Fri Jan 31st, 2020
Erica Atencio | Southern Ute Tribal Health Dept.
Tags: co-insurance, co-pay, deductible, Delta Dental of Colorado, ER visits, Erica Atencio, Forrest County Potawatomi Insurance Department (FCPID), SilverbackRX, Southern Ute Tribal Health Department, Southern Ute tribal member health benefits, Vision Service Plan (VSP)
The Southern Ute Tribal Health Department will be submitting monthly articles to the Southern Ute Drum providing important information about your Southern Ute tribal member medical, dental, vision and prescription benefits; as well as other services and resources available through the department. Below is an overall summary of your current benefits.
All enrolled Southern Ute tribal members have a medical benefit plan that covers many of your typical medical expenses. These expenses include, but are not limited to primary care visits, ER visits, and specialty clinic visits such as nephrology, cardiology or podiatry. Members do not have to see an in-network provider, and they do not have to pay a co-pay, co-insurance or deductible. The medical plan is administered by the Forrest County Potawatomi Insurance Department (FCPID), who will process all medical claims. FCPID will receive the provider’s billed claim for services and ensure the rates for each service are correct and then they pay the lowest possible rate. FCPID then forwards this information to the Tribe and payment is authorized. New member benefit cards were mailed to all enrolled tribal members in September of 2019; if you did not receive a card please call the Tribal Health Department at 970-563-4742.
All enrolled Southern Ute tribal members have prescription coverage through SilverbackRX. This benefit covers many of your doctor prescribed medications. There is no network requirement associated with this benefit. This means, members can utilize any retail pharmacy like Walgreens, Walmart or CVS. SilverbackRX process all prescription claims for members and is available to assist with any questions regarding payment of those claims. Silverback’s information is on the medical benefit card mailed in September of 2019.
All enrolled Southern Ute tribal members have a dental plan through Delta Dental of Colorado. This plan has been in place since April 2014, and cards were mailed out at that time. Members have a $3,000 annual maximum for covered dental services like preventative care, dental emergencies, and routine maintenance. Members also have a $1,000 lifetime maximum for orthodontic services. Unlike medical coverage, tribal members must utilize an in-network provider in order to avoid paying any out-of-network costs. The provider must be a part of the Delta Dental network. If you are unsure if your provider is in network, this information can be found by speaking to the provider directly or by going to www.deltadentalco.com. You will be required to input your zip code and a query will show all providers in your area that are in the Delta Dental network.
All enrolled Southern Ute tribal members have vision coverage through Vision Service Plan (VSP). This plan has been in place since April 2014-there are no cards required for this plan. Members have a $150 frame or contact allowance benefit per year. Lasik surgery is not a covered benefit. Members must utilize an in-network provider in order to avoid paying any out-of-network costs. If you are unsure of whether a provider is in-network you can request this information from the office or by going to www.vsp.com; enter your zip code and all in-network providers in your area will be listed.
Tribal Health will be providing additional information about your health plan and your member benefits. If you have any questions, please feel free to contact the Tribal Health Department at 970-563-4742.