the sample doctors collect from a Pap smear.

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

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December 15 deadline to enroll for January 1 coverage

Monday, December 15, is the last day to enroll in a Blue Cross Blue Shield of North Dakota (BCBSND) individual or family health insurance plan directly from BCBSND or on the Health Insurance Marketplace with coverage that begins on January 1, 2015.

If you enroll later than December 15, 2014 during the open enrollment period that ends February 15, 2015, your coverage will begin later in 2015.

Open Enrollment
The open enrollment window started on November 15, 2014 and will close on February 15, 2015 to purchase individual health insurance for 2015, both on the federal Marketplace and for plans purchased directly from insurance companies. If you purchase insurance directly from an insurance company or are insured through the Marketplace, you can also re-enroll in coverage for 2015 during open enrollment. This is the only time individuals can purchase health insurance during the course of the year without a unique event (such as getting married or the birth of a child) that qualifies them for a special enrollment period.

As part of the Affordable Care Act (also known as Obamacare), most Americans are now required to have qualifying health insurance coverage, or face a tax penalty when they file their annual federal income tax returns.

To shop for health insurance during the November 15, 2014-February 15, 2015 open enrollment period:

  • Contact your local insurance agent
  • Visit our website at www.BCBSND.com/shop and shop for insurance
  • Go to one of our 8 offices throughout the state for assistance
  • Call our dedicated sales consultants at 1-800-280-BLUE (2583)
  • Go to www.healthcare.gov to search or enroll in Marketplace plans

Let us know 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 to comply with the individual mandate

The Affordable Care Act (also known as Obamacare) requires most Americans to have health insurance. This requirement is known as the individual mandate.

If you have health insurance, either through your job, your spouse’s job, Medicare or Medicaid, your coverage likely meets the requirement.

But if you don’t have any type of health insurance, you will need to purchase health insurance or pay a tax penalty to the government for the months you didn’t have coverage. For 2015 coverage, you will need to enroll in a health plan between Nov. 15, 2014, and Feb. 15, 2015. This time period is known as open enrollment.

Some individuals are exempt from the mandate, including those who do not make enough money to be required to file a tax return and certain American Indians and Alaska Natives.

Tax penalty
The annual tax penalty for not having qualifying coverage in 2015 is $325 per adult and $162.50 per child, or 2 percent of taxable income, whichever is greater.

Under the ACA, plans that are purchased on the federally facilitated Health Insurance Marketplace, also known as the exchange, may be available in four levels of coverage: Platinum, Gold, Silver and Bronze. The individual mandate tax penalty will be capped at the national bronze plan average.  In 2014, the bronze plan average was $12,240 for a family of five and $2,448 for a single individual.

The amount of tax penalties for not having qualifying insurance will continue to increase in future years.

During the 2015 tax season, the Internal Revenue Service will begin asking taxpayers to attest to having health insurance coverage when filing their 2014 income tax returns. Those who are unable to do so will be assessed the tax penalty. Likewise, during the 2016 tax season, you will be asked if you had health insurance coverage in 2015.

Avoiding the tax penalty
If you would like to purchase insurance from Blue Cross Blue Shield of North Dakota to avoid paying the individual mandate tax penalty, you can:

Not sure if you qualify for a federal tax credit to help pay for your insurance? You can use our handy tax credit calculator. If you qualify for the tax credit, you will need to purchase a plan on the Health Insurance Marketplace at healthcare.gov. Either way, you can start at www.BCBSND.com/shop.

Meet the deadline
Remember, you must purchase your 2015 health insurance before the current open enrollment period ends on Feb. 15, 2015. After that, BCBSND individual and family plans will not be available for purchase until the next open enrollment period begins on Nov. 15, 2016,unless you experience a qualifying life event. Typically you have 60 days from the time of the qualifying event to enroll in coverage. Some common examples of a qualifying event include:

  • Loss of affordable employer-sponsored coverage
  • Turning  age 26
  • Marriage/divorce
  • Birth or adoption
  • Moving to a new state

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

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