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Are pre-existing conditions covered with this plan?
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Yes, pre-existing conditions are covered; however, there is a 12 month pre-existing limitation on the critical illness benefit only.
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Will I receive an ID card?
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Yes, personalized, plastic, wallet-friendly ID cards are sent to each member. The fulfillment kit also contains phone numbers, Web links, and information on how to use all the benefits included in your program.
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Can I use any doctor or hospital with the program?
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Yes, you may go to any doctor or hospital. However, you can receive substantial discounts for covered medical events when you visit a participating provider in the nationwide network included with the plan.
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Is there a co-payment amount? Is there a deductible?
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There are NO co-payments or deductibles on the program benefits. However, a $100 deductible will apply if you access the Accident Medical benefit under the Homeland Value Added Benefits.
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How do I pay for covered events or file claims?
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At the time of a visit, present your medical ID card to the provider. The back of your ID card has all the information your provider needs to verify benefits and file claims. The provider may require the full amount due at the time of service if you are filing your own claims. There are no claim forms necessary. You or your providers should simply send itemized statements, detailing the medical visits, to the claims address printed on the back of the ID card.
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How do the prescription, vision, labs plans work? Do I need to file claims?
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Homeland HealthCare Value Added Benefits (including lab and imaging, vision, and prescription) have no claims to file. The discount is provided at the time of service. So, it is important that you present your card during their visits. If you have not received your card, call 1.800.493.4240.
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When can I begin using the prescription drug cards and other discount benefits?
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You can begin using prescription benefits on the effective date of coverage, subject to the terms and conditions of the health plan you choose.
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What if I need to go to the doctor and IÕve lost my card or havenÕt received it yet?
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If the coverage is in effect and you do not have your ID card, you can contact Homeland HealthCare toll free at 1.800.493.4240. We can provide your doctor verification of your coverage and all the information needed to process your claim.
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Is pregnancy covered?
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Yes, NPX covers pregnancy and other pre-existing conditions.
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Can I use the doctor I have now?
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Absolutely, and if you are in the network, your bill should be reduced in addition to the benefits paid.
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What if my doctor is not on the network?
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You will still receive the scheduled benefit. We can nominate your doctor if he or she is willing to join the network.
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Will this cover me outside of my hometown?
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Yes, in fact this plan offers a huge nationwide PPO network, so you can never be Òout of the service area.Ó
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What if I have more doctor visits in a year then the plan allows?
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Each plan has a specified amount of covered visits. If you surpass this limit you can continue seeing your doctor at full price or take advantage of you Consult A Doctor benefit, which provides free, over the phone doctor visits.
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Can I have other insurance in addition to this?
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Yes, this plan pays in accordance with its benefit schedule regardless of other insurance you may have. In fact in some situations this is ideal; however, we do not recommend combining plans that duplicate coverage.
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Can I have this plan if I am on Medicare?
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No, only persons age 18-64 are eligible for the program.
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Can I change my coverage plan whenever I want to?
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If you need to reduce your plan or remove dependents you can do so at anytime by contacting Member services. You can only increase your coverage or add dependents on the anniversary date of your policy.
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How does Consult A Doctor work?
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Simply call 1-866-846-6406 or visit www.homeland.consultadoctor.com to enroll, after which you will be able to talk with a doctor who is capable of prescribing any medication you may need, 24 hours a day. There is also an email address that promises a response usually within 3 hours.
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