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Benefit Tips

Make the most of your benefits. Take advantage of these tips.

Medical Benefits

  1. Call Transition Care Program at 1-800-554-0281 if you have been admitted to the hospital or are scheduled for outpatient care. They can assist with coordinating your medical needs and follow-up care.
  2. Understand what is and is not covered. Click to find out.
  3. Always use PPO providers when you receive preventative care, like exams and immunizations. If you don’t, the services will not be covered under the Plan.
  4. Use PPO providers to receive a higher level of benefits. To find PPO provider call 1-800-810-2583 or go online at highmarkbcbswv.com/home/.
  5. Keep your ID card readily available to show to providers. It identifies you as a covered member of the 4th District IBEW Health Fund.
  6. Be sure to ask you doctor questions about the treatment plan and medication he or she recommends.
  7. Have laboratory tests performed at LabOne facilities. Laboratory tests are covered at 100% when you use LabOne. To find a collection site near you, call 1-800-646-7788 or go online at www.LabCard.com.
  8. Pre-certify hospitalization, surgery, skilled nursing care, and inpatient mental health and substance abuse treatment by calling American Health Holding at 1-866-898-9354.
  9. If you’re finding it difficult to quit smoking, participate in the Free & Clear Quit For Life® Program. Click here to learn more.
  10. Notify the Fund Office immediately if you move, marry, divorce, adopt a child, or experience any life-changing event. To learn more about what to do in such instances and others, click here.
  11. Elect paperless delivery option for your Explanation of Benefits (EOB). This is not only a more convenient and efficient way to keep track of your benefit claims, it helps reduce costs.
  12. When you receive an EOB in the mail, check it carefully to make sure you and the Fund are being accurately billed for services you actually received.
  13. If you need someone to act on your behalf when you need medical care, be sure to follow the Fund’s procedure for appointing an authorized representative.

Prescription Drug Benefits

  1. Ask your doctor for samples of your medication.
  2. Ask your physician if a generic equivalent is available for any prescriptions you need to have filled. By law, generics must meet the same standards for safety, purity, and effectiveness as brand name medications – but generics generally cost less.
  3. Use the mail order program for medications you’re taking on a long-term basis. Contact Sav-Rx at 1-866-233-IBEW (4239) for information about how to use the mail order program.
  4. To get started with mail order, ask your doctor for two signed prescriptions: one for an initial supply to be filled at your local participating Sav-Rx retail pharmacy and the second for an extended supply (for up to 90 days) that you can receive through mail order
  5. Find out how much medication you need, and make sure your doctor doesn’t order you more medicine than is necessary to treat your condition.
  6. Be sure to use Sav-Rx retail pharmacies. Go to www.savrx.com and enter in group number “IBEWD4” to locate a facility near you.

Dental Benefits

  1. Receive dental preventive care services. They are covered at 100% and are important for maintaining overall dental health.
  2. Request a treatment plan from your dentist for dental procedures that will cost more than $300, so you know in advance the charges you’ll be responsible for and the amount the Plan will pay.

Vision Benefits

  1. Use VSP providers for vision care services. VSP providers have discounted fees, which can save you money.
  2. To find a VSP provider, visit vsp.com or call 1-800-877-7195.

Health Reimbursement Arrangement

  1. Call American Benefit Corporation at 1-888-466-9094 and ask for the HRA Department.
  2. Keep your receipts handy in case you need to provide them to American Benefit Corporation to verify an eligible purchase. In fact, if you want, you can mail or fax your receipts to American Benefit Corporation immediately after using your HRA Debit Card. The system will be updated so that when the change is processed, the substantiation required will already be recorded and no follow-up will be necessary. You can mail you receipts to American Benefit Corporation, Attn: HRA Department, or fax to 304-525-6005.
  3. Only use the debit card for eligible purchases.
  4. Try to always use IIAS-certified merchants.
  5. Don’t forget to take advantage of your HRA credits. They can be used to pay for health care expenses, including copays, over-the-counter medications, dental treatment, physical therapy, and prescription contact lenses or glasses.

Weekly Disability Benefits

  1. Notify your employer and the Fund Office as soon as you become ill or injured.
  2. Apply for Social Security or pension disability benefits, if you are eligible.

Life Insurance and Accidental Death & Dismemberment (AD&D) Insurance Benefits

  1. Ensure your beneficiary designation is up to date.
  2. Contact the Fund Office to update your beneficiary information if you experience a life event like marriage, divorce, or birth or adoption of a child.
  3. Inform your beneficiary that they may be eligible for life and AD&D benefits in the event of your death.

Member Assistance Program (MAP) Provided Through Lyra Health

  1. Lyra’s Care Navigator Team is available 24 hours a day, seven days a week.
  2. Meet with a MAP counselor for up to eight sessions, free of charge.
  3. Confidential counseling and work-life services to help you handle personal and/or work, legal or financial concerns.
  4. Call 1-877-363-0489 to speak with a counselor or visit 4thdistricthealthfund.lyrahealth.com to learn more.

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