TRUST FUND INFORMATION

In the ongoing saga of the health care system’s rising costs and the Trust Fund’s ability to keep pace, I want to continue my information flow to the membership on what to be especially aware of when you go to the doctor or dentist. Laboratory services should still be done by the two agencies listed in the front of the AHF book. Unilab has been purchased by Quest Diagnostics but the numbers in the book for both Unilab and LabOne are still good. Be sure to utilize their services so you won’t incur additional expenses. 

Medical related topics to be watching include Anesthesiologists. None of them are AHF and you need to make your doctor sensitive to the additional costs that you will incur. Just because you go to an AHF doctor or hospital, there are other persons involved that potentially will charge well above the Trust Fund allowable amount. Even if you go to an emergency room within an AHF hospital, the emergency physicians are NOT AHF so you should ask for an AHF doctor or let them know that you want to only be charged the AHF rate for any medical doctor services rendered. This should at least put them on record that you will dispute the charges when you get the bill. 

Acupuncture is a covered benefit but must be administered by a licensed M.D. Doctor, not by an OMD or any other person who is not a licensed M.D. Doctor, licensed in the State of California. Should your doctor prescribe radiological tests for you, you need to utilize the providers also found in the front of the AHF book. This includes MRI’s, MRA’s, CAT scans, and other similar outside services that need to be done by others rather than your doctor. Don’t just go to whomever your doctor recommends. Call the number of either of the providers in the AHF book and they will schedule you with one of their members close to where you live so you will not have additional out of pocket expenses once the deductible has been met. 

Dental care covers most “normal” procedures such as cleaning, fillings, crowns, x-rays, etc. but DOES NOT cover implants. Also, debreedment is not covered but regular cleaning is a covered benefit and the Trust Fund will authorize this “normal” cleaning procedure three times a year (once every four months). Be sure to check with the Trust Fund when you need any service which is not “normal”. Don’t forget that the dental deductible is $50.00 and goes towards the $250.00 deductible so you will really have only a $200.00 deductible for medical care. 

The Vision Care benefit is $200.00 every two years (each two years from the date you first use the benefit, not calendar years) with NO deductible. This is a reimbursable expense and you need to send in your receipt along with a “green form” and the Trust Fund will send you a reimbursement check. Be sure to keep a copy of the receipt until the claim is paid so you can duplicate it should it get lost in the system. Remember that LASIK is NOT a covered benefit. Glasses, frames, eye exam, contacts and other normal vision products are covered. You may go anywhere for your exam and glasses such as Costco or similar facilities. 

Lastly, the Trust Fund is investigating the implementation of certain allowable preventative maintenance procedures. If and when the Trustees approve any changes to the plan you will be notified. Don’t forget that not being familiar with the Trust Fund rules or not communicating with them about your coverage and allowable benefits may and will make you liable for additional costs for care beyond what the Trust Fund will allow. Be sure to utilize AHF providers whenever possible as this will keep additional costs to a minimum. Be sure to be familiar with all the information in the front of the AHF book: Healthcare device companies, Lab services. Radiology services, Hearing care services, Outpatient surgery and treatment centers, Physical therapists, Chiropractors, Doctors, and Hospitals are all listed for you to utilize. Some types of doctors or services may not be located conveniently close to your home address but the cost savings will more than offset any inconvenience experienced.

Fraternally Yours,

Dana S. Levy

Business Representative

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