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Frequently Asked Questions 1 2 | |
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Membership / General Benefits / Long-Term/Eldercare /
Nurse Hotline / Dental Vision / Lasik / Pharmacy / Chiropractic / Alternative Medicine / Hearing VIP Health & Wellness / Fitness Advantage / Hospitals / Physicians |
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Who administers the AllCara programs? Both the AllCara Platinum and AllCara Gold programs are administered by New Benefits in Dallas, Texas. AllCara has contracted with New Benefits to provide membership kits, member services support and access to the provider in the discount card industry. New Benefits has created and serviced turn-key, customized, non-insurance, health benefit programs for over 14 years, and has administered programs for over 5,000 organizations. Membership What kind of savings will this card offer members? On products and most AllCara services (with the exception of Nurse Hotline and Counseling Services), the discounts range from 10% to 60%. What is the money back guarantee? There are two guarantees with AllCara. If a member is not completely satisfied with any of the benefits within 30 days of receiving their card, the member may return the card for a complete refund. Additionally, if any member uses the card six or more times during the membership year and the savings do not equal or exceed the cost of membership, upon request, the member will receive a complete refund with proof of purchase. Can a member’s cost for the program ever be increased? Yes, although pricing is not variable by member criteria. All members receive the same pricing. If a member cancels his membership, what refund will the member receive? The member is entitled to a full refund, less the $50 administration fee, if the membership is terminated within the first 30 days. What happens if a member dies? The member’s dependents are still eligible to receive benefits for the term of the membership. Is this program guaranteed acceptance or can any applicant for this program be turned down? Anyone who is at least 18 years of age in the United States is eligible to purchase this discount program and no one will be denied. Who can use the card? Who is considered a legal member? Each membership card can be used by the cardholder, spouse and all legal dependents. Legally married couples (or dependent children) with different last names are covered. But, we would recommend that they purchase an extra card with the dependent's name (but same membership number), to alleviate confusion at the provider location. Same sex partners and couples living together are not considered legal members. How can this program allow everyone to qualify? Discount programs simply discount a price at the point of service. There is no risk involved so there is no underwriting. If a particular provider is not on the approved AllCara list, how do members go about getting their physician or practitioner AllCara approved? Members may call AllCara and submit the name, address, and telephone number of the provider of their choice. AllCara will contact the provider’s office and invite him/her to join the appropriate network. When can members begin using their benefits? Members can use their card on the day it is received. All they have to do is present the card when they arrive at the provider’s office or store. How do I know which providers are in my Discount Network? You will receive a membership kit containing the closest five (5) providers for each of your benefits, or you may visit to locate providers or call our Membership Service Department and a friendly representative will provide additional listings. Does the plan apply to services provided outside the United States? Not at this time. Is the member required to sign the application if they have cognitive impairment? The applicant or their legal representative must sign the application. Do I need my card to receive my discount? Yes, you will need your card. The provider will only give you a discount when the card is presented at the time of service. Are all pre-existing conditions covered? Yes How is this plan different from insurance? This is a point of sale discount plan. There are no deductibles, claim forms, waiting periods, pre-existing condition exclusions or reimbursement. Just GREAT discounts at the time of service. You are required to pay the entire discounted bill at the time of service. Do I have to complete any claim forms? No Can the plan be paid quarterly or semi-annually? No, the plan can only be paid for annually, monthly bank draft, or check-o-matic. Is there a waiver of payment benefit? No, payments must be kept current to keep the plan and benefits current. To whom is the check payable for annual membership? Checks are always made payable to AllCara. Are the membership fees tax deductible? In general the answer is no. However, we are not tax specialists and suggest you discuss this with your accountant. Is there a grace period for late payments before a member loses benefits? No Can the program be paid for more than a year in advance? No Will my information be shared with other companies? No. Your information is kept strictly confidential within our company and is never sold or given out. Please refer to our privacy policy posted on our website and located in the membership kit. back to top General Benefits What is the AllCara Benefit package? It is a membership plan consisting of ancillary, or NON-INSURANCE, healthcare benefits that offer point of service discounts on healthcare products and services. How do the benefits work? Members may begin using their benefits as soon as they receive their card. The membership kit comes complete with an explanation of benefits and the five closest providers for each program in which they are enrolled. For additional providers, members can call the toll free phone number on the card or access www.allcara.com to locate participating providers in their area. The member then takes the card to the provider, selects the desired product or service, and presents the card at the point of sale. The member receives the contracted discount price and pays at the time service is rendered. However, if the member is accessing a telephone accessible service (i.e. Nurse Hotline, Counseling Services, etc.), the member simply calls the number and gives name and membership number to the representative. Is there a deductible? No. This program is not insurance. As such, there are no deductibles, no waiting periods, no pre-existing condition exclusions, reimbursements, etc. Everyone qualifies and a physical is not required to purchase the card. Can I receive savings and benefits from an AllCara provider if I am currently receiving services from a non-AllCara provider? Yes, if you are currently using a non-AllCara provider, you will need to choose a participating provider to receive savings with the AllCara program. How many times may a member and his/her family use the benefits? Unlike insurance, utilization is encouraged because it directs traffic to participating providers. There are no limitations on usage for active current members and their families. Can the benefits be used with insurance? AllCara may be used for any out of pocket expenses one has when using insurance (to meet deductibles and to continue particular services once insurance limits are maxed out). An example of this is most insurance companies limit mental health to ten (10) visits at a set fee. AllCara will help reduce out of pocket expenses for visits after the ten insurance paid visits are exhausted. back to top Long-Term/Eldercare What is the Long-term/Eldercare benefit? This benefit is a one-stop resource for those who are concerned about or actively caring for an aging parent or other family member. Aging experts draw on their experience, knowledge of local resources, and the latest information on aging to answer questions, identify the real issues, and arrange for the help and resources for members and their aging family members needs. How does this benefit work? Simply call the toll-free number located on the membership card to speak with an elder care representative. Once eligibility is established, the member will be asked for information that will assist the representative in directing them to the appropriate elder care specialist. The trained and experienced elder care specialist will help with understanding the issues related to caring for an older person and assist in making the right choices. Alternatively, access elder care information, personalized planning tools and other resources on the web by visiting www.nursenavigator.com What does this benefit offer? Long-term/Elder care provides members with: Elder Care Information and Referral – Care Management Associates are available 24/7 to provide assistance with elder care concerns, answer long-term care questions and help locate local assistance. Discount home health and long-term network – Long Term – Members can save up to 30% at 5,500 providers when seeking home health agency or assisted living facilities. Elder care web site access – Comprehensive website that offers features such as skill sheets, condition research, caregiver advice, two minute test, care giver tools, resource finder and member reports. Discounted fee for service geriatric care management services – 3,500 nurses and social workers provide telephonic and in-home evaluations (for an additional hourly or package fee) for all levels of care from basic to comprehensive. What are the typical savings that members can expect to receive from a provider for eldercare services? The discount network provides members with savings of up to 15% off the cost of nursing homes, assisted living facilities, and home health providers. Your location may vary due to the demographics of your area. Does the member receiving the savings pay the nursing home directly? Yes. The member will pay the facility directly the net amount after the savings have been deducted. Can a member receive savings from a nursing home or home healthcare service that is not a member of the AllCara network? No, savings only come from providers who are contracted as part of the AllCara network. What if a member of AllCara is receiving benefits or services from Medicare for nursing home or home healthcare – can they also receive savings from AllCara? No, savings or discounts are not available while receiving Medicare eligible services. What happens if a particular eldercare service provider no longer meets the network accreditation standards? AllCara’s partner for eldercare services, CareScout, monitors compliance with our providers and require that providers inform CareScout should they loose their certification or license to provide services to clients. AllCara will do everything possible to match you with an appropriate replacement provider. How can a member find an eldercare service provider in their area? Members can call our toll free number 800-571-1918 for assistance. What happens if there is no nursing home within 50 miles of a member’s home? AllCara can not control where an individual chooses to reside nor where a nursing home decides to provide care. We can expand the search for clients to 100 miles and we can also search in other states. If your question is more about not having a "participating provider" within 50 miles for a client, AllCara’s eldercare partner, CareScout, will actively negotiate a discount for an individual at an appropriate facility to meet the individual's needs. A discount can not be guaranteed. Can a member receive a discount at an assisted living or long term care facility they currently reside in? No, discounts apply to individuals seeking a new provider. If a member currently resides at a facility, they will be able to use their membership benefit to search for a new care provider in their community that will provide a discount on services. back to top Nurse Hotline How does this benefit work? Nurse Hotline offers toll-free access to experienced registered nurses, 24 hours a day, 365 days per year. The nurses are an immediate, reliable, and caring source of health and medical information, education, and support. Are members charged every time they utilize the benefit? No. Members may use the Nurse Hotline as much as they need without worry of being charged over and above the membership fee. What issues would prompt a call to Nurse Hotline? There may be a time when a member or family member is sick and in need of some expert medical advice without having to see a physician. Nurse Hotline can provide valuable medical information on over-the-counter drugs that may be helpful. Can members receive general health information through the Nurse Hotline benefit? Yes. Members can call and utilize a Health Library with over 1000 topics that have fax-on-demand capabilities. These topics cover such areas as cancer, heart disease, depression, etc. back to top Aetna Dental How does this dental plan work? Participating dental providers are listed in the membership fulfillment kit; members may also call the toll-free number located on the back of the membership card Monday through Friday, 7 a.m. to 7 p.m. and Saturday, 8a.m. to 5 p.m. Central Time. When calling to schedule an appointment the member should identify him/herself as a member of the Aetna Dental Access program. To receive the discount the member must present the membership card and pay the total bill at the time of service. Is there a limit to the number of times the card can be used? No. Members and their families may take advantage of the savings any time throughout the year. Members may also change dentists within the network whenever they choose. Can this discount be combined with dental insurance? In many cases, members may use both. Simply visit a participating dental provider, pay the bill and submit it to the insurance company. The net out-of-pocket cost will be lower because the insurance company should reimburse the member their plan allotted percentage of the reduced bill. Is there someone that can answer questions about the card and services offered? Yes. Simply call the toll-free number located on the back of the membership card Monday through Friday, between 8 a.m. and 6 p.m. Central and Saturday between 9 a.m. and 1 p.m. Central. A member service representative is standing by to answer any questions. What if a member's dentist is not a participating provider? Simply call the toll-free number on the membership card and give the member services representative the doctor's name, address, phone number and specialty. We then contact the doctor about becoming a provider. back to top Vision What is the vision benefit? Does it include eye examinations? Does it include contact lenses? The vision benefit offers 20% to 60% discounts on eyewear and eye care at more than 12,000 optical locations throughout the United States. Providers include national optical chains such as LensCrafters, Pearle Vision, EyeMasters, J.C. Penney, and Sears as well as regional chains and thousands of independent practitioners. Often many participating locations offer discounts of 10% on eye exams for both eye glasses and contact lenses. Additionally, the ophthalmology portion of the network offers 10% to 30% discounts on eye exams and surgical procedures, including the popular laser surgeries in select markets. On average, members receive a 20% discount on replacement contact lenses (excluding disposable lenses) and non-prescription sunglasses at retail locations. Members may elect to use the mail order service to purchase replacement contact lenses (including disposables) at a 20% to 50% discount. Is the Coast To Coast (CTC) discount plan insurance? No. While an insured plan is available, CTC is a discount eyewear and eye care program. There are no claim forms or reimbursement procedures. The participating retail optical locations will give the discount at the time of the purchase. Can members use CTC if they already have vision insurance? Yes. In most cases CTC can be utilized to eliminate or reduce the deductible. Once the insurance benefit has been exhausted, members may use their discount to buy additional pairs of glasses or contacts. Is there a limit on the number of times the benefit can be used? There is no limit on the number of times the member or family member can take advantage of the savings provided by CTC. Does the CTC discount plan cover family members? It covers the member, their spouse and all legal dependents. What is covered with CTC membership? Prescription glasses, non-prescription & prescription sunglasses, and contact lenses are discounted 20% - 60% in most cases. Eye exams and surgery are discounted 10% to 30% where available. Why does the discount vary from 10%-60%? Many variables go into the calculation of the discount such as market demographics, location, hours of operation, one-hour service capability and level of retail mark-up. Example - a chain provider in a major metropolitan mall, open seven days a week, 10 hours a day with an on-site lab, will more than likely have a different mark-up than an independent practitioner in a rural community. However, members will pay almost exactly the same price for the exact same materials regardless of where the purchase is made. Only the percentage of discount off retail may vary. Can members receive the discount at any optical location? No. Members must go to an optical location that is contracted with Coast to Coast Vision to receive a discount. Our providers include national, regional and local chains as well as thousands of independent professionals. What is a dispensing fee? The dispensing fee is the amount of money that is added to the provider's wholesale acquisition cost of materials. It is generally the only profit made by the provider on a purchase. Is the eye exam discounted? Yes, at approximately 4,000 of our 11,000 locations nationwide. Our member service representatives can provide the member with the locations that discount eye exams. How does the benefit work? Members should call the toll-free number located on the membership card to locate an optical provider in their area. To receive the discount, the member must show the provider the membership card and identify his/herself as a member of the Coast to Coast Vision Plan to receive the discount. Do members receive a discount if the store is running a sale? The location will not combine our contracted discount with the sale price. However, in most cases, the Coast to Coast price will be better than the sale price. Do the retail locations mark up the merchandise to give the discount? No. Members receive the discount because CTC brings the buying power of over 9 million members to the optical retailers participating in the plan. How do members nominate their doctor or optician for the Coast To Coast plan? To refer a doctor to the Coast to Coast Plan, the member must provide his/her name, address and phone number and we will contact him/her about becoming a provider. If the practitioner does not wish to join the plan, the member may still use him/her for their eye exam. Simply take the prescription to one of our participating providers to receive a discount on glasses or contact lenses. Can members purchase disposable contact lenses at a discount through a participating optical center? No. Disposable lenses are generally priced as "loss leaders" at the retail stores. However, members can use the mail order contact lens program to receive discounts when ordering disposable lenses. What if a members contact lenses are destroyed while they are on vacation? Simply call the toll-free number on the back of the membership card. The patient registration keeps the prescription on file until it expires and we can send the replacements overnight to almost anywhere in the world. back to top Lasik What is LASIK? LASIK, also known as laser vision correction, is a surgical procedure that can reduce a persons dependency on glasses or contact lenses by permanently changing the shape of the cornea. LASIK uses an Excimer Laser (an ultraviolet laser) to precisely remove corneal tissue to correct the shape for better focusing. What are the guidelines and recommendations for having the Lasik Procedure? The FDA, in cooperation with the American Academy of Ophthalmology, has developed the following guidelines and recommendations for good candidates for LASIK: *The member should be at least 18 years old (21 for some lasers), since the vision of people younger than 18 usually continues to change. An exception is the small child with one very nearsighted and one normal eye. The use of LASIK to correct the very nearsighted eye may prevent amblyopia (lazy eye). *The member should not be pregnant or nursing because these conditions might change the measured refraction of the eye. *The member should not be taking certain prescription drugs, such as Accutane or oral prednisone. *The members eyes must be healthy and their prescription stable. If the member is nearsighted, he/she should postpone LASIK until their refraction has stabilized, because myopia may continue to increase in some patients until their mid to late 20s. *Members should be in good general health. LASIK may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. *Weigh the risks and rewards. If the member is happy wearing contacts or glasses, they may want to forego the surgery. *Understand the expectations from the surgery. Are they realistic? *For patients with presbyopia, LASIK cannot correct their vision so that one eye can see BOTH distance and near. However, LASIK can be used to correct one eye for distance and the other for near vision. If he/she can adjust to this correction, it may eliminate or reduce the need for reading glasses. In some instances, surgery on only one eye is required. How much can members expect to save with this benefit? The exact amount the member will save depends upon the provider selected. Most providers guarantee discounts from 10% - 30%. After a provider is selected, the member is recommended to call the provider's office to learn what level of discount is offered. Can members go to any LASIK provider to receive a discount? To receive a discount on services, the member must go to a participating provider. To find a participating provider, the member can call the toll free number located on their membership card. back to top |
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| THIS IS NOT INSURANCE, nor is it intended to replace insurance. Terms & Conditions | Copyright © 2003 - 2005 AllCara Inc. | |||