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Frequently Asked Questions: Health Insurance - Medical FAQ
Health Insurance - Medical FAQ
Do I need a physical to enroll?
Yes, you do need a physical to work at the NIH but not to enroll for health insurance.
Where can I get my physical?
Physicals necessary for working at NIH are give in the Occupational Medical Services, Building 10, room C6306. Please contact OMS at (301) 496-4411 for more information.
I didn’t enroll within 30 days, can I enroll now?
Due to contractual agreement with CareFirst and FAES the answer is normally no. Members have their first 30 days of employment or a special enrollment reason. There is a 30 day deadline for new enrollment and for special enrollment reasons. Based on an individual circumstance, enrollment will be subject to approval by the FAES Insurance Manager and/or supervisor.
Can I have my ID number early?
You may have your ID number early only in an emergency situation. In case of an emergency situation, please contact the FAES insurance office at 301-496-8063 and your ID number will be ready in about 48 business hours.
When and how can I add dependents?
You must report any change (e.g. marriage, birth of a baby, dependents arriving from a foreign country, adoption, loss of previous coverage) to FAES within 30 days of the event, and completed the required forms. If not reported within 30 days, then the change may be made at the next open season. FAES open season is held during the month of November with a January 1st effective date.
My family members just came to the US, how do I add them to my plan?
Once a member’s family enters the United States, he/she has 30 days to add them to his/her insurance plan. Fellows must obtain a new Election of Health Insurance form from their Administrative Officer. Members must then complete an Existing Member Change Form (obtained from FAES), and provide FAES with the family members’ passports.
Can I add my parents to my plan?
Parents may NOT be added to an insurance plan. Only dependents that meet the eligibility requirements of our Carefirst Contract. Please see the Benefits Guide for more information.
Where can I find my doctors?
For service area of Maryland, Washington, D.C. and Northern Virginia:
- Go to www.carefirst.com/doctor
- Search for a doctor or facility by provider type, provider name, specialty, location and more options based on your preferences
- Choose our plan “Blue Preferred PPO”
- Click “Continue”
- Click “Create a Printed Directory”
For service area outside of D.C. Metro area (including outside of USA) please go to www.bcbs.com to find providers within the U.S. and around the world.
After I receive my bill, do I pay CareFirst or the doctor?
- Please go to www.hcbo.com and print out the claim related to the bill you received to see if CareFirst processed the claim. I f the claim cannot be found, then do not pay the bill. Please call FAES to assist with this issue.
- Co-pays are normally taken at the doctor’s office.
- If no funds are taken at the time of your visit, then the bill will be submitted directly to CareFirst and the claim is processed and the doctor’s office will send you a bill for the remainder amount.
- If the bill is more than your contractual amount, it would be best to contact FAES before paying this bill. Remember that doctor’s offices do make mistakes when billing your insurance company and CareFirst also can make an error when processing your claims.
- If CareFirst send you a (EOB)Explanation of Benefits with a check attached, then the claim was paid out of network and should be reviewed by FAES for any errors. Please do not cash the check until you are advised by FAES.
How do I receive a refund for my prescription payment?
Once a member has obtained a Carefirst ID number, he/she may return to the pharmacy within 7 business days for a direct refund. The member must supply the pharmacy with his/her insurance ID and the receipt.
How can I cover my gap in coverage between positions?
- Insurance gaps can be covered by paying out of pocket for FAES COBRA coverage
- Insurance gaps can be covered by purchasing private insurance. The insurance has to start the very next day that the FAES policy was terminated and remain in effect for one or two months depending on the date that you returned to NIH.
- Normally Gap insurance is needed for 1 or two months
When does my coverage terminate?
Benefits are terminated at the end of the month in which you leave your position. Additionally, Fellowship Award Forms/Election of Health Insurance paperwork is only valid for one year. If you or your Administrative Officer (A.O.) fail to forward your renewal forms to our office you will be terminated. At the end of your termination month C.O.B.R.A. information is sent to your forwarding address. You are given 60 days to elect C.O.B.R.A. Once you elect C.O.B.R.A. your coverage is retroactive to the first day of the month following termination.
How do I get C.O.B.R.A.?
C.O.B.R.A. information is sent to you at your forwarding address the first day of the month following your termination. You have 60 days to elect C.O.B.R.A. Once you elect C.O.B.R.A. your coverage is retroactive.
If I have a family plan now, can I get C.O.B.R.A. for my dependents by themselves?
C.O.B.R.A. can be elected for your dependents only, but cannot be changed after initial election.
Does this plan cover vision?
Yes, Bluevision offers a national network consisting of optometrists, ophthalmologists and opticians. To find a provider, go to www.carefirst.com and utilize the “Find a Doctor” feature or call Davis Vision at (800) 783-5602 for list of network providers’ closet to you. Be sure you ask your provider if he or she participates with the Davis vision network before you receive care.