From the summer 2016 issue file size 3MB of For Your Benefit newsletter
Health Care Costs
Editor’s Experience at Urgent Care
I love summer, so it was particularly disappointing to be sick most of July. After a week of not being able to swallow, I broke down and visited my PCP who confirmed I had a virus and not a bacterial infection. I followed (most of) her instructions and slowed down a little and stopped exercising, but still dragged myself into work and kept up my usual hectic pace. A week later, I had the joy of adding pink eye to my symptoms. Not wanting to take time off from work, I decided to seek care after hours. I considered going to a retail clinic, but the closest one is a few towns over from where I live, and I was exhausted after my commute home. To save time, I decided to visit a nearby urgent care facility.
Lesson #1 – Know Your Benefits
This one was easy for me. Since I write about the GIC’s benefits, I know them. The urgent care facility staff insisted that my copay was $60. I knew the copay had gone down to $20 effective July 1. My health plan’s customer service unit was closed, so I accessed the Plan’s website on my phone and showed the copay change to the urgent care center manager. He relented and charged me $20 instead of $60.
Lesson #2 – A Retail Clinic Would Have Been More Than Sufficient
Two nurses were in my room. This definitely seemed like overkill for my condition. One entered information into a computer and the other assessed my symptoms. It was a pretty easy diagnosis and my (generic!) prescription was transmitted to the pharmacy quickly. A physician stopped by to check on me and I shooed him out of the room concerned about unnecessary physician-related charges.
A few weeks later, I received my health plan Explanation of Benefits (EOB). The total billed charges were $327 and the plan paid $108. My $20 copay was reflected and I was pleased to have no deductible-related charges. My son had recently visited a retail clinic for a similar non-complex condition and the total billed charges for his visit was only $99 and the plan paid $72 – also subject to a $20 copay. If I had elected to drive a little farther, I would have saved the GIC $26. If I had no health insurance, I could have been billed an additional $228. If I had a high deductible plan, I would have paid $26 more and it might have been worth driving two towns over.
Lesson #3 – Using Telecommunications Would Have Been an Even Better Option
In retrospect – besides taking better care of myself – I should have called my PCP to see if she could have helped me by phone. If that wasn’t possible, I would have liked to have been able to have a telemedicine visit. Either option would be more convenient and no more costly than the route I took.
This information provided by the Group Insurance Commission .