Health care benefits aren’t just a perk; they are a critical component of an employee's overall compensation package and a measure of security in the event of a medical emergency. As we’ve discussed in previous articles, offering robust health care options can lead to higher employee satisfaction, improved morale and increased productivity.
Through Blue Cross and Blue Shield of Illinois, policyholders have access to a wide range of coverage types and services, including ambulatory care, emergency care services and hospitalization. In this article, we will explain all three of these coverage types and discuss the benefits that small business employees can expect from each.
What is Ambulatory Care?
Ambulatory care refers to medical services provided on an outpatient basis. These services are designed to diagnose, treat and manage a wide range of health conditions without the need for an overnight stay in a hospital. Ambulatory care encompasses a wide range of services such as routine check-ups and minor surgical procedures.
- How does ambulatory care benefit employees? Ambulatory care allows employees to undergo preventive care or seek immediate treatment for minor injuries without interfering with their busy schedules. By scheduling ambulatory services in advance and avoiding a hospital or trip to the emergency room, patients can plan around their existing work schedules without compromising their well-being.
- What health issues are treated? Ambulatory care can treat a broad array of health issues through preventive care and the ongoing management of chronic diseases. Annual physicals, diagnostic procedures, consultation and rehabilitation services all fall under the umbrella of ambulatory care.
- What makes ambulatory care unique? It aims to provide convenient and accessible health care, allowing patients to receive necessary medical attention without the typical disruptions associated with hospital stays such as prohibitive costs, prolonged hospital stays and the risk of hospital-acquired infections. While ambulatory care is among the most common type of services provided by hospitals and clinics, the wide range of outpatient solutions and improved access to care means that patients can expect to receive treatment tailored to their own unique medical needs.
What is Emergency Care?
Emergency care is reserved for immediate medical attention provided for acute, severe and potentially life-threatening conditions that require prompt action to prevent serious health consequences or death. Emergency care is meant to provide rapid, effective treatment for more serious medical issues and typically necessitates appropriate follow-up care.
- What constitutes emergency services? Emergency services such as emergency room visits, trauma centers and ambulance services are available 24/7 and are focused on rapid assessment, stabilization and treatment. Aside from sudden unexpected injuries, emergency services are also used to treat conditions such as heart attacks, strokes, severe allergic reactions and other sudden, life-threatening medical emergencies.
- How do different plans cover emergency services? Emergency care coverage differs for policyholders depending on whether they are part of a PPO or HMO plan. Both plan types typically cover emergency services, but HMO policyholders should contact their physician before or during emergency care to ensure that you can be referred to a facility within your network to avoid being charged for the full cost of treatment.
- What makes emergency services so essential? Emergency care protects employees from undue financial and health-related hardships, boosting their well-being and productivity through comprehensive care in dire circumstances. The nature of treating life-threatening medical conditions also means that emergency services are available 24/7, ensuring that patients have access to treatment no matter the time of day.
Understanding Hospitalization Coverage
Hospitalization coverage pays for the costs associated with staying overnight in a hospital in the event of inpatient care, emergency hospitalization, surgical procedures or intensive care.
- What are the benefits of hospitalization coverage? Hospitalization coverage is a crucial aspect of health insurance that ensures employees can access necessary inpatient care without facing prohibitive costs. Hospitalization coverage can be the result of extended treatment following emergency care or following an unexpected diagnosis during ambulatory care.
- How does hospitalization coverage impact premiums? Overnight stays typically incur higher premium costs compared to other services. Factors such as comprehensive coverage, network limitations and deductibles can impact total premium costs for policyholders. As such, it’s important for HMO policyholders to find hospitalization care that falls under their coverage network.
- What should small business owners consider when looking for a plan with hospitalization coverage? Small business owners should consider a few key factors to ensure that their chosen hospitalization coverage meets the overall needs of employees while falling within their health care budget:
- The scope of available facilities within their network
- Out-of-pocket costs such as deductibles and co-payments
- Coverage limits and service exclusions
Conclusion
Ambulatory, emergency and hospitalization services are vital components of any health care policy for small business owners, empowering employees to seek the care they require for any number of medical conditions or emergencies. By understanding and investing in comprehensive health care plans, small business owners can ensure their employees have access to the necessary medical attention they need, fostering a supportive and resilient work environment that puts employees first.
