Health Care Guide
Health Benefits are never easy to understand. As an AmeriCorps VISTA member you receive health benefits that are funded by the Corporation for National and Community Service.
Seven Corners contact information:
866-699-4186 or [email protected]
Explanation of Benefits:
http://americorps.sevencorners.com/docs/bw_guide_10092008.pdf
Health Care FAQ
1. When do my benefits start?
Your benefits start after you have been sworn in at Pre-Service Orientation (PSO).
2. When do I get my insurance card?
Two weeks after you have been sworn in at PSO, you will receive your insurance card in the mail.
Please note: your card may be mailed to your host site, so keep an eye out! If you do not receive a card, of if you lose your card please contact Seven Corners at: 866-699-4186 or [email protected] (they are very good about responding quickly).
3. Is there a co-pay when I go to the doctor?
You will be responsible for a $5.00 co-pay for each medical office visit. This charge will be expected to be paid at the time of your visit and will be deducted the total cost of services.
4. Do the health benefits cover pre-existing conditions?
The coverage for pre-existing conditions are very specific and vary greatly from condition to condition. It is STRONGLY suggested to contact Seven Corners to ask about coverage for any pre-existing condition. In general, most prescriptions for pre-existing conditions are covered, but doctor’s visits for those conditions are not covered. AGAIN, please call Seven Corners about any pre-existing condition you may have.
5. Are preventative doctor’s visits covered under the health benefits?
The only preventative doctor visits that are explicitly covered are women’s “yearly exams.” General physicals are not typically covered. Please contact Seven Corners to ask about specific doctor’s visits.
6. Am I covered for dental care?
Emergency dental services covering care which must be provided immediately for the RELIEF OF PAIN and the correction of the disorder causing the pain are covered. Emergency services covered may include treatment of abscesses, root canals, and extractions, but WILL NOT include cleaning, crowns, dentures, routine fillings, or the routine removal of wisdom teeth.
7. Am I covered for vision?
Charges for an eye examination, replacement of eyeglasses or contact lenses lost or damaged while at the host site can be covered. It is suggested to call Seven Corners for clarification of coverage before going in for any vision visit.
8. What is a PPO?
- Your health plan contains a Preferred Provider Organization (PPO) benefit. A PPO is
a network of physicians, hospitals, and clinics who have entered into an agreement
with AmeriCorps to accept discounted fees for services they provide to AmeriCorps
members.
- AmeriCorps uses the ChoiceCare national PPO network.
- You may search for a network provider from the provider directory at
http://www.americorps.sevencorners.com or call customer service toll free at
866-699-4186 for assistance in locating a provider. If your residence if over 35 miles
from the nearest PPO provider, you are exempt from the PPO guideline. You are
free to see any provider of your choice.
9. How do I get prescriptions?
- PharmaCare is your prescription drug plan administrator.
- Your health care identification card contains all of the information your pharmacist
needs. Simply present your card to have your prescriptions filled at any one of the
network pharmacies in your area. The pharmacy will then electronically transmit a
claim for that medication and within minutes you have approval for filling the
prescription.
- You may obtain up to a one-month supply of your prescription medication form a
retail network pharmacy and up to a three-month supply through the PharmaCare
Direct Mail Service. You may obtain the application online at:
http://www.americorps.sevencorners.com, click on “forms”, and then click on the
“PharmaCare Direct Mail Service” form.
- To find a provider in the PharmaCare network visit: www.pharmacare.com or call
member services at 800-777-1023. Reference the explanation of benefits to find
participating pharmacies on pages 11 and 12 at:
http://americorps.sevencorners.com/docs/bw_guide_10092008.pdf
10. How much do prescriptions cost with our health coverage?
There is NO COPAY for prescriptions. In other words, they are free.
11. Does our plan cover prescriptions for my pre-existing conditions?
Usually, yes. Prescriptions are not excluded because it is used to treat a pre-existing condition. There are some types of prescriptions that are not covered. The full listing can be found on page 13 at:
http://americorps.sevencorners.com/docs/bw_guide_10092008.pdf
Your benefits start after you have been sworn in at Pre-Service Orientation (PSO).
2. When do I get my insurance card?
Two weeks after you have been sworn in at PSO, you will receive your insurance card in the mail.
Please note: your card may be mailed to your host site, so keep an eye out! If you do not receive a card, of if you lose your card please contact Seven Corners at: 866-699-4186 or [email protected] (they are very good about responding quickly).
3. Is there a co-pay when I go to the doctor?
You will be responsible for a $5.00 co-pay for each medical office visit. This charge will be expected to be paid at the time of your visit and will be deducted the total cost of services.
4. Do the health benefits cover pre-existing conditions?
The coverage for pre-existing conditions are very specific and vary greatly from condition to condition. It is STRONGLY suggested to contact Seven Corners to ask about coverage for any pre-existing condition. In general, most prescriptions for pre-existing conditions are covered, but doctor’s visits for those conditions are not covered. AGAIN, please call Seven Corners about any pre-existing condition you may have.
5. Are preventative doctor’s visits covered under the health benefits?
The only preventative doctor visits that are explicitly covered are women’s “yearly exams.” General physicals are not typically covered. Please contact Seven Corners to ask about specific doctor’s visits.
6. Am I covered for dental care?
Emergency dental services covering care which must be provided immediately for the RELIEF OF PAIN and the correction of the disorder causing the pain are covered. Emergency services covered may include treatment of abscesses, root canals, and extractions, but WILL NOT include cleaning, crowns, dentures, routine fillings, or the routine removal of wisdom teeth.
7. Am I covered for vision?
Charges for an eye examination, replacement of eyeglasses or contact lenses lost or damaged while at the host site can be covered. It is suggested to call Seven Corners for clarification of coverage before going in for any vision visit.
8. What is a PPO?
- Your health plan contains a Preferred Provider Organization (PPO) benefit. A PPO is
a network of physicians, hospitals, and clinics who have entered into an agreement
with AmeriCorps to accept discounted fees for services they provide to AmeriCorps
members.
- AmeriCorps uses the ChoiceCare national PPO network.
- You may search for a network provider from the provider directory at
http://www.americorps.sevencorners.com or call customer service toll free at
866-699-4186 for assistance in locating a provider. If your residence if over 35 miles
from the nearest PPO provider, you are exempt from the PPO guideline. You are
free to see any provider of your choice.
9. How do I get prescriptions?
- PharmaCare is your prescription drug plan administrator.
- Your health care identification card contains all of the information your pharmacist
needs. Simply present your card to have your prescriptions filled at any one of the
network pharmacies in your area. The pharmacy will then electronically transmit a
claim for that medication and within minutes you have approval for filling the
prescription.
- You may obtain up to a one-month supply of your prescription medication form a
retail network pharmacy and up to a three-month supply through the PharmaCare
Direct Mail Service. You may obtain the application online at:
http://www.americorps.sevencorners.com, click on “forms”, and then click on the
“PharmaCare Direct Mail Service” form.
- To find a provider in the PharmaCare network visit: www.pharmacare.com or call
member services at 800-777-1023. Reference the explanation of benefits to find
participating pharmacies on pages 11 and 12 at:
http://americorps.sevencorners.com/docs/bw_guide_10092008.pdf
10. How much do prescriptions cost with our health coverage?
There is NO COPAY for prescriptions. In other words, they are free.
11. Does our plan cover prescriptions for my pre-existing conditions?
Usually, yes. Prescriptions are not excluded because it is used to treat a pre-existing condition. There are some types of prescriptions that are not covered. The full listing can be found on page 13 at:
http://americorps.sevencorners.com/docs/bw_guide_10092008.pdf