New York Life Group Benefit Solutions & Health Advocacy Services Support when you need it – NYL & Health Advocate What is New York Life Group Benefit Solutions (NYL GBS) Health Advocacy Services? NYL GBS Health Advocacy Services provides access to expert assistance with a wide range of healthcare and health insurance challenges. Included with your NYL GBS offering are valuable health advocacy services to help you and your family members (including spouse, dependent children, parents and parents-in-law) resolve many of the healthcare, health insurance or medical bill challenges they may face. Health advocacy services link you with clinicians and insurance professionals who are experienced in a range of clinical, health benefits and administrative issues. Personal Health Advocates know the “ins and outs” of the healthcare and health insurance worlds and are supported by medical directors and other clinical and benefits specialists. These services are available anywhere in the United States. Clinical services Personal Health Advocates are available Monday through Friday Personal Health Advocates provide clinical and between 8:00 am and 12 midnight EST at a dedicated NYLGBS toll-free administrative support for many types of healthcare, number: (866) 799-2725. Resources are available by phone 24/7 at the benefits or medical bill issues. The Personal Health same toll-free number and a Personal Health Advocate will reach out to Advocate may: the caller the next business day. Services include but are not limited to • Answer questions and provide information and those described above. resources about medical terms, tests, medications and treatments. • Help members identify primary and specialist • Assist with all types of prescription drug issues including formulary physicians, hospitals, dentists and related and benefit questions, information on generics, obtaining mail order, healthcare providers (first focus is on network or locating lower-cost sources for prescription drugs that are not relationships to help customers use their benefits covered by the customer’s health care plan. to their best advantage). • Arrange for home care, home equipment, etc. following discharge • Locate doctors for second opinions and help from the hospital. arrange appointments and research questions about • Coordinate hospice, home care and other services for terminally ill diagnoses, treatments and available support individuals. systems. • Identify and coordinate a range of services including acupuncture, • Help customers with rare or complex medical chiropractic care, massage therapy, cosmetic practitioners, etc. Any conditions identify top medical institutions and money paid by the participant are backed by a six-month money- specialized medical programs across the country back guarantee if the coaching does not save them more money and help schedule appointments and research than they have paid. If at any time within the first six months of paid transportation and lodging where necessary. membership, the participant had at least three consultations with a • Facilitate the transfer of medical records, X-rays and My Secure Advantage (MSA) Health Coach and finds that the lab results prior to a scheduled appointment with a program has not produced more financial value than the cost of the new physician. program, the participant is entitled to a full refund of fees paid. • Coordinate and help schedule diagnostic tests. • Arrange evaluation for and participation in clinical trials. Page 22 | Duncan Supply Company, Inc.| Plan Year 2025 Open Enrollment This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.
