PRIVATE HEALTH PLAN COVERAGE FOR CHILDHOOD IMMUNIZATIONS:

MAKE SURE YOU’RE COVERED!

By calling the phone number provided on your medical benefit card, you can determine whether you have coverage for IMMUNIZATIONS and whether any co-pays, co-insurance, or deductibles apply that you will be responsible for paying. This blog provides suggested questions to ask your health plan. This list is not exhaustive because other issues may apply based on your benefit design.

Please share your answers to these questions with your doctor or healthcare professional.

Questions you may want to ask your health plan:

Do I have insurance coverage for IMMUNIZATIONS?

Are there any restrictions on coverage?

Will I bear any cost for IMMUNIZATIONS? For example:

• Co-pay or co-insurance
• Deductibles that may apply to IMMUNIZATIONS
• Incremental cost if an out-of-network provider is used

Is there an annual coverage maximum on wellness or preventive services that may affect my coverage for IMMUNIZATIONS?

If you answer yes to any of the above, please print, complete and sign this form and bring it with you for your child’s doctor or healthcare professional.

Be sure to check your coverage status for IMMUNIZATIONS before each visit, because coverage status might change.

As a pediatrician I am concerned about the impact Micron’s new insurance system will have on some of the Treasure Valley’s most vulnerable citizens, children.

The new insurance is structured so that only one hospital in the Boise area is covered by the premium coverage. Use of any other hospital results in higher co-pays, and deductibles, resulting in significantly increased health care costs for Micron families.

St. Luke’s Regional Medical Center is not a part of the premium network. St. Luke’s is the only children’s hospital in the area. St. Luke’s has the only pediatric ICU and is the only hospital in the area that provides coverage by all of the pediatric subspecialists such as gastroenterology, neurology, infectious disease, oncology, etc.

With Micron’s new insurance plan families can only access services at the St. Luke’s Children’s Hospital by paying a much higher deductible and receiving lower reimbursements. This results in much higher medical bills for Micron families seeking proper, high quality medical care for their children.

In addition, many physicians that were previously preferred providers are no longer part of the premium network. Imagine the emotional toll on children and their families who are forced to leave a doctor they have grown to trust.

My partners and I at Saltzer Medical Group have seen many children of Micron employees for years, several with chronic and ongoing medical conditions. The change in insurance plan structure will result in worse outcomes for these children.

I am hoping that Micron will rethink their insurance structure, and put these children before the bottom line.

Katie Copeland, MD
Chair, Department of Pediatrics
Saltzer Medical Group, P.A.