You can’t AVOID, PREVENT or MANAGE all your Medical Costs, you’ll need to MITIGATE some of them with Telemedicine, Advocacy and other Tools.
Using modern technology for non-urgent medical needs, such as a rash or fever, instead of rushing to the doctors office, urgent care or the ER saves thousands. Members have access to a dedicated Member Advisor through the medical cost sharing provider. Your assigned Member Advisor helps you navigate confusing aspects of your health care and can be utilized for a variety of health care-related questions, surgery cost savings, counseling, medical bill negotiation, appointment scheduling, reduced prescription costs, and physician searches.
If you face (1) a new diagnosis, (2) a possible surgery, (3) a change in medication, or (4) a chronic illness, even including one currently excluded from sharing because it is a pre-existing condition and want to discuss your options with a top expert on your condition, 2nd.MD is here for you. You’ll have access to more than 300 nationally recognized, board-certified medical specialists that cover more than 120 sub-specialties. These world-renowned physicians are available for consult via video conferencing or telephone from virtually anywhere in the world within about 3 days, providing program members the peace of mind that they want and deserve.
The program’s experience with 2nd. MD is that 1/3 of planned surgeries are cancelled; that treatment plans are improved 70% of the time; and that the average savings/consultation are $3,000.
If a member receives treatment in accordance with the second opinion, his or her Initial Unshareable Amount for medical cost sharing (see the Contain section) will be reduced by $250.
Sedera (the medical cost sharing administrator) requires members to use the 2nd MD program prior to undergoing elective surgeries and suggests that members who have any of the four situations described above (including members with significant pre-existing conditions) utilize this no cost service.
If the member disagrees with the second opinion, s/he can request a third opinion and the opinion of two of the three doctors will be considered the second opinion.
Program members who don’t use 2nd MD in the case of an elective surgery will be penalized under medical cost sharing. Need sharing may be reduced up to 25% on bills over $500 for members who either refuse to utilize the 2nd MD program, intentionally skip the process, or who don’t follow the second opinion.
Teladoc™ (Telemedicine) offers convenient access to board-certified physicians, dermatologists, and pediatricians 24 hours a day 7 days a week/365 days a year through a phone call. It allows members to talk to a doctor when they need it, without having to book an appointment or take time off from work to visit an office in person. Members can call as often as they wish and there is no cost for a consultation. Teladoc physicians can prescribe medications over the phone and can even video conference in most states. It’s not for everything, but great for the small stuff.
Feeling ill is never convenient, especially in the middle of the night or while traveling. With Teladoc, the doctor is always in, day or night.
Examples of items that fall into this category: cold, sinus infection, and flu.
For emergencies call 911. Teladoc is not available in Arkansas.