Page 16 - 2020 Benefit Guide Spanish
P. 16

Donde  Buscar Atención Médica










       Confused About Where to Go for Care?
       SmartER Care  options may save you money.
                 SM
       If you aren’t having an emergency, deciding where to go for medical care may save you time and money.
       You have choices for where you get non-emergency care. Use the chart below to help you figure out when   Freestanding ER
       to use each type of care.
                                                                                                          •  Open 24 hours, seven
       When you use in-network providers for your family’s health care, you usually pay less for care. Search   days a week
       for in-network providers in your area at bcbstx.com or by calling the Customer Service number on your   Hospital ER
       member ID card.                                                                  •  Open 24 hours, seven   •  Could be transferred
                                                                                                           to a hospital-based ER
                                                                                         days a week       depending on medical
                                                                                        •  Average wait time is   situation
                                                                                         four hours, seven   •  Services do not
                                                                       Urgent Care       minutes 4         include trauma care
                                                                         Center         •  If you receive care   •  Often freestanding ERs
           Virtual Visits       Doctor’s Office     Retail Health    •  Generally open evenings,   from an out-of-network   are out-of-network. If
                                                                                         provider, you may have
                                                                                                           you receive care from an
                                                                      weekends and holidays
       •  Available 24 hours a day, seven days   •  Office hours vary  Clinic            to pay more. Providers   out-of-network provider,
                                                                                         outside the network
        a week                 •  Generally the best place to   •  Based upon retail   •  Often used when your   may “balance bill” you,   you may have to pay
       •  Access to care for non-emergency   go for non-emergency care  store hours  doctor’s office is closed,   which means they may   more. Providers outside
                                                                      and you don’t consider it
                                                                                                           the network may “balance
        medical issues or speak with a licensed                       an emergency       charge you more than   bill” you, which means
        counselor, therapist or psychiatrist   •  Doctor-to-patient   •  Usually lower out-of-pocket   your health plan’s fee   they may charge you more
        whether you’re at home or traveling  relationship established   cost than urgent care  •  Average wait time is   schedule.  than your health plan’s fee
                                                                              3
       •  Visit with a health care professional   and therefore able to   •  Often located in stores   16-24 minutes  •  Multiple bills   schedule.
                                treat, based on knowledge
        by calling 888-680-8646, going to    of medical history  and pharmacies to provide   •  Many have online    for services such as   •  All freestanding ERs
        MDLIVE.com/bcbstx or using the             convenient, low-cost   and/or telephone   doctors and facility  charge a facility fee that
        MDLIVE  mobile app 1   •  Average wait time is    treatment for minor   check-in                   urgent care centers do
            ®
                                                   medical problems
                                      2
       •  Medical: Average wait time is less   18 minutes                                                  not. You may receive
        than 20 minutes.                                                                                   other bills for each doctor
       •  Behavioral Health: Can be scheduled                                                              you see. 5
        24 hours a day, but consultations are
        conducted by appointment.
                $                     $                 $                 $ $               $ $ $             $ $ $ $
       If you need emergency care, call 911 or seek help from any doctor or hospital immediately.
     ¡MDLive está disponible 24/7/365!        El pago se tiene que hacer al final de la consulta
       1    Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details.
                                                                 Note: The relative costs described here are for independently contracted network providers. Your costs for out-of-network providers may be significantly
     MDLive es excelente para:                con una tarjeta de credito o débito. Usted
       Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe.
                                                                 higher. Wait times described are just estimates.
       Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe.
                                                                 Virtual visits, Powered by MDLIVE may not be available on all plans. Virtual visits are subject to the terms and conditions of your benefit plan, including
     ;   Síntomas de resfriado y gripe        también puede usar su tarjeta FSA o HSA para
       2  Vitals Annual Wait Time Report, 2017.
                                                                 benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance
     ;   Infecciones del oído                 pagar por el servicio.  product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-
       3  Wait Time Trends in Urgent Care and Their Impact on Patient Satisfaction, 2017.
                                                                 controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians
       4  Emergency Department Pulse Report 2010 Patient Perspectives on American Health Care. Press Ganey Associates.
     ;   Alergias                                                reserve the right to deny care for potential misuse of services.
       5  The Texas Association of Health Plans.
                                                                 The information provided in this guide is not intended as medical advice, nor meant to be a substitute for the individual medical judgment of a doctor or
     ;   Conjuntivitis                        Contacte MDLive al 888-680-
                                                                 other health care professional. Please check with your doctor for individualized advice on the information provided. Coverage may vary depending on your
                                                                 specific benefit plan and use of network providers. For questions, please call the number on the back of your member ID card.
     ;   Relleno de recetas a corto plazo y más!  8646, en el sitio web, o a través
                                              de su aplicación. Un médico
     El copago es de $10 por consulta para los   se comunicará con usted
     miembros del Plan PPO Estándar. La tarifa   aproximadamente en 10 minutos.
     de la consulta para los miembros del Plan de   El médico le puede enviar una
     Consumidor será de $44 hasta que se cumpla   receta a su farmacia electrónicamente.
     con el deducible; luego el 20%.
                                              ¡MDLive ahora ofrece opciones de salud de
                                              conducta virtual! Mire la aplicación para más
                                              información!
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