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Be a Wise Healthcare Consumer

Is There Value in Regular Check Ups?

Regular physical exams and health screenings can uncover health issues before you even notice problems. They can also detect problems in their early stages when treatments and therapies are usually easier and most effective. Establishing a regular relationship with your doctor can help him or her notice and assess changes in your health over time. A physician who knows you and has your complete and ongoing medical history can help you make decisions about appropriate lifestyle, screening, and treatment decisions.

A primary care provider is a health care practitioner who sees people with common medical problems or provides preventive care and is usually a family practitioner, internist, OB/GYN, or pediatrician, although some people with chronic conditions may see a specialist more often and treat that provider as their primary source of care. Visiting a nurse practitioner or physician assistant is also an option. Whomever you select to provide your regular medical care, it is wise to establish yourself as a patient with a primary care provider when you are well, rather than having to locate a physician during a period of stress caused by illness or injury. If you do not currently have a primary care provider, you may want to take the following actions:

Your comfort level with your health care provider and their staff can affect your willingness to return to seek care when you need it so it’s important to be particular in the selection process.

Once you’ve established you primary care relationship, follow your provider’s recommendations regarding a schedule for your preventive care. Your UT SELECT Preventive Care benefits, as outlined in the UT SELECT Medical Guide include routine physical exams, immunizations, well-baby care, mammography screening, prostate (PSA) screening, osteoporosis screening, bone density screening, and colonoscopy. Your provider must bill these visits as “preventive” to allow this level of benefits. View the table below for a summary of preventive care benefits.

 

Preventive Care

In-Area

Out-of-Area

Network

Non-Network

Routine Physical Exam
(one per plan year)

$30 copayment (PCP)*

$35 copayment** Specialist

After deductible, plan pays 60%; you pay 40% of the allowable amount

After deductible, plan pays 75%; you pay 25% of the allowable amount

Well Woman Exam
(one per plan year)

Well Child Exam
(under age 2)

Prostate (PSA) Screening

Immunizations
(age 6 and older, applies to injection only)

Immunizations
(up to age 6, applies to injection only)

Plan pays 100%
(no copayment required)

Routine Mammogram
(one per plan year)

Plan pays 100% (no copayment required)

After deductible, plan pays 60%; you pay 40% of the allowable amount

After deductible, plan pays 75%; you pay 25% of the allowable amount

Osteoporosis Screening

Colonoscopy

*Primary Care Provider (PCP) – Family practitioner, internist, OB/GYN, or pediatrician
**Specialist – Any physician other than a family practitioner, internist, OB/GYN, or pediatrician

A few more tips can help you maximize your wellness visit:

Nearly half of all adults in the United States have some form of chronic disease such as heart disease, stroke, and diabetes, much of which could be prevented, delayed, or resolved through lifestyle changes. Working with your health care provider and utilizing your preventive care and wellness benefits are tools you can use to live well and take charge of your health.

Contact Us

If you would like a specific topic discussed or have a question you would like answered in a future issue of this newsletter, please send your suggestions to benefits@utsystem.edu.

UT System Employee Benefits Website: www.utsystem.edu/benefits/
UT System Retirement Programs Website: www.utretirement.utsystem.edu
Your Local Benefits Office: www.utsystem.edu/benefits/contacts.asp#1