BNY Mellon Benefits Guide
Know What to Do After Your Visit
You've met with your doctor and have a prescription in hand. Now what? Knowing what to do next can save you time and money.
- Know your costs. Your medical option covers in-network preventive care and screenings (i.e., annual physical and age-appropriate mammogram) at 100 percent. For in-network diagnostic office and specialist visits (i.e., sick visits), you'll pay the in-network negotiated office visit rate until you meet your deductible. Once you meet your deductible, you'll pay 20 percent of the cost (in-network) until you meet your out-of-pocket maximum. Visits to out-of-network providers will always cost you more. For out-of-network services, once you meet your deductible, you'll pay 40 percent of the cost until you meet your out-of-pocket maximum.
- Get any prescriptions filled. Make sure that you use a CVS/pharmacy or CVS Caremark Mail Service to save you time and money. Generally, the CVS Caremark prescription plan automatically offered through Lower Deductible HSA Plan or the Higher Deductible HSA Plan offers lower prices for generic drugs.
- It's important to follow your doctor's treatment plan carefully. In many cases, increased health risks may occur when individuals do not follow the treatment plan outlined by their physician.
- Call your doctor with questions. It's your health. Give it the attention it deserves.
- Review your Explanation of Benefits (EOB) from your carrier. The EOB shows what BNY Mellon paid and the exact amount you owe the doctor or facility—listed under "Member Responsibility. Check to ensure that all listed services were received and coded correctly and match the copy of the bill you received from your doctor or facility. If there are discrepancies, contact your carrier. Remember: In-network preventive care is covered at 100 percent. For all other care, you must meet your deductible—which you can pay using funds from your Health Savings Account—before BNY Mellon starts sharing the cost. Review the preventive care guidelines in "Obtain 100 Percent-Paid Preventive Care" and remember to talk to your doctor and Medical Plan carrier about whether the care you receive is preventive or diagnostic for purposes of health insurance.
- Check out the amount listed under "Member Responsibility" on your EOB—that's what you owe the doctor. You can use your Health Savings Account to pay your doctor if you have money in your account, or you can pay the doctor out of pocket.
- Second opinion? Use Best Doctors Expert Medical Opinion when you need to understand a diagnosis or treatment option. This service provides an additional resource when you need information about a diagnosis of a condition or how to treat a complicated condition. A specialist will conduct a review of your diagnosis and treatment plan, and either confirm what you have been told or recommend a change.