Page 17 - 2020 Benefit Guide Spanish

Donde Buscar Atención Médica

24/7 Nurseline
La línea telefónica de Enfermería las 24 horas al día
y los 7 días a la semana le puede ayudar a identificar
algunas opciones cuando usted o su familia presenten
Confused About Where to Go for Care? con un problema de salud. Las enfermeras están
disponibles las 24 horas al día y los 7 días a la semana,
SmartER Care options may save you money. para responder a sus preguntas de salud, llamando al
SM
If you aren’t having an emergency, deciding where to go for medical care may save you time and money. (800) 581 0393.
You have choices for where you get non-emergency care. Use the chart below to help you figure out when Freestanding ER Centros de cuidados de Urgencias o Emergencias Inde-
to use each type of care.
• Open 24 hours, seven pendientes (ER)
When you use in-network providers for your family’s health care, you usually pay less for care. Search days a week ¡El saber la diferencia podría ahorrarle dinero! Los
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 centros de cuidados de urgencias y los servicios de
to a hospital-based ER
days a week depending on medical emergencia independientes (ER) pueden ser difíciles de
• Average wait time is situation distinguir. Los servicios de emergencias independientes
(ER) normalmente se parecen mucho a los centros
four hours, seven • Services do not
Urgent Care minutes 4 include trauma care de cuidados de urgencias, pero los costos pueden ser
Center • If you receive care • Often freestanding ERs más altos. Una visita a un servicio de emergencias
Virtual Visits Doctor’s Office Retail Health • Generally open evenings, from an out-of-network are out-of-network. If independiente (ER) normalmente resulta en gastos
provider, you may have
médicos que terminan siendo 10 veces más altos que lo
you receive care from an
• Available 24 hours a day, seven days • Office hours vary Clinic weekends and holidays to pay more. Providers out-of-network provider, que cobraría cualquiera de los centros de cuidados de
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 urgencias por los mismos servicios. Aquí hay algunas
• 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 formas de saber si se encuentra en un servicio de
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 emergencias independiente (ER):
cost than urgent care
whether you’re at home or traveling relationship established • Average wait time is schedule. than your health plan’s fee • Se parecen mucho a los centros de cuidados de
and therefore able to
3
• Visit with a health care professional treat, based on knowledge • Often located in stores 16-24 minutes • Multiple bills schedule. urgencias, pero tienen la palabra “EMERGENCIA”
by calling 888-680-8646, going to of medical history and pharmacies to provide • Many have online for services such as • All freestanding ERs en su nombre o en el edificio.
MDLIVE.com/bcbstx or using the convenient, low-cost and/or telephone doctors and facility charge a facility fee that • Están abiertos las 24 horas al día los 7 días a la
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 semana.
than 20 minutes. other bills for each doctor • No se encuentran dentro de, y podrían no estar
5
• Behavioral Health: Can be scheduled you see. afiliados con, un hospital.
24 hours a day, but consultations are • Están sujetos a la misma proporción de pago para
conducted by appointment. los miembros que cualquier Departamento de
$ $ $ $ $ $ $ $ $ $ $ $ Emergencias, que normalmente incluye un copago,
co-seguro y el deducible aplicable.

If you need emergency care, call 911 or seek help from any doctor or hospital immediately. Usted puede encontrar centros de cuidados de
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 urgencias cerca de usted e
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 texto “URGENTTX” al número 33633.
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
3 Wait Time Trends in Urgent Care and Their Impact on Patient Satisfaction, 2017. product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-
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. 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
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.
Clint Gollnick, Rep. Ventas Externas
Georgetown, TX 16 16