Trip to ER might be costly

Discussion in 'UPS Union Issues' started by Wally, May 8, 2014.

  1. Wally

    Wally Hailing from Parts Unknown.

    Just looking at our new insurance plan. (177)

    ER visits are only covered at 80%. With the average cost anywhere between 1250-2100 dollars a visit, that 20% could be costly.
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  2. PiedmontSteward

    PiedmontSteward RTW-4-Less


    This coverage mirrors TeamCare's. I think you're misunderstanding something:

    "100% if admitted or within 24 hours of an accident" -- this means if you have a legitimate emergency and go to the ER within 24 hours or wait and it's serious enough to be admitted, the plan pays 100%. If you're going to the ER 48 hours after the fact for, say, a couple of stitches then you're on the hook for 20%. ER visits are extremely expensive and this is to discourage members from using the ER instead of a primary care physician and/or outpatient medical facility.
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  3. bleedinbrown58

    bleedinbrown58 ahhh....the mouth breathers

    GetInline-3.jpeg first day of accident is covered 100%...whether you're admitted to the hospital or not.
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  4. bleedinbrown58

    bleedinbrown58 ahhh....the mouth breathers

    The way I read it, subsequent visits may only be covered 80% until your out of pocket is met, then it's covered 100%. Even under my old insurance, I've never paid a dime or received a bill for going to the ER.
  5. saintrick

    saintrick Member

    Teamcare pays emergency room at 80%

    Teamcare does however have an outpatient accidental bodily injury benefit that pays 100% (after deductible is met) for the first 24 hours of treatment if treatment is performed within five days of accident.

    Bottom line what you can expect to pay is

    For an accident or admitted up to you deductible.

    For an illness 20% up to the 1000 per person out of pocket limit.
  6. Xexys

    Xexys Retired and Happy

    Even the UPS plan has changed for the worse. Since I'm retired and on the old plan, I will get switched to a different version of Aetna. My wife and I used to get treatment that was covered at 100% on the old plan and even though it's still Aetna, the treatment is called "experimental" on the new version of my plan and is not covered at all.

    Can't wait to find out what else I have to pay more for to not get.
  7. UpstateNYUPSer

    UpstateNYUPSer Very proud grandfather.

    This is only if you go to the ER and are not admitted.
  8. Packmule

    Packmule Well-Known Member

    I think you are the only one here reading this carefully.
  9. UpstateNYUPSer

    UpstateNYUPSer Very proud grandfather.

    ...which is hard to do when I am driving and making my pickups....
  10. opie

    opie Member

    Wonder how would they determine if it's within 24 hours? Sometimes you might get an injury or illness, and not think much of it. And then it gets worse, so you go to the emergency room a few days after. And then to avoid the 20% out of pocket expense, you tell the hospital it just happened. Sometimes they can probably tell how old an injury is, but other times they will have to take the word of the patient.
  11. Harry Manback

    Harry Manback Robot Extraordinaire

    It would be a real bummer to put forth such effort only to find out Packmule, was talking to someone else. :/

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  12. oldngray

    oldngray nowhere special

  13. opie

    opie Member

    There are many instances where you may be sick. And like most people, we let it run its course. But sometimes after a few days or longer, it could turn into something severe, and requires a emergency room visit. Does that mean we only get covered 80%?
  14. Xexys

    Xexys Retired and Happy

    Always knew you were stealing time.
  15. UpstateNYUPSer

    UpstateNYUPSer Very proud grandfather.

    Seriously? They time punch your record when you check in.

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  16. Wally

    Wally Hailing from Parts Unknown.

    "Accident" is the term that got me worried. Many ER visits are not accident related. What if one felt chest pains? An ER visit sometimes can run in the thousands for something like that without being admitted.

    I guess everyone should remember, "you fell" and now (fill in the blank)...
  17. Inthegame

    Inthegame Well-Known Member

    What it means is use emergency rooms for emergencies.
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  18. Big Bad Wolf

    Big Bad Wolf Active Member

    How much are you expecting to go to the ER? If something is that serious, will cost be your primary concern? You have your answer now move on.

    Where are you pigs now?
  19. Wally

    Wally Hailing from Parts Unknown.

  20. 'Lord Brown's bidding'

    'Lord Brown's bidding' Well-Known Member

    Do any of you have urgent care facilities nearby? These are the places you are suppose to go in lieu of ER visits.

    Several years ago UPS sent out a mailer talking about our options when seeking medical care, in order to help reduce costs. The vast majority of times people go to the ER-for sprains/strains, broken bones that don't break the skin or don't involve trauma, flu/fever, etc.-they should use another alternative, preferably their primary care physician. Next is an ambulatory care provider, like a CVS Minute Clinic. For serious, but non-life threatening, medical situations you should visit an urgent care facility, which can take of most medical situations.

    I've been stressing that my family use the ER alternatives since I got that mailer, ending $100 bills to the ER for the $25 copay for visiting an ER (if you were admitted, or it is an emergency, like a bone break involving trauma). However, under Teamcare, that $25 copay is going away. Nice little benefit.
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