VHP Open Access Plan—FAQs

How will the Patient Protection and Affordable Care Act impact post-retirement medical benefits? What about Vermont's proposed single-payer health plan?

No one knows the extent to which these legislative changes (or proposed changes) may impact post-retirement medical benefits in the future. There is simply not enough information available.

What would I pay for a psychotherapist visit?

Psychotherapy is covered under "Outpatient Mental Health and Substance Abuse Service." Under the VHP Open Access plan, there would be no cost to plan participants who are treated by a Magellan provider.

What healthcare plan changes can I expect for retirees who are on Medicare?

There are no proposed changes for retirees who are on Medicare.

If I see a BlueCard PPO Network provider outside of Vermont, will my rates be higher than if I saw a BlueCard PPO Network provider within the state of Vermont?

No. When using a BlueCard PPO Network provider outside the State of Vermont, you will receive the same benefits and pay the same cost as if you were receiving the service inside the State of Vermont.

If I have met my current year's deductible by June 30, 2011, will I have to meet a new deductible beginning July 1?

No. Your healthcare plan deductible is based on a calendar year, not a plan year. Your deductible and out-of-pocket maximums will be carried forward into the new VHP Open Access plan, regardless of which plan you were on. (MVP members: we are still working out the details of how this will work for you, but we are committed to crediting your account for what you have already spent. Note that the amount you have already paid for prescriptions will also go toward your out-of-pocket prescription maximum, a feature that was not available on the MVP plan.)

Are new plan documents available?

Not yet. Blue Cross Blue Shield will mail a plan booklet, ID card(s) and a certificate of coverage to each household prior to July 1.

If I am transitioning from the Vermont Freedom Plan or MVP Healthcare, how would the new VHP Open Access plan work if I live in Vermont and my spouse resides in another state?

Members who live in Vermont and are transitioning from VFP or MVP will need to choose a primary care physician in the VHP network in order to pay the PCP copay of $10. This primary care physician will be used for care within the VHP network. In order to pay the same $10 copay, your spouse who lives out-of-state will need to choose a BlueCard PPO Network primary care physician. If your spouse does not choose a Network primary care physician, but instead chooses a BlueCard PPO Network provider, s/he would pay the specialist copay of $20.

What is considered "in-network" service? How does it work if I have a son or daughter on my plan who is living (or attending college) out-of-state?

If your child who lives/attends college out-of-state chooses a BlueCard PPO Network primary care physician, s/he will pay a $10 copay for office visits. If s/he chooses a BlueCard PPO Network provider, s/he would pay the specialist copay of $20.

If I missed the Benefits Fair, how can I learn more about the transition to the VHP Open Access plan?

Check the Recent Memos area of the HRS web site for the information sent out to the UVM community on April 25 and 26. VFP and MVP participants will receive further correspondence when we have more information about the details of the transition. If you have specific questions that are not addressed in the materials posted, e-mail HRSInfo@uvm.edu.

How does the new VHP Open Access plan work if I am traveling in Canada?

Any time a plan participant is receiving care from a BlueCard PPO Network provider, your cost is the same as if you were being treated within the State of Vermont. Call Blue Cross Blue Shield at 888-222-7886 to discuss how to access the global network in Canada.

I am currently pregnant and due this summer. What should I be doing about my healthcare coverage?

Blue Cross Blue Shield is working on a "Transition of Care" package which will have everything you need to transition from MVP approvals to Blue Cross Blue Shield approvals. We anticipate a letter will be going to each MVP member in the near future, outlining the steps necessary to facilitate your transition.

What do I need to know about the transition from MVP to the VHP Open Access plan?

We expect that your enrollment, durable medical equipment and prescription information will be transferred from MVP to Blue Cross Blue Shield. Blue Cross will analyze the data and let UVM know if it finds issues related to prescription deductibles or out-of-pocket maximum information. If there are any concerns, Blue Cross Blue Shield will contact individuals directly in order to gather more information and/or discuss possible solutions.