|
|
| |
|
|
|
[an error occurred while processing this directive]
|
|
Flex 2002 News:
Second Surgical Opinions No Longer Mandatory
The 90/10 and 80/20 medical options currently require second
opinions for many non-emergency inpatient procedures. They are paid at 100%
(no deductible applies) when coordinated through the Merck Medical Line
(“M-Line”). And, in situations where second surgical opinions are required
but not received, related benefit coverage is reduced by 20%. This requirement
is designed to ensure that physicians and other providers offer appropriate
diagnosis and treatment plans for certain conditions—such as coronary bypass
surgery, hip replacement, mastectomy, back surgery, etc.
To simplify and streamline
our administrative processes, starting January 1, 2002, second surgical
opinions will no longer be mandatory under the 90/10 and 80/20 options.
However, employees who are covered under these medical options may continue
to seek second surgical opinions (paid at 100% when M-Line is involved)
on a purely voluntary basis. For more information about second surgical
opinions, feel free to call M-Line at 800-451-8843.
What This Change Means
To You
If you are covered or are planning to elect coverage under the 90/10 or
80/20 option, and you are considering non-emergency surgery, keep in mind:
- Effective January
1, 2002, second surgical opinions are no longer required—however, they
are available through M-Line on a voluntary basis.
- For more information
about second surgical opinions—and requirements for the remainder of
2001—contact M-Line at 800-451-8843.
Fast Fact
Approximately 95% of the mandatory second opinions received by Merck employees and covered dependents confirm the original treatment recommendations.
|
|
|
2009 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, N.J., U.S.A.
|
The 90/10 and 80/20 medical options currently require second
opinions for many non-emergency inpatient procedures. They are paid at 100%
(no deductible applies) when coordinated through the Merck Medical Line
(“M-Line”). And, in situations where second surgical opinions are required
but not received, related benefit coverage is reduced by 20%. This requirement
is designed to ensure that physicians and other providers offer appropriate
diagnosis and treatment plans for certain conditions—such as coronary bypass
surgery, hip replacement, mastectomy, back surgery, etc.
To simplify and streamline
our administrative processes, starting January 1, 2002, second surgical
opinions will no longer be mandatory under the 90/10 and 80/20 options.
However, employees who are covered under these medical options may continue
to seek second surgical opinions (paid at 100% when M-Line is involved)
on a purely voluntary basis. For more information about second surgical
opinions, feel free to call M-Line at 800-451-8843.
What This Change Means
To You
