Careington Maximum Access Discount Dental & Vision Plan with EyeMed Vision

Transcription

1 Careington Maximum Access Discount Dental & Vision Plan with EyeMed Vision Plan Details Participant$14.95/mo PlusOne$20.95/mo Family$26.95/mo Benefits *These fees represent the Plan 503 fee schedule. Normal cost is based on the 80th percentile of the National Dental Advisory Service Comprehensive Fee Report for **Prices subject to change Description Plan Cost Normal Cost Savings 0120 Periodic Oral Evaluation $15 $46 67% 0274 Bitewings-Four Films (x-rays) $23 $59 68% 1110 Prophylaxis - Adult (light) $33 $85 61% 1120 Prophylaxis - Child $27 $62 68% 2160 Amalgam Three Surface, Primary or Permanent $68 $195 65% 2750 Crown-Porcelain Fused to High Noble Metal $540 $995 45% 3330 Root Canal-Molar (Excluding Final Restoration) $459 $930 50% 4341 Periodontal Scaling and Root Planning $109 $231 62% 7140 Extraction-Erupted Tooth or Exposed Root $58 $155 62% 8080 Comprehensive Orthodontic Treatment of the Adolescent Dentition 20% Discount $5,192 20% Deductible This is a Discount Plan. Copay N/A How To Access Discounts Step 1: To locate a participating provider, call toll-free , use the Providers tab above or go online at to access the online provider search. Step 2: Members call to make an appointment with the participating provider. The member must show their membership card at the time of visit to receive the discount. Step 3: Pay the bill. The member is responsible for the total bill, less the applicable savings, at the time service is rendered Discount Vision Plan by EyeMed Members save 20% to 40% off the retail price of eyewear with the EyeMed Vision Care Access Plan D discount program. Members are eligible for discounts on exams, eyeglasses and contact lenses from more than 40,000 providers nationwide including access to independent optometrists, ophthalmologists, and opticians and leading optical retailers such as Pearle Vision, Lens Crafters, Sears Optical and Target Optical. Replacement Contact Lenses by Mail EyeMed members may order replacement contact lenses at competitive prices via the Internet and have them mailed directly to the member s

2 home. This service is for replacement contact lenses only, and the EyeMed discount does not apply. The member s initial pair of contact lenses must still be purchased from their eye care provider to ensure proper fit and follow-up care.

3 Plan Cost Monthly Quarterly Annually Participant $14.95 $44.85 $ PlusOne $20.95 $62.85 $ Family $26.95 $80.85 $ One time Non Refundable Processing fee: $35.00 The stated rates above include a two dollar ($2) per month billing fee. Rates are guaranteed for a 12 month period, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter.

4 Plan Highlights Average annual savings of $1,200 per family on dental work Over 63,000 providers nationwide Save 20% to 60% on most dental procedures including routine oral exams, unlimited cleanings, and major work such as dentures, root canals, and crowns Orthodontics included for both children and adults at a 20% savings Cosmetic dentistry such as bonding and veneers also included All specialties included Endodontics, Oral Surgery, Orthodontics, Pediatric Dentistry, Periodontics, and Prosthodontics a 20% reduction on normal fees where available All dentists must meet highly selective credentialing standards based on education, background, license standing and other requirements Members may visit any participating dentist on the plan and change providers at any time Discount vision plan through EyeMed at no additional cost

5 Plan Disclosures Methods of Payment Visa Mastercard American Express Discover Bankdraft THIS PLAN IS NOT INSURANCE. THIS IS NOT A MEDICARE PRESCRIPTION DRUG PLAN.* This plan does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR The plan provides discounts at certain health care providers for medical services. The range of discounts will vary depending on the type of provider and service. The plan does not make payments directly to the providers of medical services. Plan members are obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount medical plan organization. You may access a list of participating health care providers at this website. Upon request the plan will make available a written list of participating health care providers. You have the right to cancel within the first 30 days after receipt of membership materials and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5). Discount Medical Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034; phone The program and its administrators have no liability for providing or guaranteeing service by providers or the quality of service rendered by providers. This program is not available in Montana and Vermont. *Medicare statement applies to MD residents when pharmacy discounts are part of program.

6 Frequently Asked Questions Is this an insurance plan? No, this is not an insurance plan. Careington s savings plan provides you with discounted prices on Dental services and products; you will pay for services at the discounted price at the time services are received. How does the savings plan work? Saving money on health care expenses is easy. First, you can find participating providers by using the "Provider Search" page or by calling (800) After confirming the provider's continued participation when making an appointment, members just show their membership card at the time of service. Members are responsible for paying all fees directly to the provider. Can I include dependents on my plan? Yes, one of the wonderful features of our savings plans is that your entire household can receive the discounts, even children living at college! Can I use my membership when I travel away from home? Yes, your membership can be used at any participating provider in all available states. What doctors can I go to? You can find participating providers for the savings plan by visiting the "Provider Search" page or calling (800) and pressing option 1, then option 1 again. How long will it take me to get into the system after I sign up? After you have successfully become a member (by filling out the appropriate information on the Web site), you will receive your membership materials and membership cards in about 7-10 business days. How do I get additional membership cards? If you need additional cards for your household, or have lost your card, please call Member Services at (800) and press option 1, then press option 1 again. They will be happy to send additional cards to you. Can I go to a provider that does not participate? You may go to the provider of your choice; however, you will only receive a discount by going to a participating provider. If my dentist refers me to a specialist who is not in the network, do I still get a discount? You will only receive a discount by going to a participating provider. You might try printing out a list of participating providers to share with your dentist to see if he/she could recommend any of the participating specialist locations. Can I use this plan even if I already have insurance? Yes, as long as your plan isn't a PPO, HMO, or another discount plan. Just go to a participating provider, show your membership card, pay the discounted fees at the time of service and ask for a copy of your bill. Then, file the claim with your insurance company to be reimbursed by them. This reduces your out-of-pocket expenses and stretches your dollar so you reach your maximums more slowly. You may also use the savings plan for services not covered by your insurance plan. For example, many people have medical insurance, but do not have dental and vision coverage. Please remember that the savings plans are not insurance and may offer discounts on many services not included in traditional indemnity plans. What do I do if I feel the provider overcharged me? You can send a copy of your bill and a written letter to the administrator of the plan, Careington International Corporation, Attn: Provider Relations, P.O. Box 2568, Frisco, TX They will investigate your inquiry, and you will be contacted regarding the findings. What do I do if I have a complaint about a provider? Please submit all issues in writing, including a copy of your bill. You may fax them to (972) , or you may mail them to Careington, Attention: Member Services, 7400 Gaylord Pkwy, Frisco, Texas, Call Member Services at (800) for help with any concerns you may have. Once I select a provider, am I assigned to that provider? How often can I change providers? Another great feature of the savings plan is your ability to select any provider from the network. You can change providers at any time, and household members can select their own providers. Call Member Services at (800) for help finding participating providers or visit the

7 Provider Search page. What should I say when I call a provider to make sure they participate? The providers will recognize the name of the network with which they participate, so when you call, it is important to use the name of the correct network. What should I expect to see on my Bank/Credit Card Statement for my premium payments? Insurance will appear on your statement as the charge for your premiums. Who do I call for billing questions? You call Morgan White Group for billing questions at When will my first payment be taken? The $35 non-refundable enrollment fee plus your first months premium is due at time of enrollment. Banking/Saving account Please allow up to 3 business days. Credit/Debit Card - Will be taken immediately. Will I receive a renewal notice? No. Once enrolled, the plan will continue unless you send a cancellation notice. All cancellations require a 30 day notice via to Individualchanges@morganwhite.com or by fax to: (601) How do I cancel my membership? Cancellations are only accepted in writing and can be sent via regular mail, or fax. You can emai individualchanges@morganwhite.com with your cancellation request. Should you prefer to send your cancellation via regular mail or fax, please contact Morgan White Administrators, Inc. at for instructions on where to send your cancellation request.