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Health Insurance FAQ

We've compiled a convenient summary of our employees' most common questions and answers regarding Rensselaer's medical and health insurance benefits.

Question: The Rensselaer HMO The Rensselaer Health Plan (RHP)
[In-Network]
How do I select my Primary Care Physician (PCP)? Choose a PCP from the provider directory. For help call Member Services at 1-800-777-4793. Choose a PCP from the provider directory. For help call Member Services at 1-877-724-2579.
Can I switch physicians within the plan? Yes. Yes, once a month. Call Member Services.
What if I need care and my PCP is not available? Your PCP is required to have a backup on call 24 hours a day who will treat you and advise your PCP. Urgent care is available at certain facilities. Your PCP is required to have a backup on call 24 hours a day who will treat you and advise your PCP. Urgent care is available at certain facilities.
Can I see a specialist? Yes, your PCP will refer you to one as needed. Yes, your PCP will refer you to one as needed.
What if I am involved in ongoing treatment with an out-of-network doctor, such as an obstetrician, on oncologist, or a dialysis specialist when I join the plan? Your PCP will coordinate with a specialist for your care. Call Member Services. In general, Plan will work with you to ensure continued treatment for up to 90 days.
If I need emergency care, can I go to any hospital? Is there a penalty if I do? For life-threatening emergencies, use any hospital or emergency room. For life-threatening emergencies, use any hospital or emergency room. You will receive in-network benefits regardless of where you receive care. However, you must contact your PCP within 48 hours.
How does this plan work for students away at college? Those who attend school away from home should schedule routine care for times when they are home. Emergency care is covered. Call 1-877-724-2579 for sick care visits. Those who attend school away from home should schedule routine care for times when they are home. Emergency care is covered. Call 1-877-724-2579 for sick care visits.
Are plan doctors accepting new patients? Many network doctors continue to accept their existing patients. Refer to the provider directory to see which doctors are accepting new patients. Most network doctors will accept their existing patients when they join the plan. Refer to the provider directory to see which doctors are accepting new patients.
Why are doctors motivated to join a network? Most join to maintain or increase their patient base. Most join to maintain or increase their patient base.
Will I get the same physician each time I need care? Yes, when you call in advance. For urgent care, you may be offered an appointment with a medical partner. Yes, when you call in advance. For urgent care, you may be offered an appointment with a medical partner.
What if my doctor (not in the network) tells me I need an operation? Can I use network surgeons and hospitals and pay less? Yes, if you are referred by a network provider. Yes, but you need a referral from a network PCP.
What if a network physician tells me I need hospital care, but the hospital I want to use is not a network hospital? Can I use it and still get paid-in-full benefits? Only with prior approval from CDPHP. Only with prior approval from CDPHP.
Can I visit a few physicians before selecting one? You need to select a PCP when you enroll. PCPs are listed in the Provider Directory. You need to select a PCP when you enroll. However, you can change your selection once a month.
Do both my spouse and I have to choose the same PCP? No, you may choose a different provider for each family member. No, you may choose a different provider for each family member.
If a physician I know joins the network, can I switch over? Yes. Yes, you can change your PCP once a month.
How were the doctors in the network selected? All doctors in the network have had their education, experience, and credentials reviewed. All doctors in the network have had their education, experience, and credentials reviewed.
What do I do if I have a concern? Contact Member Services at 1-877-724-2579. Contact Member Services at 1-877- 724-2579.
 
Last modified: June 11, 2014
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