Patriot Health Plus Plan

Transcription

1 Patriot Health Plus Plan Move towards peace-of-mind M-F 9a.m. - 7p.m. EST. Discount Medical Plans are provided by Patriot Health Florida, Inc., a discount medical plan organization. The features are not health insurance policies and are not available in all areas. The features provide discounts at certain health care providers for medical services and do not make payments directly to the providers of medical services. The member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with Patriot Health Florida, Inc., located at 160 Eileen Way, Syosset, New York Discount Medical Plans are not available in AK, MT, ND, VT and WA. Brought to you by THIS IS NOT HEALTH INSURANCE PLUS_F _v03

2 How To Access The Plan Dear Patriot Health Member, Thank you for choosing Patriot Health to help you save on your essential healthcare needs. Patriot Health is committed to providing members with overall product satisfaction and superior customer service. We believe in the immense value of our program and hope that you will utilize the benefits to their fullest potential. Please take ample time to review the plan access information on the following pages of this book. Should you have any questions, feel free to call our Customer Care Department which is a one call service center helping you with questions on billing, benefits and any other customer service need. Our Customer Care is available toll free at between 9:00 am EST and 7:00 pm EST, Monday through Friday. We look forward to assisting you with your needs and thank you for this opportunity to serve you and your family. Sincerely, Patriot Health Customer Care Department DISCOUNT MEDICAL PLANS Tiered Dental Plan... p. 1 CallMD TM Program... p. 1 Tiered Vision Plan... p. 1 Tiered Prescription Drug Plan... p. 2 Tiered Chiropractic Plan... p Hour Nurse Hotline... p. 2 Holistic Care... p. 3 Diabetic Supplies Program... p. 3 Medical Records Software... p. 3 Elder Care... p. 3 Durable Medical Equipment... p Hour Counseling Hotline... p. 4 Fitness Program... p. 4 Hearing Care *... p. 4 *Not available in WA. 2 THIS IS NOT HEALTH INSURANCE

3 Call toll-free Monday - Friday 9a.m. -7p.m. EST. How To Access The Plan Tiered Dental - A multi-tiered dental fee-for-service program, where you have access to dentists under THREE distinct scenarios. Tier 1: At select participating schedule (A) Tier 1 general practitioners across the country, you receive a nocharge* exam and x-rays in conjunction with a paid annual cleaning. Participating providers abide by a fee schedule of fixed payments for most procedures. Fixed schedule procedure rate savings are 25% - 60% on dental care, as compared to the American Dental Association surveys of usual and customary fees. Tier 2: In the event a schedule (A) Tier 1 provider is not available in a given area, a secondary schedule participating dentist may be available at some of the lowest rates of any national dental network. Tier 3: In the event a Tier 1 or Tier 2 dentist is not available in your area, please call a Customer Care Consultant for assistance in accessing a Tier 3 provider where available. 1. Call to locate a provider near you. 2. Call to make an appointment. If you are visiting a Tier 1 or Tier 2 dentist, be sure to mention that your membership has access to the Dental Directory Services, DDS dental network. 3. Present your membership card each time you visit your dentist s office. 4. Pay your dentist your special member rates directly, and enjoy the savings! *In conjunction with annual check-up prophylaxis (cleaning) provided by participating selected general practitioners of Tier 1. Note: There is no payment to the dentist from the plan, member pays doctor reduced fee. Network providers may not be available in some areas. CallMD - Get sound medical advice from the comfort of your own home! 24 hours a day, 7 days a week! As a Member you will receive two (2) toll-free physician telephone consultations. You have access to a nationwide network of medical doctors and registered nurses available to discuss your medical issues. You can also access over-the-phone prescriptions. (where permitted by law) PLUS your electronic medical records will be maintained in a highly secured internet accessible environment available to network doctors prior to your consultations. CallMD s services are completely toll-free and there are no age restrictions or limitations! Note: Additional consultations may be purchased for $35.00 Call to speak directly with a physician or nurse. That s it! CallMD offers full telemedicine in 43 states, Washington DC, and PR. Limited telemedicine services (doctor consultation only, unless member provides a copy of their annual physical prior to or at the time of consultation) in Florida, North Carolina, Oklahoma and Tennessee. Limited telemedicine (doctor consultation only) in Georgia and New Hampshire. Tiered Vision Plan - Save 10% to 50% at participating locations nationwide! Tier 1: At select participating vision outlets, a no-charge* eyeglass vision exam is available once annually per family member. You also receive discounted rates of 10% to 50% on eyeglasses, non-prescription sunglasses and contact lenses (excluding disposables) at participating independent and retail optical locations nationwide. Most frames, lenses and specialty items are available. Tier 2: You will receive 10% - 50% discounts on eyeglasses, non-prescription sunglasses and contact lenses (excluding disposables) at participating independent and retail optical locations nationwide. Most frames, lenses and specialty items are available. Ophthalmology & LASIK Features: Save 20% to 60% on medical eye exams and surgical procedures including LASIK at participating ophthalmology locations. 1. Call to locate a participating provider near you. 2. Visit your selected participating locations, present your membership card upon arrival at your eye care provider. 3. Pay your provider directly at the time of service at your member-plan rate. *Prescription must be filled by the provider performing the no-charge exam if glasses are required. NOTE: Network providers may NOT be available in certain areas. THIS IS NOT HEALTH INSURANCE D

4 How To Access The Plan Tiered Prescription Drug Plan- Save 10% to 50% at participating locations nationwide! This program is accepted at over 50,000 participating pharmacies nationwide, including all the leading national chains! Simply visit a participating pharmacy, present your membership card and pay the pharmacy directly. You have the potential to save thousands of dollars annually on prescription drug charges. Tier 1: Drugs at up to a $10.00 maximum cost.* Tier 2: Drugs at up to a $20.00 maximum cost.* Tier 3: All other drugs are available for your benefit at negotiated rates. This program also provides additional options to lower your cost on Tier 3 drugs through an independent mail order service** or free drug program.*** How to access the walk-in portion of the program: 1. Call to locate a participating pharmacy. 2. Present your membership card each time you visit your participating pharmacy. 3. Pay the pharmacy directly at your member-plan rates and enjoy the savings! *Drugs are subject to be added or deleted without notice. A nominal handling fee may apply. **Optional usage through an independent mail order service. ***Free drug programs available for pre-qualified low income families directly through drug manufacturers when and where available. NOTE: Prices on Tiers 1, 2 & 3 are based on a 1 pill per day dosage, 30 day supply. Discount is only available at participating pharmacies. Please see prescription drug member guidebook for complete information and drug listings by Tier. Tiered Chiropractic Plan - Save on testing procedures, support and orthotics, massage and bodywork. Tier 1: Save 20% to 50% at Participating Providers on adjustments, therapy, x-rays, exams and specialized procedures when visiting one of our participating providers. Tier 2: Save 5% to 20% at our large network of participating providers. In the event a Tier 1 chiropractor is not available in your area, a secondary schedule participating provider will be presented to you. 1. Call to locate a participating provider near you. 2. Call the office to make an appointment and identify yourself as a UCP (United Chiropractic Program) member. 3. Present your membership card each time you visit your chiropractic office. Your chiropractor may call the client care service number to confirm eligibility. 4. Pay your chiropractor directly at the time of service at your special member rates. NOTE: Network providers may not be available in certain areas. 24 Hour Nurseline - Unlimited, Toll-Free, 24/7 Access to Registered Nurses For You and Your Family completely confidential. The nurses are specially trained to offer prompt, confidential medical counseling to help you make informed decisions about your family s health and medical care. However, nurses will not diagnose or provide treatment. Receive information regarding: Treating common illnesses, explanations as to what to expect during medical testing, Diagnostic and surgical procedures, recently diagnosed medical conditions, and prescription and over the counter medication information. Call and a registered nurse will ask for basic information including your name, age, phone number and membership information. VERY IMPORTANT: In life threatening emergencies, call 911 (if 911 is not available in your area, call local police/fire department) or go directly to the nearest hospital emergency room for treatment. D THIS IS NOT HEALTH INSURANCE

5 Call toll-free Monday - Friday 9a.m. -7p.m. EST. How To Access The Plan Holistic Care - 20% Savings on all treatments and services and no limits on the number of visits. The integration of alternative medicine into conventional western medicine is quickly revolutionizing the landscape of the American healthcare system. The Holistic Care Service provides a concierge approach to finding a Holistic Care provider that will meet your specific need(s). A Customer Care Consultant will take your request for a particular discipline and call you back with the nearest location. Practitioner disciplines Include: Acupuncturists, Massage Therapists, Dieticians, and Naturopathic Providers. 1. Call to locate a participating provider. 2. Request your desired discipline. 3. A Customer Care Consultant (CCC) will locate a provider and contact you with their location and phone number. NOTE: Network providers may NOT be available in certain areas Diabetic Supplies - 10% to 60% Saving on Diabetic Supplies. A convenient service for members with diabetes. This program provides special member pricing on most diabetic supplies. These items include: test strips, glucose meters, lancing devices, lancets, and MORE! Call and mention the word PATRIOT when placing your order. You can also visit enter the word PATRIOT when you place your order and receive an additional 10% off your purchase. Medical Records Software - Keep your personal medical information all in one handy safe place! Keeping personal information available in one handy, safe place is critical. With FamilyKeys, a personal data organizer software program, you have a simple, convenient, and secure method to organize, record, and store financial, health, and other vital personal information without compromising privacy. How to access this software: 1. Simply go to and download the software, or call for assistance. 2. Enter your personal information in all sections of the software as indicated. 3. Re-open the downloaded software to make any changes or to add any information. 4. When needed, retrieve your important information that you have stored in the software. Elder Care - Call toll-free 24/7 for advice about your loved ones. Save on home health and long term care services, available for any member of your family including grandparents. Features: Save from 10% to 25% on home health aides, nursing homes, assisted living facilities, Alzheimer s special care units and respite care facilities.* Save on geriatric care management services such as telephone check-in, elder assessments and care plans. Geriatric care managers are professionals who are expert at advising families and coordinating care for the elderly. Call , and mention group account #101. That s it! *Savings available for new patients only. THIS IS NOT HEALTH INSURANCE 3

6 How To Access The Plan Durable Medical Equipment & Supplies You can save an average of 25% on durable medical equipment (DME) and supplies. Save on items that include: shower chairs, hospital beds & Lift chairs, surgical supplies, respiratory supplies, wheelchairs, walkers & canes, diabetic products, ostomy care products and MORE! 1. Contact the Customer Service Center at and mention group # 101. You will be asked to describe your needs. 2. The Customer Service Rep will contact several providers to determine the best available price and give this information to follow up with the provider directly. 3. If requested, a nurse navigator will arrange for the supplies to be delivered to the your home directly. 24 Hour Counseling Hotline You and your immediate family members have unlimited access to a master s level therapist via a toll-free number. All counselors have been specially trained to offer prompt, confidential counseling to help you and your immediate family members deal with and overcome the problems that they may encounter every day. You also have access to free support, self-help group referrals, and referrals to a local licensed therapists for face-to-face counseling at specially discounted membership rates. Call to speak directly to a therapist. Fitness Enjoy 10%-50% off Membership Dues at Over 1,500 Locations Nationwide! Month to month memberships at top area fitness centers* The Fitness Program includes many franchises of Gold s Gym, Bally s Fitness, Curves for Women and other chains as well as independent fitness clubs. 1. Call or log in at 2. Select a facility near you. Call the-toll free number above to enroll at any participating location or log on to com and click Patriot Health. Programs are only available at time of enrollment by calling the number above or by accessing the Globalfit website. 3. Your fitness club member card will be sent directly to you by mail. * $10 administrative fee may apply upon cancellation Hearing Care * Beltone Features: Free hearing screening and 15% discount on Beltone hearing aids at more than 1,300 Beltone locations. Lifetime care program includes complimentary hearing aid checkup, free hearing screening, free cleaning and inspection while under warranty, and a 30 day refund policy. Patients under the age of 18 must provide a physician s authorization to receive tests or treatment. Some locations are not equipped to handle small children. HearPO Features: 20% to 50% off audiology and hearing aid services at more than 1,400 participating HearPO providers. Comprehensive follow up for one year at no charge. 100% discount on repairs and a 60 day refund policy. Your hearing aid comes with a 12 month standard manufacturer s warranty. Modifications will be made without cost during warranty should a change within hearing levels require different circuitry. 1. Call BELTONE to locate a participating provider. 2. Call HEARING to locate a participating provider. 3. Present your membership card at time of service. *Not available in WA. D THIS IS NOT HEALTH INSURANCE