Free preventive and wellness services€¦ · Call Provant at 1-866-271-8144 Monday Friday, 5 a.m. 5 p.m. After your first call, your coach will schedule follow-up calls to see how

Free preventative and wellness services

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Free preventive and

wellness services

March 13, 2014

Free preventative and wellness services2

Agenda

• Benefits overview

• Preventive services

• Primary care visits

• Free lab tests and more

• Free prescriptions

• Wellness services

• Health screenings

• Optional Tobacco-free Program

• Health coaching

• Flu shot

• Employee Assistance Program (EAP)

• HAP mythbusters

• Resources


Preventive services: Primary care visits

• Four free primary care visits per year for each family member on

the Health Account Plan

• Primary care doctors include:

• General or family practitioners (including nurses)

• Internal medicine doctors

• Pediatricians

• Family nurse practitioners

• OB/GYNs

• Non-hospital urgent care services

• After four free primary care visits, you pay 10% of the costs for

future visits (no deductible required)


Preventive services: Free lab tests and more

• Routine preventive screenings and services, based on age and

gender, include:

• Chest x-rays

• Colonoscopies

• Glucose tests

• Lipid tests

• Mammograms

• Pap smears

• Urinalysis

• Visit www.mypgebenefits.com>Resources>Anthem or Kaiser

Resources for a complete list of free lab tests and vaccines


Preventive services: Free prescriptions

Free preventive and maintenance drugs

• Visit www.mypgebenefits.com>Resources to see the list of free

medications available through the HAP

• Prescriptions that are not listed on the free list are still covered by the

plan

Anthem Members Kaiser Members

Express Scripts is the pharmacy

provider for Anthem members

Kaiser provides pharmacy

benefits for its members

Free medications for Anthem HAP

must be obtained from Express

Scripts mail-order

Free medication from Kaiser can

be from any Kaiser pharmacy or

mail-order


Wellness services: Health screenings

• Annual health screenings help you earn extra credits in your Health

Account:

• Health screenings consist of four tests:

• Weight/Height to get BMI, Blood Pressure, Glucose Level (non-fasting) and Cholesterol Level

• Optional Tobacco-free Test or Cessation Program

• Health screenings:

• Assesses your risk for developing serious illnesses

• No pass or fail (except tobacco-free test)

• Completely confidential; PG&E does not know your results

Health Account Credits Single Coverage Family Coverage

Health screening Earn $250 Earn $500

Tobacco-free test Earn $250 Earn $500


Wellness services: Health screenings

• Schedule your health screening by September 30, 2014 to earn

credits toward your 2014 Health Account

• Call Provant at 1-866-271-8144 to request concierge screening

• You may schedule your health screening for credits toward your

2015 Health Account beginning October 1, 2014


Wellness services: Optional Tobacco-free Program

• If you choose to do the tobacco screening, it must be obtained

through PG&E

• Test negative for tobacco during an optional annual test at your on-site

or concierge health screening–OR

• Test positive for tobacco or opt-out of the tobacco test because you

currently use tobacco – and later complete Provant’s telephonic

Tobacco Cessation Program

• When you (or spouse/domestic partner) are ready to quit for

good, Provant offers a five-week, phone-based Tobacco Cessation

Program that gives you one-on-one support with a certified tobacco

cessation specialist

• Nicotine replacement therapy is available to complement the program


Wellness services: Health coaching

Want to get healthier, but don’t know where to start?

• The Health Coaching Program provides a dedicated health coach

to help you set goals based on your health needs

• Call Provant at 1-866-271-8144 Monday–Friday, 5 a.m.–5 p.m.

• After your first call, your coach will schedule follow-up calls to see how

you’re tracking against your goals

• If you prefer online sessions, visit https://pge.provantonline.com

to schedule a secure messaging appointment with your health

coach


Wellness services: Flu shot

• The Health Account Plan includes free flu shots

• You can visit an on-site health screening between October and

February to receive your flu shot

• If an on-site health screening isn’t available:

• Anthem members can use their Express Scripts card at an Express

Scripts member pharmacy such as Walgreens, CVS or Rite Aid

• Kaiser members can visit their physician


Employee Assistance Program (EAP)

• The EAP offers confidential support for a wide variety of life events and

concerns:

• Childcare resources and services

• Eldercare resources and services

• Financial advising (initial 30-minute consultation free)

• Legal counsel (initial 30-minute consultation free)

• Confidential counseling for:

• Stress management

• Family and relationship challenges

• Anxiety or depression

• Alcohol and drug issues

• You and each of your family members are eligible for up to six free one-

on-one counseling sessions per six-month period with a licensed EAP

counselor

• Visit www.achievesolutions.net/pge to explore all the ways the EAP

can help and to find a list of EAP on-site counselors

• Call 1-888-445-4436 to speak to a licensed EAP counselor, available 24

hours a day, 7 days a week


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HAP mythbusters


Top 10 HAP myths

10. Under the new plan, I only get a total of four

visits to the doctor each year.

•Under the HAP, you get four free

primary care visits per year, per

person

•Beginning with the fifth visit, you pay

10% of the costs, with no deductible


Top 10 HAP myths

9. Everyone covered under my plan has to share

the four annual visits to the doctor.

• Under the HAP, each person covered

receives four annual primary care

visits to the doctor


Top 10 HAP myths

8. If I have to see a health care specialist (care

outside of my primary care doctor), I have to

pay out-of-pocket.

If your primary care doctor refers you to

see a specialist:• Covered by the HAP

• You’re responsible for 20% of the

covered charges after you meet the

deductible

• May be paid using your Health Account


Top 10 HAP myths

7. The drugs on the Free Drug List are the only

prescriptions that are covered under the new

HAP.

• The Free Drug List primarily includes

maintenance drugs that keep you

healthy and are not applied to your

deductible

• Prescriptions that are not listed on

the free list are still covered by the

plan


Top 10 HAP myths

6. If my doctor orders a lab test that is not on the

Free Lab Test List, it’s not covered under the

HAP.

If your doctor orders a diagnostic test

that is not on the Free Lab Test List:• You’re responsible for 20% of the

covered charges after you meet the

deductible

• May be paid using your Health Account


Top 10 HAP myths

5. I have to pay $4,800 before the HAP plan covers services for anyone in my family.

You can use your PG&E-funded Health Account

credits to help pay for out-of-pocket costs until

you reach the annual out-of-pocket maximum.

If you have the maximum Health Account

credits, the most you’ll ever have to pay in a

year is:• $1,400 if you have single coverage• $2,800 if you have family coverage


Top 10 HAP myths

4. I’ll have a significantly higher out-of-pocket

expense under the new Health Account Plan.

• In 2013, we had 7,000 management and A&T

employees covered and less than 6% hit the

out-of-pocket max

• 63% of our employees still had credits left in

their Health Account at the end of 2013

• Don’t forget, unused credits roll over year after

year


Top 10 HAP myths

3. Having a baby is free under the HAP.

• Pre-maternity doctor visits are free

• After your deductible is met, you’re

responsible for 20% of the covered

charges for the birth of the baby


Top 10 HAP myths

2. The dependents covered under my Health

Account Plan have to get a health screening in

order for me to get the Health Account credits.

• No, only you need to get the annual

health screening to earn Health

Account credits

• Your dependents can get an annual

physical from their primary care

doctor to access their health


Top 10 HAP myths

1. When I picked my prescription up in the beginning of the year, it was $600. It’s going to cost me that much each time I get my prescription filled.

• No. On the first visit to the pharmacy,

you’ll pay 100% of the costs for your

prescription (can use your Health

Account to pay)

• Once you’ve met the deducible, you’ll

pay 10%-25% of the prescription costs


Resources – www.mypgebenefits.com

• Accessed from any

computer with internet

access

• Using Your Medical Benefits

• Using Your Wellness

Program

• Understanding Your Medical

Benefits

• Anthem and Kaiser Free

Lab List

• Anthem and Kaiser Free

Drug List


Resources – Provant

Want to talk to an expert about the Health Account Plan

(HAP)?

• Contact Provant–your one-stop shop for health and

wellness

• Match you to the right wellness tools and resources for your

specific health goals

• Help you understand how the HAP works

• Resolve claims or billing questions

• Email Provant at [email protected]

• Call 1-866-271-8144 Monday–Friday from 5 a.m.–5 p.m. PT

• Visit https://pge.provantonline.com


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Free preventive and wellness services€¦ · Call Provant at 1-866-271-8144 Monday Friday, 5 a.m. 5 p.m. After your first call, your coach will schedule follow-up calls to see how