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View the High Deductible Health Plan
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Created On: 09/29/2021
in Medicare Your Pharmacy Info Better therapeutic outcomes for members with multiple conditions Our Medication Therapy Management Program (MTMP) is focused on improving therapeutic outcomes for Medicare Part D members. To qualify for MTMP, a member must meet all of the following...
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As a new or continuing member, you might be taking drugs that are not on our formulary , or list of covered drugs, that require you to meet certain requirements , like prior authorization, step therapy, or quantity limits. If you're in the fi...
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Created On: 08/27/2020
in Medicare Your network is where you can get care. Our service areas are where we sell plans. We have service areas in North Carolina. Service Areas Sandhills Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland, Cumberland, Harnett, Johnston, Robeson,...
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A PPO (Preferred Provider Organization) plan contracts with medical providers, such doctors, clinics and hospitals, to create a network or participating providers. You pay less if you use providers that belong to the plan's network.
You won't ha...
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To determine if a doctor or specialist is in-network, click here and select your plan type (HMO/POS or PPO). Then enter the name of the physician or specialist to see if the doctor is covered in one of our networks. ...
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How can I check my claims? - Not available in Wake County. How can I see my prior authorizations? How to file an grievance or appeal a coverage decision?
Where can I get an Appointment of Representative form? How do I authorize rele...
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Created On: 07/20/2020
in Medicare
In crises like tornadoes, hurricanes, earthquakes, floods and fires, if the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic...
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A HMO (Health Maintenance Organization) plan gives you personal care from a set network of doctors and hospitals. You'll get peace of mind with: The comfort of having an in-network primary care provider (PCP) to oversee all your care and refer you...
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For a Medicare Part D plan, you'll pay: A set monthly premium. A Part D deductible (if applicable). Copayments or coinsurance for your drug costs. All your other Medicare or Medicare Supplement costs. Medicare Part C plans may include Medicare...