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Save Money in Our Network Our network is a group of doctors, hospitals, pharmacies, and other health care providers who have agreed to provide services to our members. Because of this agreement, we know how much services from them will cost, so y...
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What Is a Monthly Premium? Your monthly premium is the set amount you pay each month to have your plan. You pay it even if you don’t receive any medical care that month. Like other bills, this premium can rise when it’s time to renew your plan fo...
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While your coverage depends on the plan you choose, certain things are always covered on plans sold on the Marketplace: Doctors visits, including well woman visits, care when you’re sick, and checkups to stay healthy. Emergency room trips. Hos...
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High Cost Medical Drugs administered by Health Alliance™ providers within physician offices, infusion centers or hospital outpatient settings must be acquired from preferred specialty vendors. Health Alliance will not reimburse any drug listed as a...
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If you're having trouble affording your medicine, contact your doctor, your case manager, or our pharmacy department at (800) 851-3379, option 4 to discuss your options and support. For Group Medicare Members: If you experience hardship from hig...
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Fill out the Pharmacy Prior Authorization Request Form .
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Plan Types What is an HMO? An HMO (Health Maintenance Organization) plan gives you personal care from a set network of doctors and hospitals. Out-of-Network care is still covered in urgent or emergency situations or with an approved prior author...
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EGWP’s or Employer Group Waiver Plans are Medicare Advantage plans offered by employers or unions to their retirees. The plans are provided and managed by private insurance companies. These plans are exempt from certain rules that apply to individ...
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Balance plans are level-funded plans, which means your costs will never exceed a predetermined amount. This allows you to budget effectively. Balance plans also combine our experienced staff and administration for traditional Self-Funded plans wit...
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With a S elf-Funded plan , you keep the risks and rewards of paying for your employees' healthcare. In comparison, F ully-Insured plans pass the risk and rewards on to the insurance company in exchange for a fixed premium. Save Money Companie...