{"id":4590,"date":"2016-05-27T14:14:26","date_gmt":"2016-05-27T14:14:26","guid":{"rendered":"http:\/\/hnetalk.com\/member\/?p=4590"},"modified":"2016-05-27T14:14:26","modified_gmt":"2016-05-27T14:14:26","slug":"decoding-your-plan-coverage","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/member\/decoding-your-plan-coverage\/","title":{"rendered":"Decoding your plan coverage"},"content":{"rendered":"<p>As a valued member of Health New England, we want to make sure you have coverage for medical care when you need it and that you understand what is covered.<\/p>\n<p><strong>Using in-network providers<\/strong><br \/>\nThe Health New England provider network includes doctors, specialists, hospitals and pharmacies in your area. By using a provider that is in-network, you can be sure that you are covered.* Also, when you see a specialist that is part of our network, you do not need a referral, making it easier to get the care you need.<\/p>\n<p>Another advantage to choosing a provider in the Health New England network is that in-network doctors and medical practitioners have access to your medical history and records, and they can work together to provide you appropriate care.<\/p>\n<p>In order for Health New England to pay for your care (copays\/deductibles apply), you must stay in-network for non-emergency health care services such as a doctor or specialist visit, lab work or x-rays, and prescriptions. Otherwise, you may be responsible for the full cost of your visit. PPO plan members may use out-of-network providers for these services. However, staying in-network is more convenient and cost-effective.<\/p>\n<p>To search for in-network providers, go to <a href=\"http:\/\/www.healthnewengland.org\/provider-search\" target=\"_blank\">healthnewengland.org\/provider-search<\/a>.<br \/>\nFor GIC members, search for in-network providers at <a href=\"http:\/\/www.healthnewengland.org\/gic-provider-search\" target=\"_blank\">healthnewengland.org\/gic-provider-search<\/a>.<\/p>\n<p>*<em>In accordance with your plan benefits.<\/em><\/p>\n<p><strong>After-hours coverage<\/strong><br \/>\nMedical issues and questions don\u2019t always come up during regular office hours, so Health New England has after-hours care options available to you as part of your membership.<\/p>\n<p>First, consult with your doctor\u2019s office about their after-hours care options. Many doctors now offer weekend hours and an after-hours call service to help you. However, if you can\u2019t reach your doctor after hours, we offer some alternatives for you.<\/p>\n<p><strong>For non-emergency medical issues<\/strong> such as a cold, flu, urinary tract infection and more, you can access U.S. board-certified physicians through phone or video consultation 24\/7 by registering for Teladoc\u2122. This service is available for the same copay as a PCP visit. Learn more at <a href=\"http:\/\/www.healthnewengland.org\/Teladoc\" target=\"_blank\">healthnewengland.org\/Teladoc<\/a> or call 1-800-Teladoc to get started. (<em>Teladoc is available for most members; however, some self-funded plan members are not eligible.<\/em>)<\/p>\n<p><strong>If you\u2019re just looking for health advice<\/strong>, call the free Health New England 24\/7 nurse line. You can ask licensed nurses and clinicians questions about health-related issues and medications. To reach the nurse line, call (866) 389-7613 or email <a href=\"mailto:nurseline@hne.com\" target=\"_blank\">nurseline@hne.com<\/a>.<\/p>\n<p>If the above options don\u2019t work for you and you <strong>need to visit an urgent care center<\/strong>, go to <a href=\"http:\/\/www.healthnewengland.org\" target=\"_blank\">healthnewengland.org<\/a> and click on \u201cFind a Provider\u201d at the top of the page to search for the nearest covered urgent care center in your area.<\/p>\n<p><strong>If you have a true medical emergency<\/strong>, call 911 or go to the nearest emergency room (ER) immediately. Your emergency room copay and cost sharing will apply.<\/p>\n<p>If you have any questions about your coverage or your plan benefits, our Member Services representatives are available to assist you at (800) 310-2835, Monday \u2013 Friday, 8 a.m. \u2013 6 p.m.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As a valued member of Health New England, we want to make sure you have coverage for medical care when you need it and that you understand what is covered. Using in-network providers The Health New England provider network includes doctors, specialists, hospitals and pharmacies in your area. By using a provider that is in-network, [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":4591,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[19],"tags":[437,406,438,439,436,441,432,440,280],"class_list":["post-4590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","tag-after-hours","tag-benefits","tag-coverage","tag-emergency","tag-in-network","tag-in-plan-providers","tag-non-emergency","tag-nurse-line","tag-teladoc"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/member\/wp-content\/uploads\/2016\/05\/ThinkstockPhotos-77130925-e1463670732606.jpg?fit=700%2C467&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZGa-1c2","_links":{"self":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/4590","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/comments?post=4590"}],"version-history":[{"count":5,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/4590\/revisions"}],"predecessor-version":[{"id":4652,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/4590\/revisions\/4652"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media\/4591"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media?parent=4590"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/categories?post=4590"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/tags?post=4590"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}