I understood that my plan would pay up to $300 for one physical examination per calendar year. The explanation of benefits I received shows that you applied part of the charges to my deductible and only paid 70% of the balance.
This happens when your physician has indicated on the billing statement that your examination was for a specific symptom or complaint. The diagnosis on the billing statement must state that the reason for your visit was for a routine physical examination. The Plan and Trust cannot change the physician's diagnosis; you will need to contact your physician.
Is it important that I advise the eye doctor I have VSP coverage?
Yes. Your benefit coverage is determined based on the preferred provider agreement with VSP. If you do not advise the doctor's office at the time the appointment is made, you may end up paying more out of pocket.
What is the difference between getting prescriptions filled through a mail order facility versus a retail outlet?
Retail outlets are for prescription medications which require immediate use. Mail order is for long-term maintenance prescriptions; up to 3 months supply. When you order your prescription through the mail order facility, you will be sent a statement regarding any co-payment you owe in the mail along with the prescription medication.
The annual medical deductible is $100.00 per active member and $200.00 per family. For retirees under 65, the annual medical deductible is $2,000.00. For retirees with Medicare, the annual deductible is $200.00.
Should my doctor send my lab work to Alaska Regional Hospital as the preferred provider facility under the Plan rather than Providence Hospital?
Yes. You should request to have your lab work done at
Alaska Regional Hospital. Even though your doctor's office may be located in the Providence Hospital Medical Center, you will pay less out of pocket if have the lab work done at Alaska Regional.
I went to the emergency room and the bill wasn't paid at 100% - why not?
Hospital Emergency room benefits are extended for Hospital outpatient emergency room care when required for Emergency treatment of an Illness or Injury. They are subject to your deductible, then paid at 80% if treatment was done at a PPO facility, or 70% if treatment was done at a non- PPO facility. No benefits will be extended for emergency room care that is not related to an Emergency and/or could have been provided in a Physician's office, an outpatient clinic or urgent care center.
Is it important to take my pharmacy card with me when I get my prescriptions filled?
Yes. Pharmacists at any of the in-network pharmacies need the information off your prescription card to ensure you get the proper benefit coverage under the Plan.
How do I determine which eye doctors participate in the Vision Service Plan (VSP) program?
Check out the web site at www.vsp.com or you call VSP at (800) 877-7195 to verify which doctors in your area are VSP Providers. If you have questions, you can also contact the Trust Customer Service office at (907) 565-8300 or (800) 478-4450.