Frequently Asked Questions

GENERAL BENEFITS INFORMATION

1. The Premium PPO, Healthcare Essentials PPO and Balanced Choice PPO options use the same physician network. How are they different?

These three medical plan options offer different levels of coverage. The amount you contribute for each plan option also varies. In general, the higher the level of benefit, the more you pay for coverage under that plan option. In general, your cost for the Premium PPO will be the highest, followed by the Healthcare Essentials PPO and then the Balanced Choice PPO.

Premium PPO

Low out-of-pocket

Low deductible

High percentage reimbursement

Healthcare Essentials PPO

Medium out-of-pocket

Medium deductible

Medium percentage reimbursement

Balanced Choice PPO

High out-of-pocket

High deductible

High percentage reimbursement

2. How do I obtain claim forms for Blue Cross Blue Shield, Caremark retail and mail order and ValueOptions?

You can call the Vought Benefits Center at 1-866-689-5999 or download claim forms from the Download Forms page.

3. What is the difference between in-network and out-of-network care?

Under the Premium PPO, Healthcare Essentials PPO, and Balanced Choice PPO and POS options, there are two levels of benefits: in-network and out-of-network. When you receive in-network care, the plan options reimburse a higher percentage of your bills. You pay a lower deductible and smaller copayments for in-network care.

If you live within the network area, each time you or an enrolled family member needs medical care, you can decide whether to use a health care provider who is part of Blue Cross Blue Shield's network and receive in-network benefits. Or, you can use a provider who is not part of the network and receive out-of-network benefits.

4. Do I have to choose a PCP (primary care physician)?

If you enroll in an HMO option, you must select a PCP. For a list of network providers in your area, visit the Service Providers page.

Under the Premium PPO, Healthcare Essentials PPO and Balanced Choice PPO options you do not have to select a PCP. You can visit any network physician, specialist or facility of your choice and receive in-network benefits. However, it is your responsibility to be sure you are treated by network providers. Do not assume that your physician referred you to a network provider. For a list of network providers in your area, visit the Service Providers page.

5. What benefits do I receive when I need emergency treatment?

In an emergency, you always receive in-network benefits, whether a network or an out-of-network facility provides your treatment.

If your visit is not for an emergency, the benefits you receive depend on the medical plan option in which you are enrolled.

6. What does precertification mean?

Precertification is an advance review by the claims administrator of proposed hospital stays or other predetermined services. Mandatory precertification confirms the need for certain health care procedures and hospital admissions, which helps manage and contain medical costs.

7. If my employment with Vought Aircraft ends, when do my medical benefits end?

Your benefits end at midnight on your last day of employment. If you are retiring, your Vought Aircraft Industries, Inc. coverage ends on the date of your retirement. If you are eligible for and elect retiree medical benefits, those benefits begin on the date of your retirement.

VISION AND HEARING

8. How do I submit claims for vision or hearing care expenses?

HMO – If you are covered by an HMO, follow your HMO’s procedures for filing claims.
PPO – When you visit an optometrist, ophthalmologist, or hearing care professional for exams or appliances, you pay the provider at the time you receive the services. Then, you file a claim with Blue Cross Blue Shield for reimbursement of eligible expenses. Use the standard Blue Cross Blue Shield claim form for vision and hearing services.
For a supply of forms, call Blue Cross Blue Shield at 1-888-979-4514 or download and print claim forms from the Download Forms page of the Excel Web site.

When you file your claim, include your receipt and keep a copy for your files.

For a supply of forms, call Blue Cross Blue Shield at 1-888-979-4514 or download claim forms from the Download Forms page.

And, when you file your claim, don't forget to include your receipt, and keep a copy for your files.

9. How can I make sure my medical ophthalmic visits are not counted toward my $250 annual vision care maximum?

Your diagnosis determines whether the cost of the visit is applied to the $250 maximum. If your visit is to either an ophthalmologist or an optometrist and the diagnosis is routine, the visit is counted toward the $250 maximum. Non-routine (medical) diagnoses that result in a medical claim do not apply to the $250 maximum.

MENTAL HEALTH AND SUBSTANCE ABUSE

10. I need to see a mental health care provider. What do I do?

When you need treatment for mental health or substance abuse, first contact Value Options at 1-866-269-5800 for approval -even if you do not plan to use a network provider. If you do not contact Value Options for pre-approval of in- or out-of-network care, your medical plan option pays no benefits, except in an emergency. If you are in an HMO, call your provider for details.

11. What is the employee assistance program (EAP)?

The EAP is a confidential counseling and referral program that is available to you and your immediate family members - free of charge. Counselors are available to help you and your family resolve personal issues or problems before they affect your health, relationships, or job performance.

You can use the EAP services even if you are not enrolled in a Vought Aircraft medical plan option or HMO.

PRESCRIPTION DRUGS

12. Why are certain drugs not covered by my prescription drug coverage?

Vought Aircraft offers a managed drug program that helps you get the most out of your prescription drug dollars. In recent years, marketing efforts such as direct-to-consumer advertising increased the cost of prescription drugs. To manage the increase in drug costs, Vought Aircraft carefully selects the drugs it covers.

13. What is the difference between generic and brand name prescription drugs?

In general, generic drugs serve the same purpose as brand name drugs, and in most cases are less expensive. Generic equivalents are not available for all brand name drugs.

14. When I use the mail order prescription drug program, how long does it take for my prescriptions to arrive?

You receive prescriptions within 14 days from the date Caremark receives your request.

15. 1 take a maintenance medication and cannot wait 14 days for the mail order prescription to arrive. What should I do?

Ask your physician for two prescriptions: one for a 30-day supply to fill immediately at a local Caremark participating pharmacy and one for a 90-day supply to send to the Caremark Mail Service Program.