A Whole New Way of Thinking about - Access to Care

Health Options PlusTM Increases Access to Care

One of the most fundamental needs of employees and families is access to health care providers, particularly physicians. While increasing deductibles and coinsurance may reduce premiums they have a negative impact on an employee's ability to afford needed medical treatment. Often treatment is deferred to the point that the costs of treatment are increased.

Moreover, “access” should not be confused with “a $20 co-pay.” The illusionary $20 co-pay for an employee is a $60 - $120 expense for the insurance company and for this service, premiums are significantly increased. Health Options PlusTM incorporates alternative delivery and pricing models to more appropriately align utilization and costs while providing all employees and their families with 24/7/365 access to Physicians, RNs and other health care providers in a more-cost effective manner. Access is available either in a doctor’s office, via telephone, or even through Internet andsmartphone conferencing.

Health Options PlusTM Increases Access to Care Through -

AmeriDocTM

Innovation Benefits Group has partners with AmeriDocTM to provide all employees with telephone or video visit access to doctors 24 hours a day. Telemedicine is not intended as a replacement for primary care physicians but an enhancement for non-emergent medical issues. Access is mere minutes a way with the average wait time being about 22 minutes. Access is available either by phone or web video conference with a US based network of board-certified family practitioners, primary care physicians, pediatricians and internists who use electronic health records to diagnose, treat, and write prescriptions, when necessary. For more information view the video above.

Reduced or Eliminated Deductibles and Coinsurance

The Declining Deductible is a feature that is unique to Health Options PlusTM plans. Employees and their families earn Declining Deductible Credits each month that they have limited medical claims and do something positive for their health such as having a preventive screening or completing an online health risk assessment or work with a health coach. Credits that are not used by the end of the Plan Year will automatically carry over to the next Plan Year. Each family member can earn a maximum of $1,400 in Declining Deductible credits in the first year of plan participation.

Proactive Preventive Services

Under the health care reform legislation all persons covered under a major medical insurance policy are entitled to free preventive services including an annual physical, immunizations, and screenings such as mammograms, colonoscopies, etc. What is not so widely known (or mentioned by insurance companies) is that there are 65 preventive screenings that are covered for free. Health Options PlusTM participants are proactively evaluated and notified about their eligibility for free preventive services. In addition, each Health Options PlusTM participant receives an annual biometric blood screening, health risk assessment and personalized written health report as part of The eHOPE PlanTM. You can't fix what you don't know.

Preferred Networks

While many people mistakenly judge the desirability of a provider network by its size, we judge by its quality. While the term “PPO” refers to “Preferred Provider Network” there is frequently nothing preferred about the providers contained in them. Health Options Plus plan include traditional large, broad-based PPO networks but many of our plans also contain a customized true “Preferred Network” consisting of providers that have lower costs, greater discounts and high ratings. Employees using these Preferred Networks enjoy lower deductibles and out-of-pocket costs and employers enjoy lower overall claims costs.

Preferred Pharmacy Networks

Health Options PlusTM plan participants have access to virtually every large and small pharmacy in the country. However, considering that prescription expenses account for about 20-25% of healthcare costs it is critical to control these costs as much as possible. Our plans incorporate the First Choice preferred pharmacy network which is specifically design to lower prescription costs.

Centers of Excellence

Many people may be surprised to learn that the top hospitals in the U.S. and in the world are frequently the lowest costs facilities. Through the administrator, IMA, Inc., Health Options PlusTM plan participants have access to the top rated medical facilities available at In Network pricing – even if the facility is not in their normal provider network. These Centers of Excellence include Mayo Clinic, Johns Hopkins, Cleveland Clinic, MD Anderson Cancer Center and many others.

The Prevention PlanTM

All Health Options PlusTM plan participants are automatically enrolled in The Prevention PlanTM with US Preventive Medicine, Inc. This is not simply another “wellness” program – The Prevention PlanTM is a clinically proven proactive program centered on prevention, early detection and case management of chronic and critical conditions.

"A focus on cost-cutting and efficiency has helped many organizations weather the downturn, but this approach will ultimately render them obsolete. Only the constant pursuit of innovation can ensure long-term success."

Daniel Muzyka
  •