Benefits and Services
THE HEALTH PLAN
Medical, Laboratory, Pharmacy, Diagnostics, Dental, Vision..
PHC Standard Plan
General Primary Care Physician Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
====================================== PHC Standard Plus 2 Specialist Plan
General Primary Care Physician Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan.
The Member will have to pay a reduced fee for medical services. General Specialist Provider Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
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PHC Standard Plus 3 Specialist Plan
General Primary Care Physician Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services. General Specialist Provider Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
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PHC Dual Specialty PCP
General Primary Care Physician Services and General Secondary Specialty Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician and Secondary Specialty scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
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PHC Dual Specialty PCP Plus 2 Specialist
General Primary Care Physician Services and General Secondary Specialty Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician and Secondary Specialty scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
General Specialist Provider Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
General Primary Care Physician Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
====================================== PHC Standard Plus 2 Specialist Plan
General Primary Care Physician Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan.
The Member will have to pay a reduced fee for medical services. General Specialist Provider Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
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PHC Standard Plus 3 Specialist Plan
General Primary Care Physician Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services. General Specialist Provider Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
======================================
PHC Dual Specialty PCP
General Primary Care Physician Services and General Secondary Specialty Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician and Secondary Specialty scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
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PHC Dual Specialty PCP Plus 2 Specialist
General Primary Care Physician Services and General Secondary Specialty Services are 100% covered with an Initial Co-Payment.
All Medical Services outside the Primary Care Physician and Secondary Specialty scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
General Specialist Provider Services are 100% covered with an Initial Co-Payment. All Medical Services outside the Specialist Provider scope of services are not 100% covered under this PHC Plan. The Member will have to pay a reduced fee for medical services.
Laboratory Services: No Co-Payment
Prescription (RX) Services: No Co-Payment
THE DISCOUNT PLAN
Medical, Laboratory, Pharmacy, Diagnostics, Dental, Vision..
Discount Plan Benefits: The Member receives discounted fix rates for specific listed medical services and receives additional discounts for other medical services ranging from 10% to 65% for Primary Care Physicians, Specialist Providers, and Ancillary Providers.
The Discount Plan Benefits:
Receive discounted fix rates for specific listed medical services and receive additional discounts for other medical services ranging from 10% to 65% for Primary Care Physicians, Specialist Providers, and Ancillary Providers
Receive discounted fix rates for specific listed medical services and receive additional discounts for other medical services ranging from 10% to 65% for Primary Care Physicians, Specialist Providers, and Ancillary Providers
HOSPITAL MEDICAL ADVOCACY PROGRAM
The program is designed to help Members with outstanding Medical and Hospital Bills. Where the Advocate works directly with the Hospital and/or medical Providers to help reduce the Member’s financial responsibility or out-of-pocket portion of their outstanding medical bills (s) for a related medical incident.
Hospital Medical Advocacy Plan Benefits:
The Member total of these services must exceed $ 2500
Financial Assistance: Based on the information gathered by our team, you might be a good candidate for financial assistance. Financial assistance is a program offered by the hospital and is our preferred path to obtain the largest discounts. The hospital will typically assess household size and income to determine eligibility. Depending on approval, the program can result in significant reductions ranging from 50%-100%.
Settlement Offer:
If you are not a good candidate for financial assistance or would prefer not to apply, we are more than happy to submit an offer for review. All we need is for you to confirm a figure that you are comfortable with paying as a one-time payment. Our recommendation is to offer at least 50% of your total balance if this is something you can afford, as the hospitals typically don’t entertain less than 50% offers. We are a best-effort service and will do our best to obtain the largest discounts possible, but settlement offers depend on both patient and hospital resources.
The Member total of these services must exceed $ 2500
Financial Assistance: Based on the information gathered by our team, you might be a good candidate for financial assistance. Financial assistance is a program offered by the hospital and is our preferred path to obtain the largest discounts. The hospital will typically assess household size and income to determine eligibility. Depending on approval, the program can result in significant reductions ranging from 50%-100%.
Settlement Offer:
If you are not a good candidate for financial assistance or would prefer not to apply, we are more than happy to submit an offer for review. All we need is for you to confirm a figure that you are comfortable with paying as a one-time payment. Our recommendation is to offer at least 50% of your total balance if this is something you can afford, as the hospitals typically don’t entertain less than 50% offers. We are a best-effort service and will do our best to obtain the largest discounts possible, but settlement offers depend on both patient and hospital resources.
