Frequently Asked Questions
Am I covered if I travel outside the United States?
Expenses for care or treatment received outside of the United States or its territories, except for unexpected emergency situations while traveling, are excluded. For emergent care in other countries, you will need to pay your bill and submit it to the Claim Administrator for reimbursement pursuant to applicable Plan provisions. We recommend you pay with a credit card as it automatically adjusts the amount to U.S. dollars.
How do I add a dependent to my health care benefit plan?
To add a dependent to your health care benefit plan, please visit your local Human Resources/Benefits Department. You are required to bring original dependent verification documents (marriage license, birth certificate, etc) within the first 30 days of a qualifying event in order to add your dependents.
How long does it take to receive a new ID card?
Typically, it takes up to two weeks to receive a new ID card. In the meantime, you may print a temporary ID card by logging onto lsufirst.webtpa.com.
How much will I pay at the pharmacy?
Generics are covered 100% after the Health Reimbursement Account (HRA) has been exhausted. You will pay the full cost of a brand name or specialty drug while you are in your remaining deductible. Brand name medications have a co-pay of $40 per 30-day supply after the HRA and remaining deductible have been met. Specialty medications have a co-pay of $150 per 30-day supply after the HRA and remaining deductible have been met. Pharmacy co-pays accumulate towards the maximum out-of-pocket.
What is a Deductible?
The deductible includes your Health Reimbursement Account (HRA) and your remaining deductible (member responsibility portion). The amount of your deductible is based on your level of coverage and the effective date of your coverage.
Does LSU First have a prescription drug formulary?
What is an Explanation of Benefits (EOB)?
An EOB details how a specific claim was processed, any Member responsibility due, and the reasons for denying payment, if applicable. EOBs are available online only, unless you request for EOBs to be mailed to your home. You may do this by logging onto lsufirst.webtpa.com.
Where can I view my coverage information online?
Please visit the My Accounts link on this site. You may view medical claim information by visiting the WebTPA
website at lsufirst.webtpa.com. Prescription drug history may be viewed by visiting the Citizens Rx website at www.citizensrx.com.
You may also view the Summary Plan Description by clicking the link on the LSU First homepage.
Where can I view my dependents coverage information online?
Please visit the My Accounts link on this site. You may view medical claim information by visiting the WebTPA website at lsufirst.webtpa.com. Prescription drug history may be viewed by visiting the Citizens Rx website at www.citizensrx.com.
Why do generic drugs cost less?
Generic drugs tend to cost less because the companies that make them do not have to recover the cost of research and development.
What is a First Choice Provider and how are claims paid for First Choice Providers?
A healthcare provider that has met certain established standards and who has agreed to accept certain fixed fee payments from the plan for covered expenses. claims are paid at 100% after your Health Reimbursement Account (HRA) has been exhausted. Your HRA Rollover will not be used to pay for First Choice Providers.
What is a Verity or Aetna ASA Provider and how are claims paid for Verity or Aetna ASA Providers?
A healthcare provider that has met certain established standards and who has agreed to accept certain fixed fee payments from Verity Healthnet or Aetna ASA networks for covered expenses. Claims are paid at 90% after your Health Reimbursement Account (HRA) and remaining deductible have been met.
I visited a First Choice or In-Network facility but received a bill from an Out-of-Network Provider. Why is this?
An out-of-network provider is a health care provider that has not entered into a contract with one of the three networks used by LSU First (First Choice, Aetna ASA, or Verity). Providers cannot be required to join a network, and without a network contract, LSU First cannot limit how much an out-of-network provider charges a patient. You should be aware that even if a facility such as a hospital or surgical center is in one of the LSU First networks, these facilities may employ or contract with providers including radiology, anesthesiology, pathology or emergency room physicians that do not contract with the same network(s).
To receive maximum financial benefits from your LSU First Plan and avoid unexpected costs, you must ensure that all of your healthcare providers are in one of the LSU First networks. If you are planning to receive services in a facility such as a hospital or surgical center, you should contact the facility’s admissions or billing department to find out the names of the physicians or physician groups that work in their facility. Before you receive services, you should confirm each provider’s network status by clicking on Search for Providers or by calling 855-346-5781.