Can you briefly describe the Hospital Advocacy Program?

The Hospital Advocacy program is designed to help members with their medical bills whenever a single hospital visit totals $2,500. (For the insured, this means the amount you are personally responsible for, aside from your deductible.) Charges can be incurred from multiple providers. The patient advocate negotiates on behalf of the patient and pursues a wide range of options, from government entitlement programs to payment plans. There is a waiting period of three buisness days from the active date of your membership to utilize this program.

How is the discount calculated?

The rates that the provider charges are determined based upon either a set fee schedule that the provider has contracted, or as a percentage off of their billed charges. In general, discounts will vary between 20% and 50%. Labs and diagnostics will have discounts of up to 80%.

Is AmeriPlan Healthcare contracted on an annual basis and cancelable at any time, like Dental Plus?

Yes.

How do I locate an AmeriPlan Healthcare provider?

There are three ways to locate a provider:

1. A provider locator is available at www.ameriplanusaprovidersearch.com. This is particularly useful for medical providers.
2. Call member customer service at 800-647-8421.

Can the AmeriPlan Healthcare program be used with Medicare/Medicaid?

No.Medicare does not allow their providers to charge a Medicare patient a different price.

Are doctors reimbursed by AmeriPlan for their services?

No. As with all of our health programs, the provider receives the full discounted fee from the member at the time services are rendered.

Can members downgrade from AmeriPlan Healthcare to the Dental Plus Program?
Yes.

If the doctor’s office has lab facilities, can these be utilized rather than having to go to another lab?

Yes. The lab services will be billed up to a 40% discount.

Do members receive a fee schedule?

No. Fees will vary by zip code.

Do members receive a separate card for the AmeriPlan Healthcare program?

Yes. Approved household members receive four (4) cards; two AmeriPlan Healthcare ID Cards and two Dental Plus cards.

Are there programs for emergency services?

Yes. Emergency services may or may not be contracted with the AmeriPlan Healthcare program. Depending on the extent of the charges, these services may be eligible for the Patient Advocacy Program.

Will maternity be included?

All medical needs are included as long as we have contracted providers offering this service.

Will the member’s privacy be protected?

AmeriPlan is compliant with all HIPPA regulations.

Does AmeriPlan Healthcare include hearing tests and hearing aids?

Yes.Hearing Services will be included under our Ancillary Services providers.

Does the AmeriPlan Healthcare member have a choice of which hospital will be used?

Yes. The Patient Advocate will negotiate with any hospital of the member’s choice.