|
●
|
With this plan, you must receive
all of your care from ElevateHealth providers and hospitals
(except in a medical emergency). |
|
●
|
You will be required to choose a
primary care provider (PCP) from the ElevateHealth network to
handle your care and give you referrals to specialists. |
|
● |
If you will be covering family
members on your policy, each of them can choose different
ElevateHealth PCPs. |
|
● |
You can get acupuncture,
chiropractic care, routine eye exams and most kinds of
gynecological care without your PCP's referral, but you must see
ElevateHealth providers for these services. |
|
● |
In the unlikely event that an
ElevateHealth provider or hospital cannot provide the care you
need, your doctor can ask Harvard Pilgrim for authorization to
send you outside the ElevateHealth network. |
|
● |
In a medical emergency (e.g.,
heart attach, stroke, choking, loss of consciousness or
seizures), call 911 or go to the nearest emergency room. Once
you are out of the hospital, be sure to follow up with your PCP
for any additional care you may need. |
|
● |
You have coverage for unexpected
or unforeseen urgent care (e.g., earache, flu or sprain) when
you're traveling. Otherwise you must receive care from
ElevateHealth providers and hospitals. |
|
● |
Prescriptions
Drugs
have
a co-payment
based
on
a
4
Tier
Benefit. |
|
● |
This
plan allows
you
to
have
a
Medical
Flexible
Spending
Account
(FSA). |
|
● |
This plan offers
Care Management Services in partnership with
Benevera Health. |
|
● |
All members have access to telemedicine visits through
Doctor on Demand (DoD)
and
Optum
(Behavioral Health Providers). DoD provides treatment for 90% of the most common health
conditions affecting the mind and body. |
|
● |
Under this plan your DoD (including Optum) co-pay is
$0.00. |
