Members covered by Aetna, Highmark Blue Cross Blue Shield or UnitedHealthcare seeking information about treatment options, chronic conditions or answers to other health-related questions can call a “nurse line” for answers 24 hours a day, every day.
This free service can help you with losing weight, managing stress, quitting tobacco and much more. More importantly, the nurse line offers you information, motivation, encouragement, and the one-on-one support that can make a real difference in your health: to stay well, get well or manage a health condition.
You or one of your dependents can call your plan’s nurse line for:
1. Learn about any health topic that concerns you;
2. Change a behavior, like smoking or overeating, that affects your overall health;
3. Gather information about a recent diagnosis;
4. Learn about symptoms for certain illnesses and diseases;
5. Find out about your medications;
6. Understand an upcoming test or procedure;
7. Make an informed medical or surgical health care decision;
8. Follow through with a treatment plan;
9. Manage a chronic condition, like asthma or diabetes, more effectively;
10. Understand treatment options;
11. Learn how to handle symptoms to avoid emergency room visits;
12. Find ways to reduce risks associated with the condition.
To take advantage of this valuable resource, simply call the number on the back of your medical identification card anytime, or refer to the numbers below:Aetna: (800) 556-1555
The national railroad plans (“plan”) allow you to see any doctor in your plan administrator’s network, including specialists, without a referral. This means that you have the freedom to choose a physician or specialist without first seeing a primary care physician.
There are two levels of coverage under the plan. Your level of coverage is determined each time you receive care and whether you use an in-network provider or an out-of-network provider. Your out-of-pocket costs under both levels of coverage may include office visit copayments, deductibles, and coinsurance whether you are using services under the Managed Medical Care Program (MMCP), the Comprehensive Health Care Benefit (CHCB) or the Mental Health and Substance Abuse Care Benefit (MHSA).
MMCP and MHSA benefits
• In-network:This level of benefit will apply when you use a physician, specialist, laboratory or other provider who is a member of your plan administrator’s network. When you use in-network providers, your out-of-pocket expenses, deductibles, and coinsurance will be lower than if you use out-of-network providers. Remember, there is no penalty for seeking treatment from a specialist without a referral, providing you with quicker, easier access to health care.
• Out-of-network:This level of benefit will apply when you use a physician, specialist, laboratory or other provider who is not a member of your plan administrator’s network. The plan provides coverage if you use an out-of-network provider, but your out-of-pocket expenses, deductibles, and coinsurance will be higher than if you use an in-network provider. In addition, you will be responsible for any amounts in excess of the covered charges. Covered charges are those charges determined to be usual, customary and reasonable for a particular service in a particular ZIP code area. Additionally, out-of-network providers may require you to pay for services at the time of service which means you will have to file your claim with the plan in order to be reimbursed.
Under CHCB, the plan pays a percentage of eligible expenses for covered health services. You will pay lower deductibles and out-of-pocket expenses if you use preferred providers, who are health care providers the plan has special arrangements with who agree to discount their charges. By using a provider where a special discount arrangement exists, the amount of the eligible expense that is your responsibility will generally be less than if non-preferred provider is used because the eligible expense will not be subject to a usual, customary and reasonable charge determination for a particular service in a particular ZIP code area. The covered charge will be based on the discounted charge, after your calendar year deductible is satisfied, leaving you with a lower out-of-pocket expense. Your medical ID card shows if you are entitled to these discounts. If you are, you must make sure the provider sees your ID card and knows that you are covered under one of these discount programs.
How to locate in-network providers
Locating in-network providers online for your medical health care needs is easy. Simply follow the instructions outlined below for the plan administrator of your health benefits.
MMCP and CHCB benefits
Plan administrator: Aetna
Customer service: (800) 842-4044 (Railroad Employees National Health & Welfare Plan); (888) 332-8742 (National Railway Carriers / United Transportation Union Health & Welfare Plan)
► If you prefer to login anonymously, under the heading “Members: Access Anonymously” enter the access
► Under the heading “Member Services” (top right-hand side of site), click on “Search for clinician”
► In step 1, under heading “Search for mental health clinicians near you,” click on “Click here to use our free
behavioral health clinician search tool”
► Follow the instructions of the Clinician Search tool to search for a facility or clinician
Note: Provider information, while updated regularly, changes frequently. Always verify directly with your providers, prior to scheduling your appointment or receiving services, that they are still a participating member of your plan administrator’s network.
Discuss in-network services with your doctor
It’s important that your in-network doctor always refers you to in-network providers should you be in need of other medical services, like laboratory work or a referral to a specialist.
► At each visit, ask your doctor to use in-network providers for any medical services you might require from other providers.
► For example, you have the right to ask your doctor to send your laboratory work to an in-network laboratory, thereby allowing you to take a more active role in containing your health care costs.
► If your doctor refers you to another provider, call the number on the back of your member ID card to confirm the provider’s participation in your plan administrator’s network.
If you have any questions or need assistance in locating an in-network provider, or you do not have online capability, please call the phone number located on the back of your member ID card for assistance.
Railroad employees and/or their eligible dependents covered under the national railroad medical, prescription drug, dental, vision, and life insurance benefits plans may now find information about those benefits on a single web page.
Note that this web site pertains only to the nationally negotiated railroad health and welfare plans. If you and/or your eligible dependents are not covered by those benefits plans – and this includes Amtrak employees – you should continue to seek information about your health care benefits from your employer.
Each of the benefits administrators for rail employee health care insurance negotiated under the national railroad medical, prescription drug, dental, vision, and life insurance benefits plans hosts a home page at the Railroad Information Depot. The providers include Aetna, Highmark, MetLife, Medco, vsp, and United Healthcare.
By logging on to www.rrinfodepot.com, rail employees will find a central point of access for information about health care benefits, regardless of which benefits administrator provides coverage.
Here are some of the categories that will be available at the new website:
* Information on completing a health risk assessment to help you stop smoking, lose weight or become a happier person.
* Tips on reducing risks of developing cardiovascular disease, diabetes and other chronic diseases that are largely preventable.
* Alerts and important dates regarding annual open enrollment periods.
* Current topics of interest and news on specific health issues.
* On-line access to each of the summary plan descriptions.
* Information on medical care, mental health, substance abuse, disease management, wellness programs, pharmacy, dental care, life insurance, vision care, and sickness benefits – regardless of the health care benefits administrator.
* Links to network providers, helpful tools and educational materials, contact information, and the various forms necessary for filing for benefits.
* A dedicated retirement section providing information and links to assist you in transitioning into retirement.
* Railroad Enrollment Services information to ensure you understand who is eligible for coverage under your plan and the documentation required.
Once at the website, you will be able to navigate over a topic to read more about what it offers; and, if it’s what you are looking for, you will need only to click on the topic to find more in-depth information.