- If I am on a group plan, can I cancel my insurance coverage or make a change to my coverage (add/remove my spouse and/or dependents) whenever I want?
- You can cancel or change your insurance coverage each year during the open enrollment period. Outside of the open enrollment period, there are restrictions. Before you can cancel or change your insurance coverage, you must meet certain guidelines issued by both the insurance company as well as the IRS (Internal Revenue Service). Changing your coverage during the plan year can only be processed if you have experienced a qualifying event. A qualifying event includes marriage, divorce, birth or adoption of a child, death, change in work status, or a change in spouses insurance or work status. If you have experienced a qualifying event, you have thirty (30) days from the date of the qualifying event in which to notify the administrator of your insurance plan and make necessary modifications to your insurance coverage. If you miss this window of opportunity, you must wait for open enrollment.
- I lost my insurance identification card, how do I get a replacement?
- There are a few different options to obtain a replacement insurance identification card. The fastest option is to call the insurance carrier directly or go online to the insurance carrier’s website, register as a member, and then log in at which time you can order a replacement card as well as print a temporary ID card (in most cases). If you are a client of VISICOR and would like assistance in obtaining a new card, go online to www.visicor.net/service and complete the online service form and we will get new cards ordered for you. Keep in mind it takes about 10 business days to receive your replacement cards.
- Who is eligible to be covered under my medical plan?
- You may cover your legal spouse or your children through age 25 (up to age 26) without regard to student status, marital status, or financial dependence. Parents, grandparents, grandchildren, or other family members are not eligible for coverage through your plan.
- How do I find a network provider?
- You will need to go online to the insurance carrier’s website and perform a provider search. You will be able to perform the search based on the type of provider you are looking for as well as the location of the provider. Most provider search engines will require you to select the provider network which will be listed in the appropriate section of your benefits booklet (if you are a VISICOR client). If you need assistance locating a provider, call the insurance company using the number on the back of your identification card or if you are a client of VISICOR, call us and we will assist you.
- I received medical treatment and now I am getting an invoice, what do I do now?
- It is normal to receive an invoice after you have received treatment through an emergency room, urgent care, hospital, outpatient surgical center, etc. Don’t panic! This normally occurs between the time the claim was submitted by the provider and the time the insurance carrier pays the claim. Just because you receive an invoice does not mean you owe the amount billed. If you receive an invoice, the first thing you want to do is obtain a copy of your EOB (Explanation of Benefits) from the insurance provider and compare the information on this EOB with the invoice you received. The EOB will outline for you what was billed by the provider, what was allowed and paid by the insurance carrier as well as what amount you will owe for the procedure. If the invoice matches the amount shown on the EOB, the invoice is correct and you are responsible for payment. If the EOB and the invoice do not match more research must be done. If you are a VISICOR client, fax a copy of both the EOB and the invoice to us at 281.824.3123 or scan these items and submit them through the VISICOR online service form at www.visicor.net/service. Remember, for all submissions, we must have your company name and contact information.
- What is the primary difference between a DHMO and a PPO/PDN dental plan?
- There are two primary types of dental plans which are a DHMO (Dental Health Maintenance Organization) and PPO/PDN. With the DHMO, you are required to select a primary care provider from a somewhat limited and specific network of providers and when you need care, you MUST see the dentist you selected as your primary care provider. In addition, with a DHMO plan, you will typically pay a flat amount (copay) for most procedures and there are no annual maximums so if you need a lot of dental work, this may be an attractive option. With the PPO/PDN plan, you have access to a much larger network of providers to select from and you are not limited to seeing a specific provider for care. With this type of plan, you can go to any in-network provider you want. In fact, the plan includes benefits for out-of-network care so staying within the network, although suggested, is not mandatory. The PPO/PDN dental plan is a more traditional plan with a more traditional benefits structure that includes coinsurance as well as annual maximums. If you have any questions or need help in deciding which plan is best for you and your family, call VISICOR and we can assist you.
- Have other insurance related questions?
- If so, email us, post your question to this Facebook page, or pick up the phone and give us a call. Even if you are not a VISICOR client, we would be more than happy to help you.
Disclaimer – The questions and answers listed are very general. There are many different plans and options available when it comes to health insurance so please review your specific plan information.