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Western Association of Retired Faculty presents Navigating the Healthcare System

Western Association of Retired Faculty presents Navigating the Healthcare System. C. Dennis Simpson, Ed.D. Self-Advocacy. You are the primary agent for your healthcare WMU , BCBSM, MPSERS, Medicare and you are the payment sources You are the primary agent for your healthcare.

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Western Association of Retired Faculty presents Navigating the Healthcare System

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  1. Western Association of Retired FacultypresentsNavigating the Healthcare System C. Dennis Simpson, Ed.D.

  2. Self-Advocacy You are the primaryagent for your healthcare WMU, BCBSM, MPSERS, Medicare and you are the payment sources Youare the primaryagent for your healthcare

  3. Record Keeping Organization of records EOBs (Explanation of Benefits) Journal or filing system

  4. Networks In-network (Community Blue PPO) • Co-pay • Deductible (Individual, Family) Out-of-network (Community Blue PPO) • Referred by in-network • Not referred by in-network (Balance Billing) Check before receiving services

  5. When seeing a healthcare provider Have questions and symptoms listed on paper Have current medications and dosages and frequency listed on paper (bring prescription bottles) Write down all instructions from the provider Email your understandings to provider’s office

  6. Coverage is a moving target Medical policies change Drugs change from tier to tier • Ask provider if a generic is available Prior authorization

  7. Available Assistance The yellow handout contains important contact information WMU Human Resources • Summary of drug and health benefits • Information on network providers Blue Cross/Blue Shield of Michigan • Questions on specific services and coverage • Questions on billing statements

  8. Available Assistance Michigan Office of Retirement Services • MPSERS retirement and health insurance information Medicare • General Medicare information • (Refer to BCBSM or WMU HR for specific plan questions) Michigan Medicare/Medicaid Assistance Program • Free counseling and assistance on Medicare and Medicaid issues

  9. Remember It is yourbody and your money You have primary responsibility for your healthcare

  10. Future WARF Sessions Nutrition, diet and healthy living Sindecuse Plan, Unified Clinics and Rehabilitation Services How Medicare and BCBSM work Independent living, assisted living and long-term healthcare Wills, trusts, power of attorney, guardianship Other ideas?

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