The Complete Choice programs include defined limited benefit indemnity insurance, also known as mini medical. What this means is that you will receive a fixed dollar amount of benefits for covered medical services. This plan provides coverage for basic healthcare needs, and has limitations and exclusions from coverage. Traditional major medical plans are more comprehensive, and provide a wider range of covered services, but of course, not everyone can qualify, nor afford major medical insurance. iCan offers both major medical and mini medical insurance. If you are a current member, please refer to the Insurance Certificate of Coverage and Schedule of Benefits included in your membership kit for additional information.
Is my doctor in the plan?The network is nationwide and many Doctors are in it, but remember that you can use any Doctor you want, but using a Doctor who is in the network may significantly reduce your out-of-pocket expense because you will receive pre-negotiated fixed rates that are a lot lower than standard rates.
How long have you been in business?HCCUA was founded in 1985.
What is the typical cost for a procedure?That depends on the procedure itself and whether or not it’s a covered procedure under your membership plan. Contained in your membership package you’ll find the Insurance Certificate(s) of coverage which include a Schedule of Benefits showing the most common covered procedures and the benefits payable. The list of procedures is quite extensive, and not all procedures are listed in the schedule, so if you do not see a particular procedure on the schedule, you or your provider may contact member services for assistance. Member services can also tell you what the pre-negotiated contract rate available if you use a network provider.
Can I upgrade my membership plan?Yes, but you must re-enroll and may be required to start a new 12 month pre-existing condition exclusion period, depending upon the insurance carrier in your state. You will not be charged an additional enrollment fee if you upgrade your existing membership plan.
Can I mail in my payments in advance?No, we do not accept payments by mail. Our billing and accounting systems are not set up to process paper checks.
Children can be covered up to what age?Dependent children may be covered until the age of eighteen; however, coverage may be available for an extended period of time that varies by insurance carrier. Please review the Insurance Certificate of Coverage included in your membership package, or contact member services for assistance
Is there any way I can sign up before my current coverage runs out, because I don’t want to go for a month without coverage?The effective date available for HCCUA membership is the 1st of every month. Please contact an agent to determine the enrollment period available for your desired effective date.
No, this benefit is only available through participating laboratories. You must contact member services at 866-227-5400 to schedule your tests at a participating lab in order to receive this benefit. You are eligible for this benefit after 90 consecutive days of active membership.
I would like to add my son/daughter to my policy. How would I go about doing this?You may add any eligible dependent for any reason if the request is made within 15 days of the effective date of your membership. In order to add an eligible dependent to your membership that has been active for more than 15 days, there must be a life changing event that has occurred. For example, birth, adoption or guardianship of a child, marriage, or loss of benefits due to losing a job. You will be required to provide written proof of such event within 30 days of the event via fax, mail or email (membership@hccua.org). Please include your name, member number, date of birth, and full social security number. Also, please state that we have permission to charge your account the balance of the difference between your old and new plan. Otherwise, the addition of a dependent will require membership re-enrollment.
How do I go about changing the checking account on file?Just call member services at 866-227-5400.
How do I change my address and phone number on my account when I move?Please call member services at 866-227-5400 and they will be more than happy to change that for you.
Can I cancel coverage at any time?Yes, you can cancel at any time. If you cancel by the 24th of the current month, your membership will terminate on the last day of that month. If you cancel after the 24th, your membership will terminate on the last day of the following month.
Can I go to any doctor or hospital?Yes. There is no restriction of doctors or hospitals under the health indemnity plan. However, by utilizing a provider in the PHCS network, you will have access to pre-negotiated fixed rates that can help reduce your out of pocket expense.
How do I get reimbursed when I go to a medical provider?If your provider accepts assignments of benefits, the provider will file a claim for their services and will be paid the specific dollar amount of benefits available under your plan in accordance with the Insurance Certificate of Coverage directly by the insurance carrier.
If your provider does not accept assignment of benefits, you will be responsible for paying your health costs at the time of service and for filing a claim under the plan to receive the benefits you are due under the plan.
Am I guaranteed coverage in the plan?Yes. As long as you are between the ages of 18 and 65, you and your eligible dependents are guaranteed acceptance in the Complete Choice membership plans, which include access to limited benefit group indemnity insurance. Please refer to the Insurance Certificate of Coverage for the limitations and exclusions under the plan, including the pre-existing condition exclusion from coverage. (Please see the Pre-Existing Condition section below).
What are Pre-Existing Conditions?Under the plan, a Pre-existing Condition is a disease, injury, sickness or physical condition for which a Covered Person received medical advice, treatment or a diagnosis during a period of time that varies by state and carrier, prior to the Covered Person’s effective date of membership. Pre-existing Conditions will be excluded from coverage for a period of time beginning on the effective date of membership and continuing for a period of time that varies by state and carrier. Please see the Insurance Certificate of Coverage for the applicable time frame for pre-existing condition exclusion in your state of residence.
Repricing is the process by which the PPO discount is applied to the charges incurred by the insured for covered medical services when treated by an in-network provider.
What is an EOR?Repricing is the process by which the PPO discount is applied to the charges incurred by the insured for covered medical services when treated by an in-network provider.
What is limited benefit indemnity insurance?Health insurance that specifies a fixed dollar amount of benefits for medical services that are covered under the insurance plan.
Can a plan deny benefits for chronic illnesses or injuries, like carpal tunnel syndrome, diabetes, heart disease, and cancer using a preexisting condition exclusion?It depends on whether you received medical advice, care, diagnosis, or treatment within the 6 months prior to enrolling in a new group plan. If you did, you can be subject to a preexisting condition exclusion.
Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?Yes, as follows: Conditions present in a newborn or a child under 18 who is adopted or placed for adoption (even if the adoption is not yet final), as long as the child is enrolled in health coverage within 30 days of birth, adoption, or placement for adoption. In addition, the child must not have a subsequent, significant break in coverage (defined as 63 days). For instance, a significant break might occur if a parent lost his job and health coverage for himself and his family shortly after a child’s birth. Genetic information cannot be used as a basis to deny coverage if there was no diagnosis or treatment of the disease.
What is the Health Insurance Portability and Accountability Act of 1996 (HIPAA)?HIPAA is a federal law that: Limits the ability of a new group plan to exclude coverage for preexisting conditions; Provides additional opportunities to enroll in a group health plan if you lose other coverage or experience certain life events; Prohibits discrimination against employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information; and guarantees that certain individuals will have access to, and can renew, individual health insurance policies. HIPAA is complemented by state laws that, while similar to HIPAA, may offer more generous protections. You may want to contact your state insurance commissioner's office to ask about the law where you live. A good place to start is the Web site of the National Association of Insurance Commissioners at www.naic.org.
My group health plan says that dependents are generally eligible for coverage only until they reach age 25. However, this age restriction does not apply to disabled dependents, who seem to be covered past age 25. Does HIPAA permit a policy favoring disabled dependents?Yes. A plan can treat an individual with an adverse health factor (such as a disability) more favorably by offering extended coverage.
Yes, you may change your permanent bill date to the 5th, 10th, 15th, or the 20th of the month.
Can I post date a payment?Yes, up until the 20th of the following billing month. Ex: If your payment is due January 15th, you can post date the January payment to February 20th at the latest.
Can I mail is a payment?No, unfortunately at this time we do not accept mailed in payments.
Can I make partial payments?No, unfortunately at this time we do not accept partial payments.
What forms of payment do you accept?We accept checking or savings accounts and all major credit cards. We also accept most pre-paid credit cards.
Can I make advanced payments?We accept up to three months of premium payments at one time.
What does it mean if my account is in a “Grace Period”?A member’s account goes into a “Grace Period” when payment is not received during the month the payment is due. Ex: A January payment is not received by January 31st. February 1st the account goes into a “Grace Period”. If the January payment is not received by the 20th of February, the the membership is automatically terminated. The member must re-enroll to reinstate the policy.
Can I suspend my account?No, unfortunately at this time we cannot suspend a membership.
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I already called roadside assistance but my friend came and helped me out. How do I go about cancelling roadside assistance for this incidence?Please call 888-866-7908 to cancel their assistance as soon as you know that you no longer need their help.
I noticed that I could get tags for my dogs. How would I go about doing this?You can log onto the HCCUA.ORG website and click on pet assure and register through there or you may call 888-866-7936 and a customer service representative will be happy to assist you.
Pet Assure- Will this benefit pay for a vet?No. This is not insurance. It is a discount referral.
What kind of discounts would I get for medical services by using Pet Assure benefits under HCCUA?You will receive 25% off all medical services each and every time you go to a participating veterinarian from our network. If you should need further assistance please contact member services at 866-227-5400.
How can I access Entertainment benefits without a computer?This can only be accessed via computer. You need to use a computer of a friend, family member, or the library.
Can Consult A Doc have you admitted to a hospital?No, they cannot. This requires a doctor affiliated with the hospital, or an Emergency Admission.
I see that my HCCUA benefits include a simple will. How do I go about accessing this benefit?Please call member services at 866-227-5400 and they will assist you in having an attorney assigned to you.
What is a PPO?
A Preferred Provider Organization (PPO) is a managed health care plan which includes hospitals, medical doctors, and other health care providers that have contracted with insurance companies and employers to provide medical care at a discounted rate. A PPO has an “in-network” provider list of doctors and hospitals to choose from. Most people prefer a PPO because it gives them the option to go to the provider of their choice whether it is an in-network or out-of-network provider. The advantage of going in-network is you will receive the discounted rate that provider negotiated with the network. When you go to the out-of-network provider, you must pay the difference between the provider charge and the plan charge. Another feature of a PPO is that you do not need to choose a primary care physician or need a referral to go to another doctor, including specialists.
What is a HMO?
A Health Maintenance Organization (HMO) is a prepaid health insurance plan which includes doctor, hospital and offers a variety of services to its members, focusing on preventive care. When you belong to a HMO you usually are required to go only to the doctors and hospitals that belong to the network. You must choose a primary care physician (PCP) from the HMO member physicians. Your primary care physician will coordinate all your medical care. You will need to see your primary care physician for a referral before seeing a specialist. If you go to a doctor or hospital outside of the HMO network, you will usually not be reimbursed for the care you received unless the care was authorized in advance by your HMO. There is usually a co-payment for each visit which varies from plan to plan. By law, an HMO cannot require referrals for emergency care and therefore will pay for emergency room treatment. You must contact your HMO as soon as it is possible, to inform them ofthe emergency treatment.
What is a POS?
A Point-of –Service Plan (POS) is a combination of the PPO and HMO plans. You are required to pick an in-network physician to be your primary healthcare provider. If you choose to go to a doctor who is out of network, you will have to pay the majority of the cost, unless you had a referral from your primary physician to see that specific doctor. If that is the case your health plan will pay most or your entire bill.
What is an Indemnity plan?
An Indemnity Plan is a medical plan that reimburses the provider and/or patient as medical expenses are incurred.
What is an EPO?
An Exclusive Provider Organization Plan (EPO) is a restricted preferred provider organization plan which requires employees to only use physicians and hospitals within the network to receive coverage. You will not be reimbursed from a non-network provider. The only exception is in an emergency situation.
What is Managed Care Plans?
Managed Care Plans include hospitals, physicians and other health care providers that have contracted with insurance companies and employers to provide medical care at a discounted rate. Patients who belong to plan and use in-network providers will receive the benefits of these discounted rates. Examples of managed care health plans are:
- PPO ‘s – Preferred Provider Organization
- HMO’s – Health Maintenance Organization
- POS’s – Point-Service-Plan
- EPO’s – Exclusive Provider Organization
What is an EOB?
An explanation of benefits is an EOB, which is a statement from your insurer about your health claim. The EOB should include information about your provider, the date of service, how the insurer applied the plan benefits to the claim submitted, and the amount they paid your health care provider. It may also include information on how much you, as the patient, may be responsible for paying.
What is a benefit?
A benefit is an amount paid by the insurance company to an assignee, claimant, or beneficiary when the insured person suffers a loss.
What is a claim?
Is when a provider or individual request the individual’s insurance company to pay for services from a health care professional.
What is a co-payment?
A co-payment is a set amount of money that is paid to the provider by the insured, in addition to what is paid by the insurance company’s. For example, some HMO’s require a $10, $20 or $30 dollar payment for each visit.
What is a denial of claim?
Is when an insurance company will not pay for services rendered by a health care professional, requested by the provider or individual.
What is an Effective Date?
An effective date is the date that your insurance coverage begins. You are not covered till that date.
What is in-network?
In-network is a group of providers and health care facilities that are part of a health plans network, and have negotiated a discount for their services. Individuals insured that use these in-network providers receive services at a lower rate to the insurance company which they have contracted with.
What is out-of-network?
Out –of-network are providers and health care facilities that do not participate in your insurance plan. When using an out-of-network provider an individual can incur partial or full expenses not covered by their insurance plan.
What is Brand Name Drugs?
Brand name drugs are the patented prescription drug developed by the company that manufacturers it. Once the patent expires, some drugs will be made in generic versions of the drug and are marketed at a much lower cost by other companies. Check your insurance policy to see the policy for generic drug vs. name- brand drugs.
What is a Generic Drug?
A generic drug is known as a “twin” to the name brand drug. Once a company’s patent has expired, other companies are allowed to duplicate these drugs and sell them. Generic drugs are less expensive, and most health and prescription plans will save client money by choosing the generic drug.
What is a Primary Care Provider (PCP)?
Is the physician who is in charge of an individual’s overall healthcare needs and medical care. Your primary care provider will refer you to specialized physicians when special care is needed.
Reasonable and Customary Fees:
Reasonable and customary fees are the average fee charged within a geographic area for healthcare providers. This is the average fee used by medical plans to determine how much they will pay for a procedure or specific test. If the fee is higher than the average fee in your area, the individual having this service is responsible for the difference in price. You can question your provider about their fee and try to negotiate down to the reasonable and customary fee of the insurance company.
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When you call iCan and become a member of one of our Association health plans, you’re signing up for much more than just affordable health insurance. Our entire company shares the unified goal of extending care and support to all of our members. We go above and beyond typical companies to make sure your needs are met and your benefits are being put to good use. There’s a wealth of resources available at your fingertips, a few of which are highlighted below; we invite you to make use of them regularly to get the most value out of your Association membership health plan.
Member ServicesWe have a highly trained Member Services team that exists for one reason: to field your calls and answer your questions. They’re standing by to help you maximize the value of your membership, so don’t hesitate to pick up the phone and call. They can be reached toll-free at 1-866-227-5400 Monday through Thursday between 8:00 am and 6:30 pm EST, and on Friday from 8:00 am to 6:00 pm EST. They can also be reached through email at: membership@hccua.org.
Member AdvocacyIf you need help with a health care or insurance issue, simply call Member Services who will connect you to one of our caring Health Advocates, all of whom understand the complexities of obtaining health care and how to successfully navigate the health care system. Whether you’re looking for a doctor, trying to settle a coverage dispute, or need help understanding your medical bills, our Health Advocates are here to help. In some cases, they can even negotiate for fee reductions on your behalf. If used to their full ability, our Health Advocates could potentially save you thousands of dollars, valuable time, and more importantly peace of mind!
HCCUA WebsiteFor those customers who have decided that an association membership, including health insurance and wellness benefits, is the best fit for their needs and budget, there is a wealth of money saving tools available. Our Association health plans are made available through membership in HCCUA. The goal of the HCCUA is to enable its members to make well-informed decisions and cost effective choices regarding health and finances by providing them with access to the most valuable information, tools, products and services available. Their website is chock-full of informative articles and resources; it’s also the portal that provides access to many of your non-insured benefits. Visit www.hccua.org and explore the site to learn more about how you can improve your financial and physical health.
As mentioned above, health insurance is complicated, and choosing the right plan for you and your family can be difficult. The first step you should take is to identify your specific needs regarding health care coverage. Do you need coverage for just yourself, or for you and your family members? What type of coverage are you looking for? Would basic coverage including doctor visits and preventative care meet your needs? Or, are you looking for more comprehensive coverage to include benefits for catastrophic care? How much can you afford to pay for health care coverage? Once you’ve answered these questions, you’ll be ready to weigh your options and make the right selection.
Keep in mind that we have a variety of programs and plans available to choose from, each with varying levels of benefits, services and cost. Though cost is an important factor, we urge you to consider the details of each plan very carefully and resist the temptation to make your purchase based on cost alone. Even our most comprehensive plans are affordable, so take the time to find the plan that fits just right, for your family and your wallet.
We encourage you to browse through the available plans on our site and carefully evaluate them, checking each to see how the benefits line up with your specific needs. When you’re ready, click here and select a state, then scroll through the tabs to view the different plans that are available in your resident state. Each plan has its own tab that includes a brief description, along with some highlighted benefits and pricing. We encourage you to scroll down and read through the coverage specifics – there you’ll learn everything you need to know to make an educated decision.
And as always, if you have any questions we encourage you to call us today and speak to a caring iCan agent licensed in your state. Our entire team is committed to helping you make smart insurance choices you can actually afford!
Although our primary goal is to make sure you have the insurance coverage you need, iCan isn't just about insurance – we're also about finding ways to help save you money and improve your lifestyle.
That's why we've made Lifestyle Benefits an integral part of our business. In these tough economic times, we understand the vital importance of maintaining a cost-effective lifestyle. To help ease the burden, we offer plans rich with lifestyle benefits aimed at reducing the cost of everyday purchases. Upon enrollment, you’ll be tapped into our nationwide network of partners in the health, financial, legal, entertainment, and travel industries, giving you instant access to big savings.
Our Lifestyle Plans include:
- Doctor Visits By Email Or Phone
- Identity Theft Protection
- Legal Care Solutions
- Roadside Assistance
- Dining Discounts
- Movie Discounts
- Hotel Discounts
- Pet Care Savings
To learn more about Lifestyle Benefits programs available in your state, click here.
