Summer 2016

How to get the most benefit from your benefits

Your questions answered: How to get the right care at the right time

We get it: Sometimes it’s hard to know how to get the most out of your medical benefits. As an OEBB member, you have a lot of choices. Moda’s here to help.

Perhaps you need a little more info to help you know whether it’s best to see your primary care doctor, visit an urgent care clinic or go to the emergency room. Maybe you’re considering a new doctor and aren’t sure whether they’re in-network or not. Or you might want to take advantage of a wellness coach to help you meet your health goals. Don’t know where to start? Here’s a no-nonsense guide to understanding your OEBB benefits.

Why go in-network?

When you see an in-network provider, your benefits are paid at the highest level. Working closely with our providers helps you get the care you need, while saving you money. Log in to myModa and click on “Find Care” to see which in-network providers are near you.

Which care option is best for me right now?

You can save on out-of-pocket expenses by choosing when to visit a primary care provider, a retail health clinic, urgent care or emergency room. The following chart helps explain your options.

Care Option	Best For…	Typical Hours
Primary Care Provider	Building a relationship with your doctor, so that you can manage your health together. Often requires an appointment, but may offer the highest benefits. If your plan requires a medical home, you must receive primary care at your selected medical home to get the highest benefits.	8 a.m. to 5 p.m. weekdays
Retail Health Clinic	Walk-in patients, as these clinics are often located in stores or pharmacies and operate during business hours. If you have a plan that requires a medical home, may be considered out-of-network.	8 a.m. to 5 p.m. weekday
Urgent Care Clinic	When you need care right away, but your doctor isn’t available and you don’t think it’s an emergency.	Usually open days, evenings and weekends.
Emergency Room	Treating patients who need emergency care in a hospital setting.	24 hours a day, seven days a week

Why does it matter which lab I use?

OEBB members can save money by using Quest Diagnostics, the world’s leading diagnostic testing provider. Ask your doctor to send your labs to Quest and you can cut the cost by up to 60 percent.

What other ways can Moda help?

As an OEBB member, you have access to free Moda services, all designed to support you on your health journey. Our health coaches and case managers are here to assist you in setting goals, managing your health conditions and maintaining your progress.

Our clinical experts also are on hand for one-on-one support, whether you need help communicating with your provider, want support in making changes to your diet or exercise routine, or need some advice for managing a chronic condition. And when you want knowledgeable answers to your healthcare questions, Moda’s nurses are available 24/7. Day or night, just call our advice line at 866-321-7580.

Where can I learn more?

You’ll find more details about Moda’s healthcare services and other benefits at modahealth.com/oebb/members/.

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