Spring 2016 Our Best Rewards Yet in 2016!

For Health Benefits Officers and Federal Employees
FEDERAL FACTS
Fall 2016
Blue Cross and Blue Shield
cordially invites you
to be our guest at a
Pre-Open Season Seminar.
www.fepblue.org
2016
Open Season
November 14 –
December 12, 2016
October
21 - 29
Recent Media
If you have heard from your local
media about increases in health
insurance premiums for the Blue
Cross and Blue Shield (BCBS)
retail markets in some states,
the rate increase DOES NOT
apply to the Federal Employees
Health Benefit Program (FEHBP)
members. The Office of Personnel
Management will announce any
changes to the FEHBP plans for
2017 in late September or early
October of 2016.
Join us for our 2016 Pre-Open Season Seminar
Don’t miss our 2016 Pre-Open Season Seminar. Take this time to visit with your government
account representative. The seminar will feature:
•Updates on FEHBP benefits and rates
• Updates on dental and vision programs
• The Value of Blue®
• Guest speakers on health and wellness topics
• Complimentary breakfast and/or lunch
Watch your email for a new one-click way to register. You can also call Kelley Salazar at 505-816-2283
or Karla Candelaria at 505-816-2027.
New Mexico Pre-Open Season Seminars
Albuquerque – Tuesday, October 18, 2016
Las Cruces – Wednesday, October 19, 2016
BCBS has invited other FEHBP health insurance carriers to present their 2017 benefit materials in Albuquerque.
The Importance of Preventive Health Care
Preventive care is important at any age. It helps identify
health concerns or conditions in the early stages of
development, making them easier to treat. Americans use
about half the preventive health care services they need
to stay healthy and avoid or delay the onset of disease.
Chronic diseases that are often preventable, such as heart
disease, cancer and diabetes, are responsible for seven out
of ten deaths among Americans each year.
Millions of infants, children and adolescents in the United
States do not receive key clinical preventive services.
America must protect the health of all children and ensure
that they receive recommended screenings and services.
Increased use of clinical preventive services could improve
the health of all children and promote healthy lifestyles
that will enable them to achieve their full potential.
The adoption of the Affordable Care Act (ACA) made
preventive care from a Preferred provider accessible to
FEHBP members with no out-of-pocket costs. This means
there are no deductible, copayment or coinsurance costs to
you. So be sure to make annual doctor visits a priority.
Note: If you receive both preventive and diagnostic services
from your Preferred provider on the same day, you are
responsible for your cost-share for the diagnostic services.
Preventive Care Benefits
BCBS makes it easy for members to take advantage of
these services with adult and child preventive benefits. For
a complete description of preventive care benefits covered
under the Blue Cross and Blue Shield Service Benefit Plan,
refer to the Plan’s Federal brochure, RI 71-005.
Adult Preventive Care
The Service Benefit Plan provides preventive care
services for adults age 22 and over. They include services
recommended under ACA and by the U.S. Preventive
Services Task Force (USPSTF):
• Visits or exams for preventive care, including a history
and risk assessment, chest X-ray, EKG, urinalysis,
complete blood count, fasting lipid profile, cholesterol
tests and metabolic and general health panel tests.
• Preventive screenings, including pap smears,
mammograms, colorectal cancer tests, prostate cancer
tests, STD screenings, genetic counseling in certain
situations and related office visits.
• Routine immunizations as licensed by the U.S. Food
and Drug Administration (FDA). Refer to your
benefit brochure, RI 71-005, for a listing of covered
immunizations.
Child Preventive Care
FEHBP provides preventive care services for children up
to age 22, including preventive services recommended
under ACA. These services include, but are not limited to:
• Healthy newborn visits and screenings
• Visits/exams for preventive care
• Laboratory tests
• Hearing and vision screenings
• Routine immunizations, as licensed by FDA
• Nutritional counseling services
Call our Nurse Line at 888-258-3432 to learn more
about recommended preventive services.
Source: Centers for Disease Control and Prevention
The Value of Generics
Switching your prescriptions to generic drugs can be a
great way to save money. Drug makers spend a lot of
money on research and development. Bringing their new
brand name drug to market has huge costs. Brand name
drugs usually have a 20-year patent. During this time,
other drug makers cannot sell a generic version of the
drug. Once the patent expires, other drug makers can
start to produce and sell a generic version of the drug.
The savings on generics get passed on to you.
The Mail Service Pharmacy Program is a convenient and
cost-effective way to get your maintenance or long-term
drugs. These are drugs you take regularly and need to
take long term. Examples might include drugs for high
blood pressure, arthritis or other chronic conditions. You
can get up to a 90-day supply (minimum 22-day supply)
of your drug(s) through the Mail Service Pharmacy for
one copayment. You also have access to a registered
pharmacist, 24 hours a day, seven days a week.
Whether you have Standard or Basic Option coverage,
generic drugs are one way to save money. In a world of
rising health costs, generics offer a path to lower spending.
For more information, visit www.fepblue.org or refer to the
Blue Cross and Blue Shield Service Benefit Plan brochure.
High Quality Prescription Drugs at a Lower Price
Sources: IMS Institute for Healthcare Informatics and the
U.S. Food and Drug Administration
When it comes to drugs, generic does not mean low
quality. A generic drug is the FDA-approved equivalent
of the brand name drug. This means it is the same as the
brand name. The active ingredients are the same. Only
the inactive ingredients, which may affect color, shape or
taste, may differ.
Facts about Generics
More than 80 percent of prescriptions in the United
States are filled with generic drugs. The average cost of
a generic drug is 80 to 85 percent less than the cost of its
brand name counterpart.
Standard Option Generic Incentive Program (GIP)
If you have Standard Option, you can save even more
money. If you currently use a brand name drug listed on
the 2016 GIP drug list, we will waive your coinsurance
for your first four prescription fills or refills if you change
to a corresponding generic option during the calendar
year. You must also fill your prescription at a Preferred
retail pharmacy or through the Mail Service Pharmacy to
participate in the GIP.
Helpful Information
Customer Service
Monday through Friday,
8 a.m. – 5 p.m. Central Time
800-245-1609
[TDD 800-676-3777]
Precertification
800-325-8334
Mail Service Pharmacy
800-262-7890
[TDD 800-216-5343]
Retail Pharmacy Program
800-624-5060
[TDD 800-624-5077]
Nurse Line
Available 24 hours a day,
seven days a week
888-258-3432
Health and Wellness Programs
www.fepblue.org/healthwellness
Affinity Discount Vision Care Program
800-551-3337
To find a provider or learn more about the Service Benefit Plan, go to www.fepblue.org.
Federal Facts is published for Health Benefits Officers and federal employees by Blue Cross and Blue Shield of New Mexico.
Contact your Government
Account Representative
with any questions.
Federal Employee Program
1001 E. Lookout Dr.
Bldg. A, 05.401C
Richardson, TX 75082
Karla Candelaria
5701 Balloon Fiesta Parkway, N.E.
Albuquerque, NM 87113
South central and southwest New Mexico
and parts of Albuquerque
Kelley Walter
5701 Balloon Fiesta Parkway, N.E.
Albuquerque, NM 87113
Northern and southeastern New Mexico
and parts of Albuquerque
Phone: 505-816-2027
Fax: 505-816-3619
karla_candelaria@bcbsnm.com
Phone: 505-816-2283
Fax: 505-816-3613
kelley_walter@bcbsnm.com
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