Laserfiche WebLink
<br />\Vhich services require a referral from Care Access? <br />Allergy treatments, Mental Health, certain specialists, Diagnostic Services, Home Health, <br />Ambulatory Surgical Services, Rehabilitative Services and Durable Medical Equipment require <br />referrals from your PCP and authorization from our UM Department. <br />Please refer to Schedule of Benefits for more specifics. <br /> <br />For Care Access, when are premiums due? <br />This answer is best addressed as follows: <br /> <br />· For Individuals the premium is due on the 15t of the month for the following <br />month's coverage (Premiumsfor coverage in the month of September are due by <br />August 1sl.) <br /> <br />. <br /> <br />· For Groups of Individuals the premium is due on the 151 of the month for the <br />following month's coverage. (Premiumsfor coverage in the month of September <br />are due by August 1st.) <br /> <br />· For Groups the premium is due by the 151 of the month for the month of coverage. <br />(Premiums for coverage for the month of September are due by September 1st.) <br /> <br />Is there a pre-existing clause? <br />Yes. If the underwriting department considers a condition as pre-existing, certain treatments andlor <br />medication pertaining to that condition will be not be covered for a period of up to 2 years, at the <br />sole discretion of the plan. <br /> <br />Can a member or applicant nominate their physician to be a part of the Plan? <br />Yes. Simply fill out the provider nomination form at the back of the Provider Directory or <br />download from our website (in the Enrollment section, under other downloads) and submit to Care <br />Access, We can't guarantee that a particular physician will choose to join Care Access, and of <br />course, s/he will have to pass our Care Access requirements, but we would be pleased to notify you <br />if s/he comes aboard. <br /> <br />Can I enroll a child without their parents? <br />Yes. We can accept children from birth, with or without their parents. Since applicants are <br />medically underwritten each can be viewed on an individual basis. <br /> <br />How can I access your Health Plan's Drug Formulary? <br />Each member receives a copy of the Drug Formulary in their new member welcome packet. It can <br />also be downloaded from our website at www.mycareaccess.com <br /> <br />CAHP <br /> <br />2 <br /> <br />Gen FAQ 12-IS'{)S <br />