is a provider specializing in the medical care related to pregnancy and the birth of children. Not all members have this coverage. First rate service from the team at A-Plan. You don’t live together. The Fair Access to Insurance Requirements (FAIR) Plan is a state-mandated program that provides fair access to insurance for individuals who are having trouble insuring their property due to the fact that insurers consider them high risk. Experimental, investigational or for research purposes is January 1 through December 31. A member identification card A health insurance premium is an upfront payment made on behalf of an individual or family in order to keep their health insurance policy active. is the amount of money that an individual must pay out-of-pocket for medical services before the health plan pay its portion. Very happy to recommend! Usual, customary, and reasonable charges (UCR) Our brokers find the deal that’s best for you, and are paid a small commission by the insurance company for doing so. refers to treatment which, as determined by the Plan, is required to treat or care for symptoms of an illness or injury or to diagnose an illness or condition that is harmful to life or health. We’ve been offering a personal and great value to service to clients since the 1960’s. eHealth is committed to helping you understand all the nuances of health coverage. If no one provided more than 50 percent of the person's support, the person will be treated as the dependent of whoever provided the most support. After enrolling in a Marketplace plan for individual health insurance benefits, you are billed $200 per month. Overall, most Americans are enrolled in a private health insurance plan, according to the U.S. Census Bureau. They could not have been more helpful and clear with their explanation of the insurance possibilities offered. A physician assistant Members more Guaranteed Issue Life Insurance Typically, this means paying all deductibles, co-payments, and other fees before the insurance company pays for their part of the medical expenses. Medically necessary Deductible A family practice physician Integrated HSA, HRA and FSA  An emergency medical condition is a medical condition that manifests itself by symptoms of sufficient severity that a prudent layperson possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate attention would place the health of a person (or a fetus, in the case of a pregnant woman) in serious jeopardy. See common insurance terms explained. Integrated HSA, HRA and FSA typically involves the combination of high-deductible health plan with a health care bank account, for example a health savings account (HSA) or health reimbursement arrangement (HRA). is a convalescent or chronic disease facility which is accredited by the Joint Commission on Accreditation of Hospitals or certified as an "SNF" by the Secretary of Health & Human Services according to Title XVIII of the Social Security Act as amended, section (j). is the limitation on the amount of money you will have to spend for specified covered health services in a calendar year. Custodial care services 1  Indemnity health plans are also known as: What Is an Indemnity Health Insurance Plan? If you are a commercial Providence Health Plan member, you can view your benefit summary online once you have registered for a myProvidence account. A PPO health insurance plan provides more choices when it comes to your healthcare, but there will also be higher out-of-pocket costs associated with these plans. An individual visits a doctor for a routine checkup. A-Plan Insurance is a trading style of A-Plan Holdings. refers to the organization whose employees are covered by the Plan. Durable medical equipment (DME) The Plan pays the rest of the cost of the service. A participating provider or Plan provider 84638), Registered office: 57 Ladymead, Guildford, Surrey GU1 1DB. Coinsurance amounts are listed on your benefit summary. We do much more than just ‘broker a deal’. An internist A gynecologist Although a common core of Flexible benefits plan (Cafeteria plan) (IRS 125 Plan) – A benefit program under Section 125 of the Internal Revenue Code that offers employees a choice between permissible taxable benefits, including cash, and nontaxable benefits such as life and health insurance, vacations, retirement plans and child care. is a personal physician/provider trained to diagnose and provide health care services to infants, children, and adolescents. A general practice physician Coronavirus (COVID-19) Advisory: Please help us limit exposure. means a physician, women's health care provider, nurse practitioner, clinical social worker, physician assistant, psychologist, dentist, or other practitioner who is professionally licensed by the appropriate state agency to diagnose or treat a bodily injury or illness and who provides covered services within the scope of that license. Some insurances, such as income protection or critical illness need to be tailored to your individual needs, so buying them through a comparison site could mean you buy cover that isn’t right for your needs. The monthly amount an individual pays for a health insurance plan is called a: premium. An employer group Petplan Pet Insurance - North America is a New York City-based pet insurance company, providing insurance for pet owners to cover veterinary bills. The higher deductible can be offset by using funds set aside in an HSA or HRA. For the most part, your kids can stay on your plan until the age of 26, even if they: Get married. Calendar year Plan means Providence Health Plan. is a nurse, physician or other health care professional who has advanced education and training in one clinical area of practice. Infertility Your monthly premiums will be higher and your copays for office visits will also cost more. You may need to furnish this certificate to another insurance carrier to obtain medical coverage in the future. With some basic information provided by the patient, Who Is Your Insurance allows you to search for anyone's vision insurance in just a few clicks of the mouse, allowing you to focus on providing immediate patient care. means services determined by Providence Health Plan or our authorizing agent to not be medically necessary or accepted medical practice in the service area. The premium is the amount you or your employer pays for your health insurance coverage every month. It can withstand repeated use and is generally considered to be safe and effective for the purpose intended. Riders (endorsements or supplemental benefits) Some gynecologists have been approved to act as personal physician/ providers and will be listed as such in the Provider Directory. CDHP, which stands for consumer-driven health plan, is a type of medical insurance plan that is structured differently than most health insurance plans that’ll you find when comparing quotes.. CDHPs allow the use of health savings accounts, health reimbursement accounts, or other similar accounts to pay routine medical bills. Final determination will be based on the covered benefits and eligibility on the date of service. Having used A Plan for our caravan insurance we were aware of good they are and are pleased we have changed insurers. Always present your card when you seek medical care or benefits. A-Plan Holdings registered Office: 2 Des Roches Square, Witney, OX28 4LE. 1282939) and Allianz Insurance plc (Registered in England No. DME may include items such as oxygen, wheelchairs, and other medically necessary equipment required for the treatment of an illness or injury. Certified nurse midwife A participating provider or Plan provider is any credentialed physician, provider, hospital, or facility which has an Agreement with Providence Health Plan to provide care to Plan members. A-Plan is an insurance broker. Not sure where to start? A specialist You can confirm our registration on the FCA website, Financial Services Register or by contacting the FCA on 0800 111 6768. is a description of your benefits and copayments. We’re proud to say our people are some of the best and they stay with us for a long time, giving you continuity in your dealings with A-Plan. It’s pet insurance that pays you before you see the vet. Our brokers will understand your personal circumstances and requirements to find you the right policy. Go to or leave school. In determining whether services are experimental, investigational, or for research purposes, the Plan will consider whether services are, in general: used in the medical community in the state of Oregon; under continued scientific testing and research; show a demonstrable benefit for a particular illness; proven to be safe and efficacious and; approved for use by appropriate government agencies. Your children can also usually stay on your plan even if: You don’t claim them as tax dependents. A qualified practitioner Acute care And we are more than impartial — we are on your side. Excellent service as usual with this excellent company. Copayment / copay  It’s real insurance for real people. is care received in an inpatient hospital setting. This helps the policyholder to inculcate the habit of financial savings. Group health insurance plans are purchased by companies and organizations, and then offered to its members or employees. These providers are trained to provide routine gynecological care (including the annual gynecological exam) and some also provide obstetric care. Some obstetricians have been approved to act as personal physicians/providers and will be listed in the Provider Directory. is defined as medical or surgical treatment primarily for the purpose of improving appearance or self-esteem. Support for Members and Providers affected by Oregon wildfires  Check your member materials to determine if your coverage includes rider benefits. Out-of-pocket maximum are services which require you and/or your provider to seek Plan confirmation before seeking or receiving care. If you have enrolled in your employer's health insurance plan, your premium is deducted pre-tax from your paycheck. You can choose different ‘items’ for your health insurance like you do with food options in a cafeteria. Copays are listed on your benefit summary. The FAIR plan is a "shared market plan." A company needs to understand the amount of money they are obligated to pay for maintaining the health insurance policy, take actions to ensure payments are made timely and all needed changes have been dutifully reported and documented. Adult female members may also select a provider specializing in obstetrics or gynecology; a nurse practitioner; a certified nurse midwife; or a physician assistant specializing in women's health care as their personal physician or provider. provides medical services under the direction and supervision of a licensed physician. is the percentage of cost that you may need to pay for a covered service. Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. Contents 1 History We are completely independent and impartial and can, therefore, always act with our clients’ best interests at heart. A-Plan Holdings is Authorised and Regulated by the Financial Conduct Authority (FCA registration number 310164). Good price and excess. A pediatrician This enables you to build a wealth corpus and meet the necessities at unique existence levels. The Plan retains documentation of the criteria used to define a service deemed to be experimental, investigational or for research purposes and will make this available for review upon request. This maximum amount is shown on your benefit summary. is a licensed primary care provider who is trained to diagnose and provide health care services to adults and teens, including routine gynecological care and the annual gynecological exam for women. is a licensed physician specializing in the diagnosis and treatment of the diseases of women's reproductive systems. We guarantee to seek out the best quotes for our clients — in terms of price and cover. Health insurance that offers day-to-day benefits as well as hospital cover. Registered in England. Petplan's trading address is: Great West House (GW2), Great West Road, Brentford, Middlesex TW8 9DX. are the eligible individuals covered by Providence Health Plan. Who Is Your Insurance saves you time and frustration when trying to find out a patient's vision insurance plan. Providence Health Plan covers certain preventive care services in full when received from an in-network provider. A very competitive quote, excellent communication and service. The Providence Health Plan service area Thanks once again for your help and guidance. I now have van insurance & home insurance with A - Plan. Plans can only be purchased by … is a participating provider specializing in family practice, general practice, internal medicine or pediatrics; a nurse practitioner; a certified nurse midwife; or a physician assistant, when providing services under the supervision of a physician; who agrees to be responsible for the member's continuing medical care by serving as case manager. The amount an individual must pay annually for healthcare services before the insurance company begins to pay is called a: deductible. A personal physician or provider A-Plan Holdings is Authorised and Regulated by the Financial Conduct Authority (FCA). Examples are: vision, alternative care, chiropractor prescription drug riders. Compassion, Dignity, Justice, Excellence, Integrity, To view PDF files, download free Adobe Acrobat Reader, ©2021 Providence Health & Services. Petplan insurance covers unexpected illnesses, accident and injuries for dogs, cats and rabbits. They get the best prices by comparing product features and ensuring you only pay for what you really need. The fact that services are provided, prescribed or approved by a physician or provider does not in and of itself mean that the services are medically necessary. In the case of a student, amounts received as scholarships for study will not be considered in determining source of support. (Note: Not all these providers are personal physician/providers – see the Provider Directory for a listing of designated personal physician/providers.). Employer-based coverage continues to be the most common, followed by 19% of Americans with Medicaid and 17% with Medicare. In simple terms, an insurance broker is an intermediary between a client (that’s you) and one or multiple insurance companies. Benefit summary Our expert brokers take the time to get to know you and fully understand your individual circumstances so that they can search through the insurance products on offer to find the very best policies for you — at the right price. We help guide you through the whole process, either by talking to a claims adviser on the phone or in your local branch and they will be able to negotiate on your behalf. is a licensed personal physician/provider trained to diagnose and provide health care to patients of all ages. is a licensed nurse who has a master's degree in nursing and advanced training which allows him or her to provide primary care. are services or supplies that do not require the technical skills of a licensed nurse at all times, assist solely in activities of daily living activities or personal grooming and are not likely to improve your condition. means a person for whom you or your legal spouse provided, during the most recent calendar year, more than 50 percent of the person's support. A healthcare plan is an insurance policy that provides certain benefits in exchange for following the terms of the agreement. Insurance companies don’t always advertise all their different types of cover on their websites or comparison sites. Making a claim can be stressful so we’re here to help. The rest may have coverage through a public or government program like Medicaid or Medicare. Some physician assistants have been approved to act as personal physicians/providers and will be listed in the Provider Directory. are charges that the Plan determines fall within a range of those most frequently charged for services and supplies. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage. Talk to us to save yourself time and money. Registration Number 750484. Some nurse practitioners have been approved to act as personal physicians/providers and will be listed in the Provider Directory. A cafeteria plan is a health insurance plan that lets employees make their choice from various categories of health benefits.This is why it is called a cafeteria plan. In fact, we are one of the biggest networks in the UK, with over 80 branches across the country, most of them conveniently located in high streets. The plan administrator is the person designated to enroll employees and their dependents in insurance plans. We’re also proud of our long-term relationships with insurers which mean we are in a position to negotiate great prices for you. Any insurance plan you have through your employer, where you are the active employee, is your primary health insurance plan. Our brokers are experts, so you can rest assured that the cover they recommend is perfectly suited to your needs. However, all our advisors take the CII Certificate of General Insurance in their first year of working with us. Deductible Lots of additional items offered, all tailored to my needs. An Indemnity health insurance plan is a healthcare plan that allows you to choose the doctor, healthcare professional, hospital or service provider of your choice and gives you the greatest amount of flexibility and freedom in a health insurance plan. In the event there is a discrepancy between the benefits described on this page and your member handbook, content in the member handbook governs. is an impaired state of health, due to a specific illness or injury that requires skilled professional treatment or services. is defined as the inability to become pregnant after a year of unprotected intercourse or the inability to carry pregnancy to term as evidenced by three consecutive spontaneous abortions (miscarriages). A subscriber Any group insurance coverage you have as an inactive employee, such as through layoff continuation or as a retiree, is secondary, if you also have group health insurance as an active employee. You may view your materials online if you have a myProvidence account. The rule allows an individual who drops FEHB coverage when he or she enrolls in a Medicare-sponsored plan, or in Medicaid or a similar State-sponsored program of medical assistance for the needy, to return to FEHB coverage during the annual Open Season or immediately upon being involuntarily disenrolled from the non-FEHB coverage. They’ll also check your existing policies to make sure you don’t double up on something you’re already covered for. United Medicare Advisors’ online database of insurance can help you get coverage soon, eliminating hours spent calling for plan options — and save … is a person who is licensed or certified to supervise the conduct of labor and childbirth; advise the parent as to the progress of the childbirth; and furnish prenatal, intrapartum and postpartum care. A women's health care provider You may choose to have a Plan gynecologist provide your annual gynecological examination. are any benefits purchased by your employer in addition to Providence Health Plan's basic health care coverage. With our long-term relationships with insurers, we are in a position to negotiate the claims on your behalf. is an obstetrician, gynecologist, physician assistant specializing in women's health, advanced registered nurse practitioner specializing in women's health or a certified nurse midwife practicing within the applicable lawful scope of practice. An out-of-area dependent A nurse practitioner A child will also be considered a dependent if you or your spouse are required to provide medical care to a child under a qualified medical child support order, as defined by federal law. Routine services such as screenings and immunizations for the purpose of health maintenance and/or the early detection of health care conditions. Updated October 05, 2020. They are offered health insurance by … We offer, impartial, qualified expertise and advice from real people who are easy to talk to and dedicated to helping you find what you need. The amount determined is based on charges in the community where the services and supplies were furnished, by those who provide them. My online renewal this year was excellent! is rated 4.74 stars by Reviews.co.uk based on 3731 merchant reviews. Equally helpful when a claim is unfortunately necessary. A-Plan is an insurance broker. Support for health plan members and Medicare beneficiaries impacted by COVID-19 › So, what is a broker? An obstetrician Excellent, quick and efficient service and a much better price than last year's car insurance. Our high street branches are located in convenient sites, meaning that you can quickly and simply consult with an expert about products and claims. is a licensed personal physician/provider trained to diagnose and provide health care services, including routine gynecological care and the annual gynecological exam, to patients of all ages. So, what is a broker? Individuals with CDHPs pay lower premiums for their health insurance because the deductibles are higher. Protecting the health of your loved ones with quality health coverage is one of the most important things you can do for them. Health insurance plan organization and administration duties are a full-time practice of taking in and distributing needed information for overall plan maintenance. We now have over half a million policy holders — for just about every kind of insurance. No you don’t. Petplan is a trading name of Pet Plan Limited (Registered in England No. Our brokers are able to search through all available insurance products to find the one that is just right for you. As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable. And as real people, they can also be more flexible on pricing than comparison sites. We’re very proud of our 4.78 (out of 5) stars review on Reviews.co.uk and the fact that many of our clients choose to come back to us again and again. For example, an individual may have a $200 deductible whereas a family may have a $400 deductible. is any credentialed physician, provider, hospital, or facility which has an Agreement with Providence Health Plan to provide care to Plan members. In simple terms, an insurance broker is an intermediary between a client (that’s you) and one or multiple insurance companies. Have a baby or adopt a child. Policies provide coverage for hereditary, congenital and chronic conditions – including cancer, diagnostic testing, prescription medications, non-routine dental treatment, MRI, CAT scan and ultrasound imaging as … Plan Insurance Brokers is an independent, market-leading commercial insurance brokerage. For more information, read Coverage of Preventive Care Services or refer to your benefit summary and/or member handbook for details. You also won’t find cover for niche areas on most comparison sites, so if you need to cover an unusual property, a high-value antique or a high performance car, for example, our brokers can help. is an eligible family dependent of a subscriber, who does not reside in the Plan's service area and who is properly enrolled in the Plan as an out-of-area dependent. Prior authorized services Preventive care services provides proof of prior medical coverage. Dependent Cosmetic treatment In fact, we are one of the biggest networks in the UK, with over 80 branches across the country, most of them conveniently located in high streets. Certificate of Creditable Coverage Preventive care services Learn more about COVID-19 and where to go if you have concerns. If you need to make a claim, our brokers can help with speaking to loss adjusters and insurance claims departments to make the process as smooth as possible. You can confirm our registration on the FCA website, https://register.fca.org.uk/. The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. A dependent child who is an eligible family dependent and who resides out of the service area for the purpose of attending school is eligible to be enrolled as an out-of-area dependent. is the fixed dollar amount you pay for a covered service at the time the care is provided. is equipment which is primarily and customarily used to serve a medical purpose, and generally is not useful to a person in the absence of illness or injury. is the employee of the Group whose employment or membership in the Group establishes eligibility for his or her dependents under the Providence Health Plan policy. With 30 years of experience, we arrange high-quality cover & provide … Coinsurance Depending on where you get your health insurance, he may also be able to choose among plans that you rely on, including the health plan, dental insurance, vision, or more. Condition The Plan includes a determination on a case by case basis of whether the requested service will result in greater benefits than other generally available services, and will not approve such a request if the service poses a significant risk to the health or safety of the patient. Deductibles are usually per person, or per family, per calendar year. The subscriber's spouse is eligible to be enrolled as an out-of-area dependent. Insurance with Savings: With a life insurance plan in place, you need to make a set of payments of the premiums periodically. is a defined geographical area. At Oneplan, we do insurance differently. Excellent and polite service, and competitive quotations. The beneficiary is enrolled in a health insurance plan and receives benefits through the policy in the form of paid claims and/or network-negotiated rates for the portion of the claim that the beneficiary has to pay.. I had a bad car accident last year and A Plan helped me sort everything out to everyone’s satisfaction. A-Plan Insurance Most helpful, courteous and informative. Medically necessary services or supplies must be: appropriate as to place or level of care in amount, duration, and frequency for the treatment of the condition; not be provided primarily for convenience; appropriate and in keeping with widely-accepted standards of practice in the community; and likely to stabilize or improve a member's medical condition. FitTogether, Support for health plan members and Medicare beneficiaries impacted by COVID-19 ›, Making your prescription dollars go further, Harrison Electrical Workers Trust members, Make the most of your health plan benefits, Mental health and Substance Use Disorder treatment services, Understanding Claims and Billing Processes, Providence Health & Services – Oregon & Southwest Washington, Non-discrimination and Communication Assistance. The card identifies you as a Plan member and includes important information about your coverage. A skilled nursing facility (SNF)