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    Frequently Asked Questions

     

    LOCATING A PROVIDER
      Do I need to name a Primary Care Physician (PCP)?
       How do I change or elect my Primary Care Physician (PCP)?

    OUT-OF-NETWORK COVERAGE
       My doctor wants me to have a test or see a specialist out-of-network. What can I do?

    MEMBER ID CARDS 
      I lost my member ID card(s). How do I get a new one?
      My medical/dental insurance just started with the County. How long should I expect to wait to receive my member card(s)?
      What should I do if I need to see my doctor, get prescriptions filled, etc. and I haven't received my cards yet or I am waiting for a new card?
      What are my group numbers?
      Where will my cards come from and how many will I get?
      What if I need additional cards for out-of-area dependents?

    MEMBER SERVICES
      How can I contact Member Services?

    CLAIMS & CHARGES 
      Where can I get a claim form?
      Where do I send my claim (medical or dental)?
      What should I do if Aetna denied my claim?
       How can I check on the status of my claims?
      I got a bill from my doctor and he/she applied the charges to my deductible. I didn't think we had a deductible. What should I do?

    URGENT CARE
       What can I do if I am sick but my doctor can't see me? 
       Where can I find the nearest Lee Convenient Care center?

    QUEST LAB
      Do I have to pay Quest Diagnostic Lab in advance for my lab services? They asked me to pay $40.00 or give them my credit card for billing.

    COVERAGE WHEN TRAVELLING
       I'm planning a trip out of the country – will my health insurance cover me?
       What if I'm on vacation out-of-state and my child has a medical emergency (i.e. bad cold, fever, severe allergy attack)?

    LIFE INSURANCE
      How do I change my life insurance beneficiary?

    ADDING/DROPPING FAMILY MEMBERS TO/FROM MY PLAN 
      What is a Qualifying Event? 
       What events are not considered Qualifying Events?
      I just got married. Can I add my spouse and/or dependent(s) to my plans? 
       I just got married. How long do I have to add my spouse and/or dependent(s) to my plan(s)?
       How do I add my spouse and/or eligible dependent(s) to my insurance plan(s)? 
      I just got married and added my spouse and/or eligible dependent(s) to my plan. When will the coverage become effective?
      I am getting a divorce. How do I drop my ex-spouse from my plan(s)?
      What will happen if I notify Human Resources of an ineligible spouse or dependent after the 60 day qualifying event period widow?    
       I'm having a baby. How do I add my baby to my medical plan?
       Can my grandchild be covered under my health plan? If so, what do I need to do?
       Can I add other family members (e.g. niece, nephew, mother-in-law) as dependents to my plan(s)?

    CHANGE OF NAME
      I just got married. How do I change my name?

    VISION INSURANCE
       Do I need Vision Insurance?
       How do I sign up for the vision plan? 
       When I sign up for the vision plan, how does it work?
       I didn't sign up for the vision plan. Do I have any vision coverage under the Aetna medical plan?

    LEAVING YOUR JOB
      I'm leaving my job. When does my insurance coverage stop?
       What is COBRA continuation health coverage? 
       What benefits can I continue under COBRA? 
       What do I need to do to get COBRA coverage?
       When does COBRA coverage begin?
       What's a HIPAA certificate and why do I need one?
       What is the cobra subsidy?

    RETIRING SOON
       I'm retiring next month. What do I have to do?

    RETIREES
       I am already retired. I/my spouse will be going on Medicare soon. What do I need to do?
      I am retired and want to terminate my insurance coverage with Lee County. What do I have to do?
       I'm retired and live outside of Lee County. How do I find out what Doctors to go to?

    DEPENDENT COVERAGE
       How long can my dependents remain covered under my plan?
       My dependent child is 26 years old. Can I keep them under my insurance plans? Is there an additional cost?
       My child is no longer an eligible dependent. How can I remove him/her from my plan?
       My child is going away to school. Can he/she still be covered under my plan?
       How do I find care for my son or daughter who goes to college outside of the area? 
       What is an Affidavit of Eligibility Form?  

    PREMIUMS
       Does it cost more for me to cover more than one child?
       What are pre-tax premiums? Why would I NOT want to elect this option?
       How can I know that my premiums are being deducted pre-tax?

    FLEXIBLE SPENDING ACCOUNTS
       How do I sign up for a Flexible Spending Account (FSA)? 
       How do I file a claim to be reimbursed through my FSA?

    SHORT TERM DISABILITY
       How do I enroll in short term disability (STD)?
       I am going to have surgery next month and would like to use my Short Term Disability (STD) plan to cover my time out of work. How do I file a claim?
        How long will it take to receive my short term disability (STD) benefit checks once I have submitted the claim forms?
       How will my benefit plan premiums be paid if I am out of work not receiving a County paycheck?

    BENEFITS STATEMENTS
       I just received my annual Benefits Statement and it doesn't show that I have Optional Life insurance, STD, and/or Vision coverage?
       My annual Benefits Statement showed that I have 120 hours of vacation time, but my pay stub shows only 47.5?

    MISCELLANEOUS
       What is OASDI? 
       My doctor says I need the Shingles vaccine; does our plan cover this vaccine?