Lennox VPC

Jargon is the worst. Let’s put this in real English for you:

• Premium. Your  premium is like rent: it’s the amount you pay for your health insurance every month. 

• Copay. Your copay is the amount of money ($20, for example) you pay for any doctor visit or healthcare service covered by your insurance. 

• Deductible. Your deductible is just the amount of money you’ll pay towards doctor visits and other healthcare services yourself, before your insurance plan starts to pay. Plans have different deductibles. You “meet” your deductible when you have spent that amount on healthcare services.

• Coinsurance. Coinsurance is the percent of costs of doctor visits and other healthcare services you’ll pay after you’ve reached your deductible and your insurance plan has started to pay.
  
  It’s a lot. Here’s an example. Say you get a $3000 medical bill.
  Your plan has a deductible of $2000 and coinsurance of 20%.
  You’ll pay $2000 (“meeting” your deductible), and have $1000 still left to pay.
  Of that $1000, you’ll pay 20% and insurance will pay 80%.
  Your final total: $2200. 
  $2000 deductible + $200 coinsurance (20% of $1000 =$200).

Unfortunately, it’s not just about the lowest monthly costs, or even lowest deductibles. Best guesses are your best bet. Jot down anything you can think of you might need in the upcoming year or any changes you anticipate. Here are some helpful questions:

• Do you imagine next year will be about the same as last year as far as your healthcare needs?  
• Do you have any anticipated large medical expenses in the next plan year, such as surgery, pregnancy, or chronic conditions that require many appointments/tests? (If you have conditions you need to manage or high cost medical expenses, a PPO/ HMO may be more cost effective in the long run.)
• Or are you healthy and engaging mostly with preventive care? (Then you might consider a High Deductible Healthcare Plan, or HDHP.)
• Are there screenings or vaccinations that are now recommended for you?

Honest answer, it could take a few calls. But it’s worth the time, including any time spent on hold, to get the right answer.

Call your doctor’s office or your health insurance company. They can check and confirm first-hand whether or not your doctor will still be in-network. We suggest calling again at the beginning of the year. It’s rare, but sometimes things change and doctors change which healthcare insurance they accept at the last minute.

Even easier: clients of Included Health who have our Open Enrollment Support service can use the app to quickly check if their doctors will remain in-network.

Healthcare spending accounts  are a great way to save money on medical expenses. There are three types, explained below. In two of them, you choose a set amount to deduct from your paycheck every month, pre-tax. The third is a fund that your employer puts money into on your behalf. 

In all three, the money in these accounts is not taxed, which means that if you pay for expenses using these accounts, you save around 30%.You can use this money to pay for copays, deductibles, and other medical expenses. You can also use it for vision expenses, sunscreen, bandaids, pain relievers and more. Many online-retailers have special HSA and FSA ‘stores’.

Here are the three types, with some of their pluses and minuses:

• Health Savings Plan (HSA): A savings account that you own. 

You decide how much to put into the plan every month, and that money goes into the savings account, tax-free. You can deduct these HSA contributions on your taxes. Employers can also contribute to your HSA. Rules for what you can spend it on can be complicated and they are only available if you have a high deductible health plan (HDHP). The money rolls over from year to year and if you leave, you keep the account.

• Flexible Spending Account (FSA): A savings plan owned by your employer. 

An FSA is like an HSA: you decide how much to put into the account, the money goes in tax free, and your employer can also contribute to the FSA. But you cannot deduct this money from your taxes. On the plus side, the account can be used for many types of health insurance plans, not just a high deductible account that an HSA. If there’s unused money at the end of the year, you can: 1) Get 2.5 more months to spend the left over money, or 2) Carry over up to $615 to spend the following year. 

• Health Reimbursement Account (HRA): An account funded by your  employer, on your behalf.

With this one, money is not deducted from your paycheck. Your employer chooses which medical expenses the money can be used for and reimburses you with tax-free dollars for those expenses. Unused amounts can be rolled over to use the next year. You lose any money in the account if you leave the company.

Doctor On Demand is a health care service that provides on-demand access or same-day appointments with board certified physicians or next day appointments with psychologists and psychiatrists from any device with a front-facing camera such as a smartphone, table, or computer. Doctor On Demand providers can treat most common non-emergency medical issues through live, face-face video visits. Our approach to care is all about breaking down the walls of an office and supporting your health wherever you are. Doctor On Demand by Included Health’s US-based, board-certified doctors, nurse practitioners, therapists, and psychiatrists are available on your schedule.

If you have already seen a specialist and you need to send your records to Doctor On Demand, you can contact Member Support team for assistance either through the messaging tool within the Doctor On Demand app or by calling Doctor On Demand’s Support team at 1-800-997-6196. 

Our providers see a broad range of conditions from preventive care and everyday care, to chronic condition management. Examples of common conditions we treat include: 

Chronic disease management:

• High Cholesterol
• Asthma
• Diabetes
• High Blood Pressure
• Weight Management

Preventive care: (see section below for more details)

Urgent/acute:

• Cold & Flu
• Sinus Infections
• Bronchitis & Pneumonia
• Urinary Tract Infections
• Vomiting & Diarrhea
• Conjunctivitis
• Vaginal & Yeast Infections
• Cellulitis & Skin Conditions
• Allergies 
• Fevers 

If your treatment includes a prescription, the provider will review the order and confirm your pharmacy during the visit. The provider will then electronically order the prescription, and it will be ready for you to pick up once your pharmacy prepares your medication. You can select your preferred pharmacy anytime in the Doctor On Demand app.

The process for each is similar to what you’d expect when going to see a doctor in person. Here’s how it works:

1. If your Doctor On Demand primary care provider orders imaging for you, they will review their recommendations with you during your visit.
2. Following your visit, you’ll be contacted by a member of our Care Team who will help you find an affordable and convenient location within your network for you to get the imaging done.
3. A member of the Care Team will help you schedule any necessary appointments and provide you with documentation to bring with you to the imaging center.
4. Once the imaging center sends results back to Doctor On Demand, the results will be sent to us to review. Your primary care provider will then contact you with information about what the results mean and if any further action or follow up is necessary.

During your visit, if the provider thinks a lab test would be beneficial for you, they have the ability to order a lab test. You simply visit the lab location closest to you, have the test run, and the results will be sent to you from Doctor On Demand within ten business days.

In the event your primary care provider needs to see you regarding your lab results, a member of the Care Team will reach out to coordinate scheduling the visit. The lab results will also be available for you to review under “My Health” in the app.

The process for seeing a specialist or getting a referral is similar to what you’d expect when going to see a doctor in person. Here’s how it works:

1. If your Doctor On Demand primary care provider recommends that you see a specialist or need to see a doctor in person, they will review those recommendations during your visit.
2. The provider’s recommended order will be automatically sent to our Care Team who will follow up with you within a few days, depending on the urgency of your situation.
3. You’ll receive an email confirmation that your provider has made this recommendation for a referral and that you’ll hear from us soon.
4. A member of the Care Team will contact you with recommendations for nearby, affordable, and high quality providers that are your network. Our care team can help you schedule an appointment or give you the provider’s contact information so you can schedule directly with an in-person clinician.
5. A member of the Care Team will also provide you with any documentation you’ll need to bring to your appointment.
6. After you’ve seen the specialist, your primary care provider will review the findings and recommendations, and if needed, will schedule a follow-up appointment for you so that they can review your results and create a treatment plan that’s personalized and appropriate for you.

 During a virtual Annual Check Up, your Primary Care Provider (PCP) will:

• Review your vitals captured via your Primary Care Kit which includes a blood pressure cuff and thermometer. 
• Discuss personal and family medical histories
• Review current lifestyle and health choices
• Review immunizations
• Screen for potential illness such as depression or anxiety
• Discuss personal health goals such as weight loss, smoking cessation, etc
• Guide you through a virtual physical examination

Our PCPs follow the recommended preventive care services by U.S. Preventive Services Task Force (USPSTF) and provide screenings based on age and gender. From a preventive care visit you will receive a personalized plan focused on their health needs and goals.

If in-person preventive care is needed, your PCPs can order appropriate labs, imaging, and make referrals to in network, in-person care. Examples of services that may require a referral to an in-person provider include vaccines, blood work, mammograms, or colonoscopy. 

To learn more about our preventive care visits, watch this Virtual Primary Care video. 

We believe that preventive care is a key component of primary care. Our solution was designed to effectively deliver preventive care in a virtual setting. Through video calls, our primary care provider (PCPs) can conduct the majority of the preventive care screenings you may need. 

Preventive care visits will provide our PCPs with a status on your members’ overall health. Our PCPs follow the recommended preventive care services by U.S. Preventive Services Task Force (USPSTF) and provide screenings based on age and gender. From a preventive care visit you will receive a personalized plan focused on their health needs and goals.

In addition to primary care providers, our Care Team is available to assist with any additional questions you may have outside of your visit. They can be contacted through the messaging tool within the Doctor On Demand by Included Health app or by calling 1-866-646-6963.

Yes. For urgent needs, you may have a visit with any Doctor On Demand provider. Simply click “See First Available” when you open the Doctor On Demand app. 

However, for preventative care and routine visits we strongly encourage you to see your Doctor On Demand primary care provider. 

Yes. You may change your primary care provider at any time in the Doctor On Demand by Included Health app or at doctorondemand.com. Simply go to “My Health” and select your primary care provider from “My Providers.” From your primary care provider’s biography, you will see the option to “Change Primary Doctor.”