Diabetes Health Plan FAQ

DIABETES RESOURCES

Visit the Diabetes Resources page for other helpful tools including presentation videos for managing diabetes and living a healthy lifestyle.

Below are commonly asked questions about the Diabetes Health Plan. If you don't see your question answered below, call the Diabetes Health Plan Hotline at 910-667-7777.

Q. If I participate in all of the action items, I will have to take time off of work and drive a long distance. What should I do?

Q. Will I be penalized if I do not choose to participate in the DHP, now or in the future?

Q. What if I don't have diabetes? What are the savings or benefits for me?

Q. Will participating in the DHP negatively affect my ability to get insurance in the future?

Q. What are the dependent requirements if they are covered under my benefits?

Q. What if my doctor charges me a co-pay for a diabetes visit?

Q. Can my husband or family members also get free medications?

Q. Will there be a High Blood Pressure class since DM (Diabetes Mellitus) and HTN (hypertension) are so related?

Q. Will a gluten free class be taught?

Q. Will I get a free glucose meter?

Q. Do I have to see my doctor if can I get everything done in Employee Health & Clinic?

Q. Do I have to register for classes or can I just show up?

Q. Can I come to the classes if I am not part of the DHP?

Q. What should I do if I know I will be unable to attend the required classes due to medical or personal reasons? Who should I contact?

Q. How will the action items be evaluated at the end of the year? Will I be ineligible if I do not complete all required action items?

Q. Should lab work only be done at NHRMC’s Employee Health & Clinic?

Q. What is the benefits website?

Q. How can I reach someone about the Diabetes Health Plan?

Q. How can I make an appointment to see a Dietitian or Pharmacist?

Q. Why wasn’t my eye exam co-pay covered?

Q. What if I visit the doctor to discuss many topics, not just diabetes? Will my co-pay still be covered?

Q. If my A1C is above 8, will I have to be seen every month for a year?

Q. I’m having trouble making an appointment. Who do I call?  

Q. Is there a prescription drug list of medications covered at $0 co-pay?

Q. Can a class be substituted with a personal visit with the Pharmacist and/or Dietitian?

Q. Do the classes need to be taken in a certain order?

Q. How do I deal with co-pays when the office wants it up front?

Q. I’m the member who has Diabetes and was happy to learn that, since my spouse is covered under my plan, his high cholesterol medication is also free. Does he have to   have labs done at the NHRMC Employee Health & Clinic and attend classes?

Q. Do a majority of Wilmington Doctors participate in the Diabetes Health Plan?

Q. Am I going to carry a label forever? Will this affect my life insurance costs?

Q. Does the foot exam need to be a separate appointment or can it be done in a regular appointment with an endocrinologist or primary care provider?
 
Q. Is a visit with an endocrinologist required?

Q. Will I be penalized or will my rates go up if I choose not to participate in the DHP now or in future years?

Q. Can Employee Health & Clinic provide me with a referral?

Q. I would like more information about the program offerings at the Employee Fitness Center (EFC). Who should I contact?

Q. How was I enrolled in the plan?

Q. Will everyone know that I am part of the DHP if I start going to the Employee Fitness Center (EFC)? Will I have to feel embarrassed or singled out when I go there?

Q. Why do I have to repeat my lab work at Employee Health & Clinic if I have already had blood drawn at my doctor's office?

Q. What do I do if my doctor doesn’t agree with the Employee Health & Clinic lab results or my enrollment in the plan?

Q. Why didn't I receive a copy of my initial or follow-up lab results in the mail?

Q. Why can't I bring lab work in from an outside doctor?


Q. If I participate in all of the action items, I will have to take time off of work and drive a long distance. What should I do?

A. Yes, it is true that you do have to take time during your non-working hours to complete the plan requirements throughout the year. However, the trade-off is that you have free access to a wealth of information, resources, providers and professionals who will help you manage your condition and teach you ways to prevent the onset of more serious complications. In addition, the educational sessions are scheduled regularly so that you have some flexibility in planning. Pharmacy and Dietitian appointments can also be scheduled back-to-back for your convenience.

Q. Will I be penalized if I do not choose to participate in the DHP, now or in the future?

A. No. The Diabetes Health Plan was designed as an additional set of benefits that may help reduce financial strain and remove barriers to proper care, allowing participants to live healthier lives. You may decide the plan is not right for you, and that is OK. Each person will be given the choice to opt out with no penalty within 30 days of his or her enrollment date. However, if you opt out, you will not be able to take advantage of the many benefits offered under the Diabetes Health Plan. Please note that if your opt out form is not received within the 30 day opt out period, you will stay enrolled in the plan for the remainder of the year and will be held responsible for the health action item requirements.

Q. What if I don't have diabetes? What are the savings or benefits for me?

A. The plan was designed to be inclusive for those who are pre-diabetic as a means of potentially preventing the onset of diabetes and other related complications. In fact, many of those who are enrolled in the DHP are pre-diabetic. By participating in the DHP, you and your covered family members will have access to free medications for conditions including high blood pressure, cholesterol and depression. In addition, the educational sessions and one-on-one consultations with the Pharmacists and/or Dietitians are valuable resources offered at no cost to those who participate in the plan.

Q. Will participating in the DHP negatively affect my ability to get insurance in the future?

A. No. Our organization is committed to providing you with a variety of health plan benefits. However, if you choose to leave NHRMC, new Health Care Reform legislation will prevent health plans from excluding anyone with a pre-existing condition. You can also feel confident that your employee medical records are always kept safe and confidential, and these records will not be shared with anyone by NHRMC.

Q. What are the dependent requirements if they are covered under my benefits?

A. Dependents that are diabetic or pre-diabetic are required to complete the same health action items as employees who qualify under either of these conditions. These health action item requirements apply to Type 1, Type II and pre-diabetic individuals. Dependents who are not diabetic or pre-diabetic do not have to complete the required health action items. However, they can still take advantage of the $0 co-pay for eligible blood pressure, cholesterol and depression medications. 

Q. What if my doctor charges me a co-pay for a diabetes visit?

A. This is a new plan and our local physicians continue to learn about this benefit through our ongoing communication pieces to their offices and plan participants! If you feel that you paid a co-pay erroneously, please contact your HR Benefits Administrator to re-submit claim(s).

Q. Can my husband or family members also get free medications?

A. Dependents who are covered by our medical plans and have a diagnosis of pre-diabetes or diabetes are eligible to participate in the Diabetes Health Plan. This includes approved medications for diabetes, high blood pressure, cholesterol and depression at zero co-pay. In addition, if an employee is a participant in the DHP and has covered dependents who take related medications on the approved DHP Drug List, they may receive these medications at zero co-pay as well.

Q. Will there be a High Blood Pressure class since DM (Diabetes Mellitus) and HTN (hypertension) are so related?

A. Actually, HTN and healthy eating are covered in classes two and three. We will also look to expand the classes to include other vital health management topics in the coming year, so plan participants will have new opportunities for classes in 2015.   

Q. Will a gluten free class be taught?

A. This is something we’d like to offer in the future, but all employees are eligible to schedule an appointment with our Wellness Program Coordinator and registered Dietitian for guidance on eating gluten free. Becky Maynard has partnered with our Food Services team to create and post signs in all three (17th Street) cafeterias, so employees know which items are gluten free – including the most popular and best tasting gluten free products on the market! You may also contact Laura Greenhow, a Registered Dietitian and Master of Public Health, for assistance by calling 667.7445.

Q. Will I get a free glucose meter?

A. Yes, Diabetes Health Plan participants can get a free meter from a Diabetes Health Plan provider, along with free test strips and lancets. Please call 667.5183 to make an appointment with a Dietitian or Pharmacist.

Q. Do I have to see my doctor if can I get everything done in Employee Health & Clinic?

A. The NHRMC Employee Health & Clinic (EHC) shouldn’t replace your primary care provider or any other specialist with whom you are receiving care. The EHC can be used by all employees for minor illnesses and injuries, as well as their Health Risk Assessments. Our DHP plan participants will also have required labs drawn at the EHC, and it is one of the office areas used by the Dietitians. Remember, we will not take the place of your doctor - we will work to support them and their goals for you! In order to properly manage your health long-term, a strong relationship with a primary care provider and regular annual visits are essential.

Q. Do I have to register for classes or can I just show up?

A. Yes. We do ask that you register for classes ahead of time so we can ensure we have enough space and resources for everyone in attendance. You may register up until the day before any class by calling 667-5959. You may also use the electronic enrollment option on the 2015 Diabetes Program Classes webpage.

Q. Can I come to the classes if I am not part of the DHP?

A. Yes, but only if you attend as a guest of a DHP participant.

Q. What should I do if I know I will be unable to attend the required classes due to medical or personal reasons? Who should I contact?

A. Please contact your Benefits Administrator and the Diabetes Health Plan Administrator as soon as you are aware of a medical situation or life event that may impact your participation in the DHP. They’ll help you explore your options.

Q. How will the action items be evaluated at the end of the year? Will I be ineligible if I do not complete all required action items?

A. We strongly recommend that you complete all required action items by December 2015. However, if you are unable to do so, we will evaluate your scorecard to determine future eligibility based on how many action items you were able to complete during the 2015 benefits year.

Q. Should lab work only be done at NHRMC’s Employee Health & Clinic?

A. For 2015, the labs required as DHP Health Action Items (at least bi-annually) must be completed at NHRMC’s Employee Health & Clinic to ensure accurate recording and tracking of results. We will evaluate this requirement in future years to determine if we can accept lab results from your doctors’ offices. There are a few ways you can get your lab work done outside of Employee Health & Clinic. For more information, call 910.667.7441.

Q. What is the benefits website?

A. The benefits website is a resource that details all of the benefits available to our employees. For NHRMC employees, the website is www.nhrmcbenefits.com . For NHRMC Physician Group employees, the website is www.nhrmcpgbenefits.com . Don’t forget to check out the Good For You information on CapsulesLive too!

Q. How can I reach someone about the Diabetes Health Plan?

A. You can always call the DHP Hotline at 667.7777. The Diabetes Health Plan Administrator is also an excellent resource and can be reached by phone at 667-5959.

Q. How can I make an appointment to see a Dietitian or Pharmacist?

A. It’s easy. Just call 667-5183, or email diabetes.pharmacy@nhrmc.org.

Q. Why wasn’t my eye exam co-pay covered?

A. DHP participants’ eye exams must be coded as a comprehensive eye exam to be processed with a $0 member co-pay. It must also be billed to BCBSNC. Other services, such as contact lense consultations, need to be billed to Community Eye Care, if you have elected this coverage.

Q. What if I visit the doctor to discuss many topics, not just diabetes? Will my co-pay still be covered?

A. Yes, provided diabetes or pre-diabetes is the primary diagnosis code for the visit, the co-pay will be waived.

Q. If my A1C is above 8, will I have to be seen every month for a year?

A. Yes. Participants with initial A1C levels above 8 are required to schedule and see the DHP Dietitian or Pharmacist each month, alternating months. It’s great to know that several of our plan participants have already lowered their A1C levels below 8 and have shared that their meetings with these knowledgeable clinicians has helped them reach their goals!    

Q. I’m having trouble making an appointment. Who do I call?  

A. Appointments with a DHP Dietitian or Pharmacist can be made by calling 667-5183, or by email at diabetes.pharmacy@nhrmc.org. Appointments for required lab work can be made by calling the NHRMC Employee Health & Clinic at 667-7445.

Q. Is there a prescription drug list of medications covered at $0 co-pay?

A. The 2015 NHRMC Diabetes Health Plan Drug List is available in PDF format on the main page of the Diabetes Health Plan website.

Q. Can a class be substituted with a personal visit with the Pharmacist and/or Dietitian?

A. No, you are expected to attend all required classes – regardless of when or how many visits you have with the DHP Pharmacist and Dietitian. The best news is that we have received wonderful feedback about the sessions, including the content and group interaction! If you haven’t already attended, check out the new schedule on http://www.nhrmc.org/dhp.

Q. Do the classes need to be taken in a certain order?

A. No. Each class handles a different important topic, so they don’t have to be taken in succession.

Q. How do I deal with co-pays when the office wants it up front?

A. You should tell them that you participate in the Diabetes Health Plan, and NHRMC is paying for the entire cost of the visit. You do not have to pay a co-pay, as long as the primary diagnosis is pre-diabetes or diabetes. You may want to bring along the letter you received about being enrolled in the plan, since your BCBSNC medical ID card has nothing on it that identifies you as a DHP plan participant. If the doctor’s office persists, pay the co-pay so you can be seen, and then follow up for a refund once the claim is processed (and you receive the explanation of benefits from UHC with $0 member responsibility). For help with co-pay reimbursement, contact the Diabetes Health Plan Administrator.

Q. I’m the member who has Diabetes and was happy to learn that, since my spouse is covered under my plan, his high cholesterol medication is also free. Does he have to have labs done at the NHRMC Employee Health & Clinic and attend classes?

A. Only the pre-diabetic and diabetic plan participants on the DHP need to have their initial and follow up lab work drawn at EHC. While your covered dependents do not have to comply with the plan’s required Health Action Items, we encourage them to come to classes to help with planning and support.  

Q. Do a majority of Wilmington Doctors participate in the Diabetes Health Plan?

A. The Diabetes Health Plan is administered through NHRMC Benefits, and participation is up to the individual. We have been working hard to build relationships with the physicians and specialists in the area so that each participant will be supported by NHRMC and his or her health care provider(s). As long as your visits are billed appropriately to BCBSNC, you should receive the benefits for eligible visits and services at any in-network health care provider's office.

Q. Am I going to carry a label forever? Will this affect my life insurance costs?

A. No. NHRMC protects our employees’ personal health information and preserves confidentiality. Eligibility for the plan will be evaluated on an annual basis. Therefore, enrollment will be determined by yearly Health Risk Assessment (HRA) lab results. Participation in the plan and HRA results will never be shared with anyone by NHRMC.

Q. Does the foot exam need to be a separate appointment or can it be done in a regular appointment with an endocrinologist or primary care provider?

A. No. You can have your diabetic foot exam done at a regular appointment with your primary care doctor, or you may make a separate appointment with a specialist, such as a podiatrist. Once complete, please document your visit on an Action Item Completion Form and submit it to the Diabetes Health Plan Administrator to ensure you receive credit.

Q. Is a visit with an endocrinologist required?

A. No. This type of visit is specifically for those who need the expertise of a specialist. Such a need will be determined by your primary care provider. Visits to an endocrinologist will require a referral. Although Employee Health & Clinic (EHC) does not provide referrals for endocrinologist visits, they can assist you with finding a primary care provider who can pair you with the appropriate specialist in your area. To contact the EHC, please call 667.7441.

Q. Will I be penalized or will my rates go up if I choose not to participate in the DHP now or in future years?

A. No. The DHP is a subplan of the NHRMC plan and is provided as an additional benefit to our employees. Participation is up to the individual. The plan's purpose is to remove barriers, provide educational resources and help our employees better manage their health and the health of their covered dependents and/or spouse. The plan does not raise benefits costs, and in actuality, may help reduce some health care costs for those enrolled. However, if you choose to opt out, there will be no penalty, and your choice will have no effect on your benefits costs.

Q. Can Employee Health & Clinic provide me with a referral?

A. No. Although Employee Health & Clinic (EHC) does provide many services, it can't serve as a primary care office and does not generally provide referrals. The EHC focuses primarily on acute care, immunizations and general wellness needs. Referrals are not offered by the EHC, because these often require follow-ups and additional communications that are normally fulfilled by a primary care provider. For questions about referrals, or if you are in need of a primary care provider, please contact the EHC at 667.7441.

Q. I would like more information about the program offerings at the Employee Fitness Center (EFC). Who should I contact?

A.You have several options here. For general questions related to program offerings at the EFC, you may reach a staff member by calling the front desk at 667.4151. To reach Sheri Albertson, Program Coordinator and Personal Trainer, please call the front desk at 667.4151. To reach the Manager of the EFC, Jason Albertson, please call 667.6250. You may also visit the Employee Fitness Center website for additional information, schedules and resources at http://www.nhrmc.org/fitnesscenter.

Q. How was I enrolled in the plan?

A. In 2015, enrollment is based on 2014 participation and HbA1c results from the 2014/2015 employee Health Risk Assessments (HRAs).

Q. Will everyone know that I am part of the DHP if I start going to the Employee Fitness Center (EFC)? Will I have to feel embarrassed or singled out when I go there?

A. The Employee Fitness Center (EFC) is a very welcoming place. Although many DHP participants have enrolled in the 12toLife program, each team is highly diverse. Other members of the EFC will not be able to tell that you are enrolled in the Diabetes Health Plan, unless you choose to share that information. We emphasize family and camaraderie here at NHRMC, and we do not label anyone. The staff at the EFC are here to guide you and help you reach your goals, and you will never be singled out or made to feel embarrassed. They will do their best to uplift you, encourage you and challenge you to reach your health and wellness goals. For more information about program offerings at the Employee Fitness Center, call 667.4151 today!

Q. Why do I have to repeat my lab work at Employee Health & Clinic if I have already had blood drawn at my doctor's office?

A. In order to evaluate the success of the plan and accurately track compliance, we must have each participant visit Employee Health & Clinic for a follow-up appointment. This appointment will be exactly like your initial Health Risk Assessment and will include a fasting blood draw and measurement of your height, weight and body fat percentage. These appointments require at least 9 hours of fasting to ensure accurate lab results. For questions, or if you need to make an appointment, please call Employee Health & Clinic at 667.7445.

Q. What do I do if my doctor doesn’t agree with the Employee Health & Clinic lab results or my enrollment in the plan?

A. Reference ranges and guidelines utilized by your doctor may differ from those of the American Diabetes Association. Even if your doctor does not agree with your enrollment in the plan, participation is up to you. If you feel that the plan will benefit you, we strongly recommend that you participate. For more information on guidelines and standards of diabetes care published by the American Diabetes Association, please visit the DHP document library at http://www.nhrmc.org/document-library. Here you will find a full PDF document containing the 2015 recommendations set forth by the American Diabetes Association.

Q. Why didn't I receive a copy of my initial or follow-up lab results in the mail?

A. Employee Health & Clinic will no longer be mailing paper copies of lab results. Instead, each patient will need to activate his or her MyChart account online in order to view appointment details and lab results. For more information on MyChart, visit http://www.nhrmcmychart.com. You may also visit the DHP Document Library to view a PowerPoint presentation and handout detailing how you can sign up for a MyChart account.

Q. Why can't I bring lab work in from an outside doctor?

A. After the launching of EPIC in Employee Health & Clinic, NHRMC requires that all employees and DHP participants who need to complete one or more Health Risk Assessments (HRAs) do so at a location that utilizes EPIC. This includes: (1) getting an order for your lab work sent by your primary care doctor to the medical mall; (2) visiting a doctor who already uses EPIC; or (3) completing your HRA(s) at Employee Health & Clinic. Questions? Call the DHP Hotline at 667.7777.