Friday, November 17, 2006

Sandra Knoesel to Shirlee Zerkel re: Questions about preventive services in basic policy

From Sandra Knoesel, November 17, 2006

Dear Mrs. Zerkel:

I received your e-mail about the information retirees receive regarding their health care options. STRS Ohio agrees it is important for members and retirees to receive information they need about their health care options. We appreciate feedback from our retirees and will take your suggestions into consideration.

Based on previous overwhelming feedback from multiple member surveys, STRS Ohio learned retirees wanted the health care information they received to be simplified. Based on this feedback, STRS Ohio now sends retirees an/a:

  • Annual Open-Enrollment Guide,
  • STRS Ohio Health Care Plan Options and Premiums Sheet, and
  • Plan Overview Chart.

The Health Care Program booklet entitled “Your STRS Ohio Health Care Plan Options” is sent initially to all new benefit recipients and health care enrollees, to enrollees when they turn age 65 and to current retirees when requested.

Regarding your questions about the Basic Plan’s preventive services coverage, we send a handout entitled “Basic Plan Preventive Services Coverage Enhanced for 2007” to retirees who ask questions about this enhancement. As you referenced, this information may also be found on the STRS Ohio Web site. It is important to note the “designated services” covered have not changed; the only change is whether the services are subject to the deductible. STRS Ohio and its plan administrators followed national guidelines.

STRS Ohio is working with the plan administrators to ensure patient services are coded and paid correctly; however, when an enrollee goes into a provider’s office for a preventive service and also indicates they have another health concern that may result in additional testing, proper coding can be complicated. That is why it is important for doctors to keep track of patients’ preventive services versus other routine services. To continue educating Basic Plan enrollees, STRS Ohio will be sending an information piece in December that further explains the preventive services benefit.

Health care issues are complex. STRS Ohio is committed to providing information you and other retirees need to make informed decisions about the STRS Ohio Health Care Program. You may also call the Member Services Center toll-free at 1-888-227-7877 if you have any further questions.

Thank you for sharing your thoughts and opinions with us.

Sandra L. Knoesel

Deputy Executive Director - Member Benefits

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