My Coverage Explained

Benefits Value Advisor: New BFF … seriously!

Eighteen. The magical age of adulthood. They’ve got driving down pat. They can vote for our political leaders. Some leave the nest, but some don’t, which means most 18 to 20-somethings are somewhere in between. That poses a problem for a mom like me with several kids, ages 18 and above, when it comes to health care.

BVA BCBSA health care conversation with my 23-year-old son is held via text and goes like this:

Young adult son: i’m sick

Me: What’s wrong?

Young adult son: throat again

Me (texting faster): How bad is it? Do you have a fever? Have you taken your temperature? Can you call me? Do you think you need to see a doctor?

A long minute goes by while my mind is racing. I’m calculating my son’s location away from home and which doctor I should call. I try to remember if the urgent care provider is in-network and recall not being overly thrilled with the in-network practitioner we frequently use. I internally debate sacrificing the time it takes to locate physicians in his area who are taking new patients, then spending more time on the internet to cross-reference consumer ratings versus sending my son back to the familiar doctor. Whew!

The Fox and Hound ringtone jars me back to the present.

Young adult son: maybe

Me: Want me to set up an appointment with the doctor you saw last time?

Young adult son: the bad breath guy?

Me: Yes, that one.

Another minute goes by.

If you’ve had similar conversations then you know how this goes. You select the doctor and schedule the appointment only for your child to forget about a conflict – something much more important than seeing the doctor (I’m sure). By the end of the process, you’re one step away from a professional concierge certificate or in need of medical attention yourself.

It is easier to take children to the pediatrician when they’re under 18 and within your reach than when they’re off at college or have a place of their own. Throw in HIPAA (the privacy policy act that protects individuals ages 18 and over) and you’ve added a two-hour project to your day with the back and forth coordination.

Some providers will allow me to make appointments for my adult kids, but that’s not always the case – especially if it’s a new provider. You may subscribe to the insurance and subsidize the “co” in co-pay and co-insurance, but the doctor’s office wants to speak to the “adult” who will be seen at the appointment.

Sure, I could remind my son he has a health insurance card to go forth and use, but that’s where it gets tricky. One study shows that the prefrontal cortex (the part of the brain’s ability to make decisions) isn’t fully developed until the age of 30 and beyond, so that may not be a battle I’ll win.

Another hurdle—when it comes to terms like in-network or out-of-network, co-pays, etc., my son could be operating with a minimum seven-year deficit – a deficit that could affect my contribution or cause him to select the wrong type of doctor for the best treatment!

When I discovered the Benefits Value Advisor* or BVA service offered with many Blue Cross and Blue Shield of Illinois (BCBSIL) plans, I knew that I had found a best friend forever (BFF)seriously! BVA is a one-call solution to help members navigate the health care system and it does the following and more! Check out this video to see what else it can do!

Benefits Value Advisor

Sometimes terminology, especially in health care insurance, is best introduced by others. I don’t want to be totally hands-off, but when it comes to minor illnesses I dream about having this conversation instead:

Young adult son: i’m sick

Me: I’m sorry to hear that. What’s wrong?

Young adult son: throat again

Me: Sounds like you need to see a doctor. Call the customer service number on the back of your insurance card and ask to speak with a Benefits Value Advisor or BVA.

Young adult son: then what?

Me: The BVA will help you decide on the best type of doctor to see and schedule an appointment for you.

Young adult son: that’s it?

Me: That’s it, except call me afterwards and let me know what the doctor said.

Thirty seconds lapse.

Young adult son: what about the payment?

Aaand back to reality.

For now, I may be the “co” in co-pay and co-insurance, but our BVA (my BFF) will save me some serious time and unnecessary out-of-pocket money. More importantly, the BVA will help my young adult son experience a life lesson on how excellent health care insurance works with BCBSIL.

If you have questions, we can help! Call us at 855-604-1515.

*About Benefits Value Advisor
Benefits Value Advisor (BVA) is a consumer advocacy program that guides members through the universe of health care, prompting them to examine and weigh every aspect of their health care decisions. It is a one-call solution, providing members with access to specially trained advisors who can assist them. Presently, BVA is available to more than one million large group plan members in Illinois, Montana, New Mexico, Oklahoma and Texas with plans to expand in 2015. Not sure if you have BVA or not? Call the Customer Service number on the back of your member ID card to find out more.

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