The questions on this form will help you get the most out of your next medical visit. If you do not ask questions, your doctor may think you understand everything you are being told. Remember to take this form and a pencil or pen with you. It may be helpful to bring a family member or friend to the appointment.
Jan 182012
You will need the HNE tax identification (ID) number to file your 1099HC tax form. To determine the correct tax ID number to use, find the group number on your HNE member ID card:
- If the Group number begins with the letter S, then use the tax ID number 043012347.
- If your Group number begins with any other letter or number, use the tax ID number: 042864973.
Pharmacy Correction!
Member Announcements
Comments Off
Dec 052011
If you were one of the many members who experienced difficulty filling your prescription this past weekend, December 3rd and 4th, we truly apologize for any inconvenience this may have caused. We are pleased to announce that a solution has been put in place and you can reprocess your prescription at your convenience.
It is our goal to provide you with excellent service and not only meet, but exceed your expectations. We value your membership and will continually work to eliminate hassles. Thank you for your patience and understanding.
Sincerely,
Gary Tereso, Director of Pharmacy Services
Nov 072011
RE: Semi-Annual Notice of Changes
Dear HNE Member:
Health New England (HNE) is making some changes to your Plan, most of which become effective January 1, 2012.
I have enclosed an amendment to your HNE Explanation of Coverage. This amendment outlines changes to certain benefits and programs that are part of the standard benefit plan. Please read the information carefully and keep it with your membership materials for future reference.
If you have any questions, please feel free to call Member Services at 413-787-4004 or 800-310-2835. Our staff is available Monday through Friday, 8:00 a.m. to 5:00 p.m. We will be happy to help you.
Sincerely,
Peter P. Lore
Member Services Manager
Important Notice from Health New England (HNE) About Your Prescription Drug Coverage and Medicare
Member Announcements
Comments Off
Oct 132011
Notice for Commercial Plan Members Who Are or Will Be Eligible for Medicare in 2011 and 2012. This does not apply to Plans that do not have prescription drug coverage through HNE.
Deductibles 101
Summer 2011
Comments Off
Jun 222011
Many HNE plans are offered with deductibles. A deductible is a way for you to share in the cost of the health care you receive. A deductible is an out-of-pocket expense that you pay to a provider for certain medical services prior to the insurance payment. Insurance plans with HNE can vary, so it is important to review the Explanation of Coverage (EOB) for the specific benefit packages offered by your employer. This will ensure that you know what out-of-pocket expenses you may incur in the policy year.
There are some exclusions to what applies to your deductible, based on the plan type. The federal health care reform bill mandates that health screenings and preventive services be covered without copays or other fees.* These benefits are usually offered once per calendar or benefit year, based on your specific benefit.
You can meet the deductible by paying many small claims, for example, office visits, lab test, or radiology, or by applying larger claims to a deductible, for example, hospital stays, outpatient surgery, or MRI services. Once you meet your deductible, claims will be paid by HNE and will apply to any applicable copays or coinsurance.
Your use of medical services throughout the year might be minimal. In that case, the out-of-pocket cost towards your deductible is low, if any. You don’t need to meet the deductible, but if you do, your responsibility switches to only copays and applicable coinsurance.
If an employer offers you different plan options, it is important for you to make an educated decision based on your health expectations. For example, if you expect your medical use throughout the upcoming year to remain low, you might choose a policy with a higher deductible that will have a lower monthly premium. A lower deductible plan will likely carry a higher monthly premium; in that case HNE would start paying claims sooner.
* This requirement will apply only to new plans, not to existing plans that are grandfathered under the new law. Federal regulators determine what is a grandfathered plan.
No Copayments for Preventive Care
Summer 2011
Comments Off
Jun 222011
Staying healthy involves commitment – to eating right, staying active, and scheduling regular check-ups with your doctor. At HNE, we want to help you keep that commitment. HNE covers these services 100% – you pay nothing.* We’ve done this for years, not because we have to, but because it is the right thing to do.
What is preventive care?
Preventive care includes periodic health evaluations, like annual physicals. It does not include services to treat an existing illness, injury, or condition.
The health care industry uses medical guidelines to identify preventive care. Medical guidelines describe appropriate care and treatment. Guidelines also indicate what you can do to stay healthy and prevent illness. HNE used these guidelines to decide which services don’t require a copayment.
What services don’t require a copayment?
- Routine Prenatal and Well-child Care
- Adult Routine Exams
- Child and Adult Immunizations
- Annual OB/GYN Exams
- Annual Routine Vision Exams
For plans with a deductible, these in-plan services will not apply to the deductible either.
* Does not apply to any self-funded group that has elected to be a Grandfathered Health Plan (GHP). Federal regulators determine what is a grandfathered plan.
Try This Healthy Recipe! Grapesicles
Recipes, Summer 2011
Comments Off
Jun 222011
Try this healthy snack on a hot summer day– frozen grapes will pop in your mouth!
48 Green Seedless Grapes, rinsed
48 Red Seedless Grapes, rinsed
6-inch Wooden Skewers
Directions
1. Thread six grapes, alternating grape colors, onto each wooden skewer.
2. Place skewers into freezer for 30 minutes, or until frozen.
3. Serve immediately.
Calories: 83 | Total Fat: 0g | Saturated Fat: 0g
Cholesterol: 0mg | Sodium: 2mg | Total Fiber: 1g
Protein: 1g | Carbohydrates: 22g | Potassium: 229mg
Find this recipe on line at:
http://hp2010.nhlbihin.net/healthyeating/RecipeList.aspx?linkId=12&cId=10&cbId=2
“Why Am I Receiving These Things?”
Summer 2011
Comments Off
Jun 222011
HNE Member Services get calls frequently about why members keep getting HNE Explanation of Benefits (EOBs). When you have a plan with a deductible, HNE sends an EOB for claims when the deductible or coinsurance has been applied. Coinsurance is when HNE pays a percentage of the claim and you pay a percentage. Deductible is a dollar amount you pay out of pocket prior to HNE paying for an expense covered service.
To access HNEDirect, go to hne.com/HNEDirect and follow the simple instructions.
Remember, the EOB is not a bill. It is an advice statement to tell you that HNE received a claim for a service provided to you. The billed amount is the total amount of the claim that HNE received. The EOB shows the provider name, date of service, type of service, amount paid by HNE, amount of copay, and the amount applied to the deductible.
EOBs also show you how much of your deductible you have met for that year. You also get correspondence similar to an EOB from HNE when we deny a claim. Denial letters tell you why we denied the claim and how to appeal a denial. If you have a deductible plan, HNE will not send an EOB for claims that did not have any deductible or coinsurance.
If you have a plan with no deductible, and only copayments, you will not receive any EOBs. Your copayments are listed on your HNE ID cards.
Most HNE members have access to our secure website, HNEDirect through our website, hne.com.
On HNEDirect, you can:
- View your Member Material and Benefit Information
- Change your Address and other Personal Information
- Change Primary Care Physicians
- View your Claims and Referrals
And lots more! Signing up for HNEDirect is easy:
- Go to hne.com
- Click HNEDirect
- Follow the simple instructions
Once you sign up for HNEDirect, you can go green by asking us to stop sending paper EOBs. You will need “Level 2” security access to do so. Once you get Level 2 Security, you can start getting your EOBs electronically.
Why not sign up today!
 |
 |
 |
Ask HNE Enrollment
Summer 2011
Comments Off
Jun 222011
With this issue of Living Well for HNE Members we’re starting a new column, Ask HNE Enrollment. If you have questions for HNE’s Enrollment Department, please send them to NewsletterEditor@hne.com. We’ll ask the folks in Enrollment and print their answers in the next issue of the newsletter.
Here are a few questions that have come in to Enrollment by phone in recent months:
Q. Why do I receive multiple mailings of ID cards?
A. ID cards are generated for multiple reasons:
- When you add a dependent
- When you remove a dependent
- If your copayments or deductibles change
- If your plan benefits change
- If you re-enroll with us
- If you renew your coverage with us
If you feel you’ve received new cards in error, or if there is a mistake on your card, please contact HNE Member Services at 413.787.4004 or toll-free at 800.310.2835.
