Molly Janczyk re: Basic health insurance plan
Molly Janczyk to Retiree, February 8, 2007
Subject: Basic Health Insurance plan
Subject: Basic Health Insurance plan
No, hospital meds are part of your medical coverage, not RX, as you are in the hospital and they provide them under Medical. No changes until fall of each year.
(Retiree), Are there more tests covered under Basic than those listed in our 2007 info sheets? If so, please send so I can put out. Here is what is listed in our info:
Basic: STRS pays 100% for:
1. mammogram
2. annual physicals (not sure but usually consists of blood tests, EKG, urine analysis, blood pressure, eye ck for general eye health not to replace a visit to your ophthalmologist (Eye Dr. with MD)
3. colorectal cancer screenings (depends of risk factors and age: fecal tests, sigmoidoscopy, barium enema, colonoscopy: need to ck to see if all covered but generally precerts are done by Dr. for colonoscopy anyway) 4. RX Plan to increase to the first $5000 that STRS pays at 100% with generics being exempt.
(After STRS pays the first $5000 for RX's, for name brand RX's, enrollee pays 100% of all costs the remainder of the year except for generic which remains at the $25 copay.)
5. Out patient alcoholism increased to $1000 from $550 for both basic and plus.
6. Nutritional counseling expanded to single conditions that can be altered by diet such as hypertensions, diabetes, kidney disease and obesity. Normally conditions can only be altered in early stages.
1. mammogram
2. annual physicals (not sure but usually consists of blood tests, EKG, urine analysis, blood pressure, eye ck for general eye health not to replace a visit to your ophthalmologist (Eye Dr. with MD)
3. colorectal cancer screenings (depends of risk factors and age: fecal tests, sigmoidoscopy, barium enema, colonoscopy: need to ck to see if all covered but generally precerts are done by Dr. for colonoscopy anyway) 4. RX Plan to increase to the first $5000 that STRS pays at 100% with generics being exempt.
(After STRS pays the first $5000 for RX's, for name brand RX's, enrollee pays 100% of all costs the remainder of the year except for generic which remains at the $25 copay.)
5. Out patient alcoholism increased to $1000 from $550 for both basic and plus.
6. Nutritional counseling expanded to single conditions that can be altered by diet such as hypertensions, diabetes, kidney disease and obesity. Normally conditions can only be altered in early stages.
Basic deductible: In network: $1500 Out of network: $3000
Out of pocket max for network: $2,500 Out of pocket max for out of network: $5000
Basic Premiums:
30 yrs. Recipient: $94; Spouse: $313
30 yrs. Recipient: $94; Spouse: $313
15yrs.: $235; spouse: $313
Please provide additional items for circulation. Thanks.
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From a retiree to Molly Janczyk, February 8, 2007
Subject: Basic Health Insurance plan
Subject: Basic Health Insurance plan
We could have probably taken the Basic Plan, but until today I was not aware of how comprehensive the Preventative tests were. I called and they said we could not change until next year. Another thing we were not aware of was that hospital medications are not under the prescription limit. I called and found STRS had more comprehensive information, but we were not provided with this.
This would help save money for the STRS member and also for STRS so the fund would last longer.
posted by Kathie Bracy at 5:12 PM
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