Understanding Health Insurance

Understanding Health Insurance

Understanding Health Insurance

In Network With:

+ Access
+ Aetna
+ Aetna Better Health
+ BCBS
+ CIGNA
+ First Health Network
+ Health Partners
+ IBC Personal Choice
+ Keystone First
+ Keystone Plan East
+ Medicare
+ Multi Plan
+ Tricare
+ United Healthcare

Understanding health insurance can often be confusing to most consumers. Here is a list of our most frequent questions regarding health insurance at myDoc. If you have any additional questions, we are always available to assist you.

 

WOULD MY  INSURANCE PAY FOR YOUR VISIT?
It depends on the type of plan you have. Most insurance plans DO NOT pay 100% of the medical costs. Plans with lower monthly premiums have higher deductibles. Plans with lower monthly premiums usually have lower deductibles.

It depends on your plan benefit details such as:

– Copay amount
– Deductible amount
– Coinsurance %
– Out of state UC benefit
– Referral or preauthorization

We accept most common insurance in PA, plus Medicare and Medicaid, please see the left column.

WHAT IS A DEDUCTIBLE?
The amount you pay for covered health care services BEFORE your insurance plan starts to pay. You are responsible for today’s visit if deductible is not met and urgent care copay is not specified. We will collect a portion upfront, will bill you the rest, or refund you if over-charged.

WHAT IS COPAY?
A fixed amount you pay for a covered health care services AFTER you’ve MET your deductible.

WHY DOES MYDOC URGENT CARE CHARGE $50 UPFRONT?

  • If the copay is NOT specified and the deductible has not been met
  • or your coinsurance is >= 20%

PREVENTIVE CARE IS COVERED AT 100%
Most health plans cover preventive services – like flu shots, immunizations, and annual physical exams. MyDoc offers primary care hours.

HOW DOES BCBS WORK?
There are 35 BCBS across the country. myDoc has an urgent care contract with HIGHMARK, our LOCAL BLUE, who submits claim to your home plan. Your in network benefit will be honored, even we are not directly contracted with your home plan.

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