From: Henry Trevino
Retiree Healthcare Representative (Fire Dept)
 
Henry is a regular contributor to “The Grapevine” the SA Fire Union Magazine. He is a representative of our Retirees Healthcare Fund along with Alex Perez, SAPD Rep.
Attached is his article for December 2021.

From: Henry Trevino -  Retirees Health Benefit Trustee
Subject: Treatment at the Emergency Room
Attached above is a an article written by one of our Retiree health trustees. 
Problems after visiting a hospital ER for treatment.
Article Attached
FELLOW AND FUTURE MEMBERS                                 
 
This article will discuss the tremendous financial burden people suffer when they go to the hospital for emergency treatment.

             When a person receives care at an in-network hospital, he generally assumes that the attending physicians and specialists are also in-network.  They are mightily surprised when they receive a bill from the attending providers that are not in net-work.

             Many physicians working in hospital’s E.R’s are contract workers that are not directly employed by hospitals.  Many of these contract physicians that provide care in hospital’s E.R’s might not be in net-work.  
             Knowing whether a doctor in or out of net-work is generally not known until weeks later when a bill is delivered to the patient.  The bill is the difference between what the insurance paid and the out-of-network costs.  The bill balance is now the responsibility of the patient.  The amounts can vary from a few hundred to thousands of dollars. 

             This very unfair method of billing blindsides patients that are most vulnerable. This unfair practice of billing is disproportionately tied to emergency room care. 

             State representatives should have the courage to confront and fix this problem as other states have done.  It is suggested that if patients go to in-network hospitals they should receive in-network billing.  The medical provider and the insurers should settle out the difference.  

             Florida, New York and California have tackled the problem by requiring in-network billing when patients go to in-network hospitals and other facilities.  Two Texas Lawmakers, state Representatives John Smithee, R-Amarillo, and state Senator Larry Taylor, R-Friendswood have said that they would consider such legislation.
 
             Unfortunately the Fire and Police Health Fund cannot intercede for our members when they are hit with not in-network billing. Furthermore, the Fund cannot determine whether a physician is or is not in-network in an emergency situation.  It is the responsibility of the member to determine whether the doctor is or is not in-network. 
  
             If emergency care is necessary, a relative or a friend can call the Health Fund and pre-certify the patient.  If this happens on a week end the patient has 48 hours in which to pre-certify.  However, it is the responsibility of the patient to ask and determine if the doctor is in-network.

             What can you do if this happens to you?  Go to the hospital or to the doctor and bargain the extra billing down.  They may or may not agree, but argue the point of the unfairness of the extra billing.  I suggest that when arguing this point that you remain calm and composed while presenting your case.  Sometimes more often than not, offering a fully paid discounted amount will be accepted.

From: Armando Ynostrosa 
Subject: Flu shots
I have had a couple of retired officers saying that when they called the
clinic, Health Designs, for an appointment for a flu shot
They were asked, “Are you over 65 yrs old”, and they were over 65 yrs,     
to call back later to make an appointment. They had no vaccine.

I notified Alex Perez and Henry Trevino about members being told by the
Health Care Clinics they could not get a Flu shot. Ask them to check into it.

Response was Quick from our Police and Fire Health Rep’s.
From: Alex Perez / Henry Trevino – Health Benefit Retirees Rep. 
Subject: Flu shots
Armando, I followed up with James at the Health Fund and he checked on the
issue of Flu shots at the Health Clinics.
We found out the clinics ran out of the vaccine for the retirees over 65,
but have the regular flu vaccine for those retirees under 65 years of age.

The CDC recommends that people over the age 65 receive the extra strength
flu vaccine which is the vaccine that the clinics ran out of.
They did not receive the Full Shipment for the extra strength vaccine.
They are waiting for the next shipment to come in hopefully within the next week.
If retirees over the age of 65 call in, the clinic’s will take their names
and call them back when the extra strength vaccines arrives.
The Clinic does not want to make the appointments when they don’t know when
the vaccine will be in.
We ask the retirees to be patient and we will get back with them as soon as
we can.
Thanks, Alex Perez – Police Health Benefit Trustee

Retirees Health Care Clinics
By the end of September our Health Care Clinics, all three locations, should have
enough Flu Vaccine available for members interested in getting one.

Be sure to call and set up an appointment to receive it. It is free to members and immediate family.

TO MEMBERS OF THE
 FIRE AND POLICE HEALTH FUND
                                                                          
                                                                                                          AUGUST 1, 2020
           The Board of Directors of the Fire and Police Retiree Healthcare Fund has extended the Telehealth Benefit due to the COVID‒19 Pandemic.  The benefit change will apply to Telehealth visits with a date of service of 3/23/20 to 2/28/21.  The benefit will only be considered for payment if the service is provided by Aetna Signature Administrators physician to an established patient.
           It’s been hard changing the way we used to live.  Not being able to hug your grand kids; difficult to come together to celebrate a birthday or an anniversary; prayers and goodbyes to a love one.   When is this all going to end?  When are we going back to normal?
           I myself thought that after two or three months everything would get back to the way it was.  I was terribly wrong.  It’s now going on 9 months.   Hopefully, we can soon start seeing a light at the end of the tunnel.  We may be close to a vaccine; maybe we will have it by the end of the year. 
           All this will come to pass.  We must be ready when that time comes.  We have to continue living and working. We must continue striving and paving the way for our young generation that is coming to take our place.  The important thing is to keep busy and our bodies healthy so we can welcome our upcoming generation. 
           Now is not the time to give up.  Let’s talk about exercise.  Don’t miss your daily walk or run.  While you’re doing cardio exercise, you must walk or run fast enough to increase your pulse rate.  After you stop or slow down your heart rate will revert back to its normal beat.  
           While doing cardio exercise you’re strengthening your heart.  Over time, as your heart gets stronger it will work more efficiently.  It will pump more blood with less beats per minute.  As you exercise you will breathe faster and your lungs will expand. Your heart will distribute oxygenated blood throughout your body faster and more efficiently. 
           Osteoporosis is a condition in which bones become weak and brittle. The body constantly absorbs and replaces bone tissue. With osteoporosis, new bone creation doesn't keep up with old bone removal.  Many people have no symptoms until they have a bone fracture.
   
           Osteoporosis onset usually starts after the age of 50.  Both men and women are prone to this malady.   Women, especially, suffer from Osteoporosis earlier than men.  Women start losing bone mass after menopause.  This does not have to be in your future if you eat wisely and exercise regularly.  
           Borrow or buy a few light weights.  Exercising with weights helps you in many ways.  It strengthens your muscles, gives you flexibility, and helps solidify your bones.  Elderly people are very prone to falls.  Broken bones are extremely debilitating and they take a long time to heal. 
           Watch where you walk; get rid of all your throw rugs; get rid of all furniture that you never use; get rid of all clutter around the house. Have small lights on all rooms that you go to at night. 
           Continue having your physical exams.  The new clinic on Tezel road is now open.  If you need some service from a Health Fund Clinic, be sure to call the clinic first.  They will help you make an appointment and tell you what procedures will be necessary while visiting one of the clinics. 
 
Henry Trevino
Fire and Police Health Fund Trustee

Healthcare Fund Information
 
The Fire and Police Retiree Health Care Fund has extended the Telehealth Benefit due to the Covid-19 pandemic.
The benefits (date of services) from March 23, 2020 to August 31, 2020 will only be considered for payment.
 
This announcement was mailed to every participant in the system. Contact the Fund if you did not receive the letter by mail.
 
Also included in the Health Fund letter was new info about Alternative Therapy Program from WELLDYNE.
 
The purpose of the Fire and Police Retiree Health Care Fund, San Antonio is to provide retired firefighters and police officers with family health plan.
Their website is here.
 
CONTACT US
Fire and Police Retiree Health Care Fund, San Antonio
11603 W. Coker Loop, Suite 130, San Antonio, Texas 78216
Office: (866) 652-4237 / Fax: (210) 494-6505
e-mail: faprhcf@swbell.net
www.prefundedsa.com

Subject: TELE MED Appointments
 
Currently most doctors offices are trying to minimize people coming into the clinic and doing TELE-MED.
 
TELE MED from "HEALTH BY DESIGNS” is still covered but NO TELE-MED for Outside In Network or Out of Network DOCTOR for regular care will be covered
 
Our Health Benefit plan DOES NOT cover any form of TELE-MED except if it relates directly to a diagnosis of Covid-19. If you call and talk to your doctor about adjusting your meds or some other issue
on a NON – COVID related issue and they (Doctor Office) will bill you for a TELE-MED appointment you will be paying 100% out of pocket.
 
On a Note
Have been told by two Doctors Office’s and our own Retiree Health Benefit , that MEDI CARE is paying ALL MED-TELE appointments
If you have Medi Care, they would be billed first. Most Doctors are NOT having patients come into the office, especially the elderly
 
Each Retiree’s will have personal circumstances concerning Health Issues.
 
CALL DIRECTLY TO the Fire and Police Retiree Health Care Fund, San Antonio, 11603 W. Coker Loop, Suite 130, San Antonio, Texas 78216
Office: (866) 652-4237 , Fax: (210) 494-6505 , e-mail: faprhcf@swbell.net