Health care can be difficult to understand and to navigate, and the Mille Lacs Band's Circle of Health team knows that. Beginning this month, Circle of Health will begin a series of articles to help take the confusion out of health care so that you may be empowered to take control of your own health care.
Circle of Health is a Mille Lacs Band program whose mission is to promote physical and mental well-being in all of our communities, by assisting Mille Lacs Band members to acquire health coverage and eliminate barriers to health care access.
The program pays for deductibles, copays, and insurance premiums for Mille Lacs Band members and eligible first descendants. All Band members are entitled to Circle of Health benefits regardless of income or where they live, but it is important to understand that Circle of Health is not health insurance. To be eligible for benefits there must be a Mille Lacs Band member on the primary policy. The program pays for single or family medical and dental premiums, one premium per household, and Band Members must accept and be willing to apply for medical and dental coverage that is available to them.
Circle of Health benefit coordinators are available to assist Band members in understanding and applying for applicable insurance policies and can help navigate you through the process of enrolling in health plans.
Intake specialists process the documents that you send in when you enroll in Circle of Health and do your yearly update. The purpose of these updates is to maintain updated information from Band members and to determine who is eligible on their policy. Initial enrollments require several accompanying documents. Your annual update should be submitted along with your tribal identification card and health insurance cards prior to any claims being paid through Circle of Health. A consent form is included in your update packet; this allows Circle of Health staff to directly deal with providers, employers, and insurance companies on your behalf.
Claims processors process payments for premiums and reimbursements.
To ensure timely reimbursements
There are a few things that you can do to help this process to ensure timely reimbursements.
— It is important that when you send in documents for reimbursement, medical bills must always be accompanied by an explanation of benefits, which is mailed out by your insurance company.
— If you are seeking reimbursement for a copay, a receipt is required.
— Reimbursement for prescription copays requires the receipt from your prescription bag as well as the cash register receipt.
— Provider payments and medical bills may be submitted for payment up to six months from the date of service, so it is very important that you send any bills you receive as soon as possible.
You can streamline this process by ensuring that you present your Circle of Health card at patient registration and when picking up prescriptions, as well as listing Circle of Health as your payer of last resort.
Ultimately, the more you know about your health care and how to get the greatest benefits from your coverage, the better you will be able to advocate for your needs. Becoming a better consumer of health care will also help to sustain the Circle of Health program.
Contact Circle of Health in District I at Ne-Ia-Shing Clinic, 800-491-6106, or in District III at the Hinckley Corporate Building, 320-336-0224. Staff make regular visits to all districts and the urban area.