Money Matters
vlagrl29
member
Dear Community,
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Health Insurance Question
We've been with Coventry for 3 years now and they called me up last night to schedule a well visit. I guess someone comes to your home and everyone on your insurance plan will be assessed. Never heard of this before. DD and I have already had our well visits with our doctors this year. Seems kinda weird and why do I think they are wanting to pry into our health? Maybe I'm paranoid 
Has anyone else had this happen with their insurance company - we buy our own.
Has anyone else had this happen with their insurance company - we buy our own. 
Re: Health Insurance Question
Outside of life insurance, I have never heard of anything like that. And, over my lifetime, I've had health insurance with many different companies across two states.
I would question this hard, if you didn't already.
@lbonga1, speaking of pre-existing conditions, I changed jobs and had zero lapse in coverage between the two companies. The first time I go see my specialist, I get the "auto-letter" in the mail that I need to show proof of no lapse in coverage longer than 30 days. But the funny part was, both companies used the same insurance company.
So I call the 1-800 number and explained that...multiple times. She doesn't seem to understand because I don't think she is really listening to me. So I finally give up and tell her, "Great, whatever, can you fax me my proof of prior coverage or connect me to the department that does that...so I can submit it your department?" I think that confused her, so it got her attention. I only had to explain they were the same company one more time, lol. And in 20 seconds she was able to pull up my prior policy with them. Argh!
I know the ACA is a controversial subject, but forcing insurance companies to stop with their BS of not covering a pre-existing condition for 12 months after starting under a new group policy was fantastic and so overdue.
Okay! Thanks for the update. Now that I understand it better, I can see where it is more of a perk for their members than something onerous. Sort of like a "house call" for the family, if they want one.
Random comment: One thing I've missed with my current insurance is they don't have a "nurse's hotline" like most other insurances I've had. It's basically a number you can call, talk to a qualified professional, and get an idea of what might be wrong.
Now I'm forced to go to WebMD, which is just a dark and bad place, lol. I'm always potentially dying, having kidney failure, or some other huge medical problem.
Q. Who can take the health assessment?
A. The health assessment service is available to Individual and Small Group (5-‐50 in 2015 and 2-‐ 100 in 2016) members who purchased their plans either on or off the public exchanges.
It’s free, voluntary, confidential and convenient.
It won’t change or affect coverage in any way.
It won’t replace a member’s regular doctor -‐-‐ In fact, it complements the care they
receive from their regular doctor.
Q. Who will be conducting the health assessments?
A. We’ve contracted with MedXM and Your Home Advantage (YHA) to conduct the health assessments. Members with questions about the health assessments can also call the vendor directly at:
These contact numbers are also on the member letters.
Q. What can members expect?
A. During the in-‐home health assessment, members get a 45-‐minute session with a licensed doctor or nurse practitioner. The nurse practitioner will conduct a brief physical exam, take a blood pressure reading, listen to heart and lung sounds, and review a list of current medications. Members may ask any questions they have about their health.
As a final step, we’ll share the results with the member’s primary care physician (PCP). Members will be able to review the recommendations and will get a list of questions to ask their doctor at a future visit.
We’re working with two vendors, MedXM and Your Home Advantage (YHA), to conduct the health assessments. We began reaching out to members about the in-‐home health assessments in April and will continue as we move through the rest of 2015 and into 2016. Outreach calls take place in all regions and are aimed at members with a previously diagnosed condition and that have not visited their doctor for a give submission year.
During outreach, members:
• Will get a letter from us letting them know this service is available. A sample of the letters can be found at the links below:
o MedXM
o Your Home Advantage (YHA)
Med XM
1-‐888-‐306-‐0615
YHA
1-‐888-‐998-‐9880
Will get a call from one of our vendors to ask preliminary questions and schedule an appointment for an in-‐home health assessment.
Can schedule their health assessments immediately.
Q. Do members have to complete the assessment in their home? Can they go to another location?
A. We found that many of our members actually prefer the convenience and comfort of doing the assessment in their own home.
However, in some Florida locations MedXM may provide members a local wellness clinic where they can go for a health assessment appointment, if they prefer. When MedXM calls to schedule an appointment, they’ll give them the option of going to a local clinic. These local clinics will be at Walmart locations.
Q. What’s the difference between in-‐home and telephonic health assessments?
A. Previously, we contacted some Aetna and Coventry members to complete a health assessment over the phone. In some cases, we may ask these same members to take part in the in-‐home health assessment as well. The in-‐home health assessment is more detailed and will give us a more complete picture of a member’s health status and opportunities for health management programs. We’ll replace telephonic health assessments with in-‐home health assessments going forward. Members will no longer receive outreach calls for both.
Q. Can my client take the telephonic or online health assessment (instead of the in-‐home health assessment)?
A. No. It’s important for us to conduct the health assessment in person. That way we can tailor the appointment to the member’s needs and also answer questions they may have.
Q. How long will the health assessment take?
A. The health assessment visit usually takes about 45 minutes.
Q. Is there a cost if my client decides to participate in the assessment?
A. No. Our members are eligible for this free service once per calendar year.
Q. What will Aetna do with the information from the in-‐home health assessments?
A. We will share the results with the member’s primary care physician (PCP) who can then answer any questions from the member. Also, as part of the Affordable Care Act (ACA) Aetna is required to submit diagnosis and claims information to the government for our insured population (Individual & Small Group on and off exchange) in conjunction with risk adjustment. This program supports our National strategy for risk adjustment as it relates to the ACA laws and provisions.
Q. Is there an incentive available for clients to complete the assessment?
A. In 2015, Aetna will offer a $25 gift card for Amazon (SE Florida members receive a $25 gift card for Walmart). In 2016 this incentive will expand to include Coventry members.
Q. Are members required to complete the health assessment? If they decide not to, will they lose their coverage or will their premiums go up?
A. Members aren’t required to participate in the health assessment. Their coverage and premiums won’t change if they choose to participate or not. We strongly encourage our members to take advantage of this opportunity because of the benefits it offers them.
With the additional information, it sounds like something my H does through his job yearly to get a VISA gift card and a tiny bit off our premium. He goes, gets weighed, takes a blood test and signs a non-smoking pledge. I should have figured it was really just data mining.
TTC since 1/13 DX:PCOS 5/13 (long, anovulatory cycles)
Clomid 50mg 9/13 = BFP! EDD 6/7/14 M/C 5w6d Found 11/4/13
1/14 PCOS / Gluten Free Diet to hopefully regulate my system.
Chemical Pregnancy 03/14
Surprise BFP 6/14, Beta #1: 126 Beta #2: 340 Stick baby, stick! EDD 2/17/15
Riley Elaine born 2/16/15
TTC 2.0 6/15
Chemical Pregnancy 9/15
Chemical Pregnancy 6/16
BFP 9/16 EDD 6/3/17
Beta #1: 145 Beta #2: 376 Beta #3: 2,225 Beta #4: 4,548
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