We’ve all been in that situation: You or someone you love is sick and you’re panicking. Then on top of being worried, you have to navigate the world of health insurance to make sure the care is covered. Health insurance is complicated, but it doesn’t have to be stressful. Blue Cross Blue Shield of Michigan has done a lot of work to find out how our customers feel and understand areas of frustration. And we’re using what we’ve learned to change how we do business, and to make it easy for members to navigate the health care system with confidence. Here are just some of the issues we’ve seen members experience and the innovative ways we’re working hard to resolve them:
Issue: Doctor’s bills can be confusing, making members unsure about what to pay.
Solution: We recently launched an easier-to-understand Explanations of Benefits (EOB), the piece of paper you get after a doctor appointment that explains what services your insurance company paid on your behalf. It’s simpler to understand, and makes it clear what Blue Cross paid and what you’re responsible for. How did we come up with the improved version? We asked our members. In a two-hour workshop, we watched members cut and reassemble sections of content from several EOB formats so we could see firsthand what their ideal EOB would look like.
Issue: You don’t want to have to study your plan, you want to use it when necessary and have it work.
Solution: We want members to have a full grasp of how to use their plan, which is why we send detailed documents that focus on a specific instance when you might use your insurance. Whether it’s explaining the difference between going to the emergency room and an urgent care clinic, or detailing the specifics of what happens when you go to an out-of-network doctor, these documents break down each kind of situation into small, easy-to-digest pieces of information. This means you’ll understand how to use your health insurance, no matter what issue arises.
Issue: Managing complicated health conditions, such as cancer, transplants or diabetes, can feel overwhelming.
Solution: We know you need support when dealing with these kinds of procedures and conditions, which is why we provide care management programs. These programs can help improve our members’ quality of life and reduce the stress of managing a condition. Program participants receive in-person or over-the-phone assistance and get help coordinating their care, monitoring their illness and adjusting their diet to ensure they’re getting the nutrients they need. They also get reminders for taking their medication and refilling prescriptions as well as have access to a 24-hour nurse line.
Issue: You need information, when you need it.
Solution: Whether you're sitting at your computer or on the go with a mobile device, we’ve created an award-winning online experience that’s chock-full of helpful features. Bcbsm.com allows you to easily access benefit information, check what is or is not covered by your plan and search for doctors by criteria like extended office hours, gender, specialties and quality designations. See what languages doctors speak and check out patient reviews, too. You can monitor your claims, find out how close you are to reaching your deductible and double-check coinsurance or copays – all in one spot. At bcbsm.com, you can also elect paperless EOBs. Instead of waiting for snail mail, you'll receive an email notification when a new EOB is available for your review.
Issue: Too much jargon and acronyms.
Solution: We use clear language that’s easy to understand. Blue Cross is working organization-wide to eliminate confusing industry jargon when we speak with members. For example, instead of saying “formulary” we say “drug list” and instead of “provider” we use “doctor.” These may seem like small changes, but when a member is trying to understand their health plan, using everyday words can make a huge difference. Not a Blue Cross member? If you’re under age 65 and don’t have a plan through an employer, there’s still time to purchase health insurance on your own. There’s a set window of time each year, called “open enrollment,” when you can buy health insurance directly from private insurance companies. This year’s open enrollment runs through January 31, 2016. To get help choosing the right plan and navigating the enrollment process, call our health plan advisors at 888-899-4931. You can also check out plan options at bcsbm.com/myblue. For more helpful information for Blue Cross members, check out these blog posts:
- Q&A: How Do I Know if my Medication Is Covered by my Health Plan?
- Open Enrollment Deadlines You Need to Know for 2016
- What to Do at 26 to Secure Your Own Health Insurance
Photo credit: Susanne Nilsson