A plan for life IN SICKNESS AND IN HEALTH
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1 A plan for life IN SICKNESS AND IN HEALTH
2 Keeping You Healthy As a health plan that truly puts our members first, CDPHP does more than just help you when you re sick. Many health problems can be prevented. That s why CDPHP offers free preventive care, gym access, and personalized resources to help you meet your goals while saving you money, too. Whether you re trying to get healthy or stay that way, CDPHP has you covered. Free Preventive Care You ll never pay anything out of pocket for preventive services, like: CHECKUPS WELL-CHILD VISITS VACCINATIONS CANCER SCREENINGS Healthy Activities with CaféWell CaféWell is an interactive website where you can receive healthy activities tailored to your individual needs and goals. By completing your activities, you can earn Life Points that can be redeemed for gift cards from a variety of retailers.* Wellness Resourses GYM MEMBERSHIPS NUTRITION SERVICES WEIGHT MANAGEMENT CDPHP FITNESS CONNECT SM FREE WELLNESS CLASSES Save on your membership fee Take the guesswork out of eating healthy Save on weight loss programs Five free fitness centers Fitness, nutrition, and more HIGHEST IN MEMBER SATISFACTION AMONG COMMERCIAL HEALTH PLANS IN NEW YORK Capital District Physicians Health Plan, Inc. received the highest score in New York in the J.D. Power U.S. Member Health Plan Satisfaction Studies of customers satisfaction with their commercial health plan. Visit jdpower.com/awards Learn more at * All adults age 18 and older in select plans are eligible. Points accumulate per calendar year, per contract. Points must be redeemed by December 31 each year or prior to contract termination. 2 3
3 Making Good Health Affordable More than 825,000 Providers Nationwide Most CDPHP plans include a national network.* By seeing an in-network doctor, you pay significantly less than if you see an out-of-network doctor. In addition, all plans include worldwide coverage for emergency care. CDPHP makes it easier than ever to locate a doctor with Find-A-Doc. Visit findadoc.cdphp.com, enter some brief information, and you ll be on your way to finding the doctor or specialty provider you need! Preferred Locations Within Find-A-Doc, you ll have access to an extensive list of preferred locations for free or reduced cost radiology, X-ray, laboratory services, and more. Finding the Care You Need Start With Your Doctor In a non-emergency situation, it s important to start with your primary care doctor. He or she knows your health status best and can treat many health issues, from colds and the flu to sprains and insect bites. When choosing a new primary care doctor, consider one who participates in the CDPHP Enhanced Primary Care program. These doctors have proven that they can lower costs while providing better, more comprehensive care. Look for the Enhanced Primary Care icon when searching on Find-A-Doc. Try Doctor On Demand You can visit the doctor from the comfort of home through your mobile device or computer. Doctor On Demand treats many medical and mental health conditions and is available 24/7. Learn more at or download the free app today. 24/7 Account Access In addition to coast-to-coast coverage, you can also access your CDPHP account from anywhere by logging in at ffview your medical, dental, and prescription drug benefits ffreplace missing ID cards ffcommunicate with CDPHP fftrack, submit, and substantiate claims if you have a funding account NOT REGISTERED YET? It s easy! Click the Register link in the login box to create an account. You will need your member ID number (from your ID card) and a few other pieces of identifying information. Urgent Care Before ER If your doctor isn t available, visit an urgent care location before going to the ER. Urgent care has short wait times and is more economical. In fact, visits to the ER are generally not covered for non-emergency services. 825,000 PROVIDERS COAST-TO-COAST Knowing where to go can save you time and money. No Providers 100+ Providers * Available for EPO and PPO plans. Not available for HMO plans. Refer to your member materials or call member services at the number on your ID card to determine complete benefits 4 5
4 Dependable Rx Coverage Prescription medications can have a big impact on your health - and on your wallet. That s why it s important to know how your prescription drug coverage works. CDPHP makes it easy to save at the pharmacy and get the medications you need. A Penny a Pill! * Mail Order ** Save Big at CVS! With Rx for Less, get deep discounts on specific generic drugs at any CVS/pharmacy, Hannaford, Price Chopper/ Market 32, ShopRite, Target, or Walmart. If you take medications for chronic conditions, consider signing up for the Prescription Mail Order Service, which allows you to obtain up to a 90-day supply mailed to your home. Check your CDPHP member ID card to find out which formulary (list of covered drugs) is available with your plan. The tier assigned to a drug determines how much you will pay for it. Excluded drugs are covered only by medical exception, which your doctor can apply for. CDPHP is affiliated with Caremark, a leading national prescription benefit manager. With the Premier Rx network, you can fill prescriptions at virtually all chain store pharmacies and most independents. The CVS ExtraCare Health card offers a 20-percent discount on CVS-brand health products. You ll receive your card in the mail when your plan starts. Ongoing Support CDPHP Customer Connect SM Meet face to face with a CDPHP representative to get answers to your claims and benefit questions, request ID cards, enroll, and more. Please visit customerconnect for hours and additional information. MedCheck CDPHP MedCheck is designed to improve the safety of prescription drug use and the management of chronic disease. Call the number on your member ID card to get started. CDPHP Smoke-Free TM To help our members kick their smoking habit for good, CDPHP partners with Roswell Park Cancer Institute to offer CDPHP Smoke-Free, a no-cost telephonic smoking cessation program. For more details and to join, visit cdphp.com/quitsmoking. Mental Health Counseling If you need mental health support, call Monday through Friday from 8 a.m. to 6 p.m. For help after-hours, call To learn about how you can visit a mental health doctor using your tablet or smartphone, visit or download the free app today. Care Management If you have serious health issues or just want more ways to improve your health, CDPHP has programs that can help. For support or advice, call CDPHP. 6 Visit or call Caremark 24/7 at to find out: ffif a particular drug is covered ffhow much you can expect to pay ffif there is a generic alternative For more information, visit * Rx for Less does not apply to mail order service. ** Specialty pharmacy agents, including injectables and certain drugs used to treat hepatitis C, HIV, multiple sclerosis, and other serious conditions, are not eligible for this program. Get more information about specialty drugs at TELL US WHAT YOU THINK Want to help shape the future of health care? Give your opinions on health and health care topics at insights.cdphp.com/join 7
5 Connect with us! Tell us what you think at insights.cdphp.com/join Get fitness tips, wellness ideas, and more! Follow us on social and visit blog.cdphp.com. Discrimination is Against the Law Capital District Physicians Health Plan, Inc. (CDPHP ) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Multi-language Interpreter Services ATENCIÓN: Si habla otro idioma que no es el inglés, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al número que figura en su tarjeta de identificación de miembro (TTY: 711). 注意 : 如果您使用的語言不是英語, 您可以免費獲得語言援助服務 請致電您會員 ID 卡上的電話 ( 聽力障礙電傳 :711) Contact CDPHP at Capital District Physicians Health Plan, Inc. Capital District Physicians Healthcare Network, Inc. CDPHP Universal Benefits, Inc. 500 Patroon Creek Boulevard, Albany, NY (518) or Form #
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