Plan Specifications
     NO AFFORDABLE CARE ACT TAX PENALTY - Inclusion of the Basic Plan means that you will not be required to pay a tax penalty for 2018. You'll have the option to cancel your MEC program for 2019. Specific DPC services vary between DPC practices and you will need to speak to your DPC provider to determine specifically what preventive care services he or she provides. 
     WELLFIT WELLNESS Platform - Managed by My Academy of Health Excellence
     PREVENTIVE CARE AND OFFICE VISIT NETWORK and SERVICES - You can use your DPC provider for most preventive services and small medical expenses that can be provided by a primary care doctor. If you require specialist services or other services that are not provided by a DPC doctor you would have to pay for those services, or if the service qualifies as a Need, you could use your Medical Cost Sharing program. If you use a non-DPC provider for preventive services, you would need to use a doctor in the PHCS network to receive those services on a no-cost basis.
     MONEY MANAGEMENT - Health Matching Account (HMA) optional
Direct Primary Healthcare
    Small Medical Expenses - Mitigate using Teladoc™ or use of your DPC provider.
    Large Medical Expenses -

     Contain with Medical Cost Sharing Powered by Sedera Health
     Medical Cost Sharing Network - Open Access network; can use any provider who accepts cash payment
     Initial Unshared Amount (IUA) Options - Choice of $500, $1000, $1500, $2500, or $5000
     Maximum Number of IUA's Annually - 3 per individual/5 per membership unit
     Prescription Drugs - normal sharing rules apply for curative medications; 120 days for maintenance medications (blood pressure, cholesterol,etc.)
     Pre-Existing Conditions - 36 month look-back: no coverage for 1st 12 months; $15K 2nd year; $30K 3rd year; unlimited thereafter
     Maternity Benefits - $5K IUA for normal deliveries and $7.5K for non-emergency/elective C-sections; conception must have occurred after membership per section 9 of the Guidelines
     Therapies and TMJ - range from $1.5K to $2.5K/Need under Section 8 of the Guidelines
     Psychiatric and Behavioral Health - $5K inpatient maximum/Need; $1.5K outpatient/Need under Section 8 of the Guidelines
     Tobacco Use - $75 surcharge per membership unit. If age 50 or over, $25K sharing restriction for cancer, stroke, heart conditions and COPD
     Sharing Limits - No annual or lifetime limits unless restricted by Sections 8 or 9 of the Guidelines
Enroll Today!
Call 877-734-3884
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