Inside Iowa State

Aug. 29, 2008

Become a 'guest' for broader health care coverage

by Paula Van Brocklin

Put yourself in this scenario: You have an amazing opportunity to do groundbreaking research for Iowa State, but it requires you to leave campus -- and the state -- for the next six months. And, you are enrolled in ISU's Blue Advantage HMO benefits plan, which mandates you see network physicians in Iowa to receive benefits. How will you receive health care while you're away?

Become a guest.

The Blue Advantage plan (and the Blue Access plan for non-supervisory merit employees) offers the option of guest memberships, which provide you and your dependent family members with health care insurance for non-emergency services while temporarily away from home. It works well for employees who have children residing outside Iowa, either attending college or living with a custodial parent.

Some employees opt for ISU's preferred provider plan (PPO), which offers access to more health care providers nationwide -- at a higher premium. But the HMO's guest membership option offers some flexibility.

"If you want to have lower insurance premiums but still have good coverage for those out of state, the HMO may be a good option," said Jane Walter, human resources specialist. "There are just more hoops to jump through."

And there are some restrictions. These include:

• Time limit -- Guest memberships must be used for a minimum of 90 days and a maximum of 180 days. For example, if you're leaving on a month-long vacation to Arizona, a guest membership is not the way to go. It also means your child attending college in Nebraska will have to re-register for guest membership in the middle of second semester, around February or March.
• Become a guest before you leave -- You must register for a guest membership with Wellmark before you or your family member leaves Iowa. For instance, if your son attending college in Minnesota needs to see a doctor for a non-emergency and he has no guest membership, you are unable to designate one for him at that time.
• Get regular exams in Iowa -- Make sure you get a physical or have your eyes checked before you leave. Guest memberships do not cover routine exams outside of Iowa.

Additional facts

• Other important things to remember about guest memberships:
• There is no premium increase to add a guest membership to your plan.
• There is no limit to the number of guest memberships you can designate. But, only you and your dependent family members qualify.
• You must visit a hospital or doctor that accepts Blue Cross/Blue Shield insurance to receive the most benefits. It's a good idea to select a new physician first, before you need assistance.
• Non-emergency services are accepted only in the state where you are registered for a guest membership. For example, if you're registered in Arizona but you see a doctor in California, you will not receive benefits.
• You need to contact Wellmark when you return to Iowa to end the guest membership.

If a guest membership sounds like a good fit for someone in your family, contact Wellmark using the customer service phone number on your identification card to find out more.

ISU's Blue Advantage HMO benefits plan offers guest memberships, giving coverage options when you or your dependents are out of state.