| Q |
Is
this a health insurance plan? |
| A |
No,
this is a discount program whereby the sponsors of the
program have negotiated to obtain discounts from the providers
of the services and goods to reduce health and consumer
expenses for members. |
|
|
| Q |
Can
I choose any physician? |
| A |
No,
you must choose a physician from our network, which is
extremely large with over 400,000 physicians nationwide. |
|
|
| Q |
What
if my physician or dentist is not in the network? |
| A |
All
you need to do is submit to us in writing the name, address
and telephone number of your doctor or dentist via fax
or regular mail. We will invite him/her to become one
of our providers. However, we cannot guarantee that your
doctor or dentist will join our networks or agree to give
a discount. |
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|
| Q |
How
much do I have to pay when I visit a physician? |
| A |
You
will receive the lowest rate depending on the agreement
with that particular provider. |
|
|
| Q |
Can
I use the health discount services if I have health insurance? |
| A |
Yes.
If your health insurance policy pays a percentage of your
medical bills such as a standard 80/20 indemnity policy,
then the health discount services can be used. The discount
will be applied to the entire bill, which should make
your portion much less than 20%. In many cases, your portion
will be reduced to zero after your deductible with your
insurance company has been met. |
|
|
| Q |
If
I need to go to the hospital, do I need to be pre-admitted? |
| A |
Yes.
You need to contact Galaxy Health Network to obtain a
preauthorization before you go to the hospital. For emergency
room admissions, you must obtain a pre-admission number
the next business day following admission. Remember, since
this is not health insurance, you will be required to
secure payment with a major credit card or health insurance
plan, if any. |
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|
| Q |
How
does the Preferred Prescription Plan (Economy) work? |
| A |
You pay no more than either $3 on one formulary or $10 or less on another formulary for eligible generic
drugs and $20 for eligible brand drugs and receive discounts from 15% to 60% for brand name drugs not on formulary at
over 58,000 participating pharmacies nationwide. For increased
savings on maintenance (long-term) medications, 30 to
90 day supply, we recommend the Mail Order Prescription Drug Benefit available to our
members. |
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|
| Q |
How
much of a discount can I receive from the Dental Care
Plan? |
| A |
You
can receive up to 20% to 50% on dental care through over 19,000
participating dentists nationwide. |
|
|
| Q |
How
does the Eye Med Care Plan work? |
| A |
Locate a provider that is convenient to you, schedule an
appointment, and when you arrive identify yourself as a Eye Med
Care Member and present your card. Eye Med offers its members discounts
15% to 45% on eyeglasses, lenses, contact lenses(excluding disposable). We
also offer substantial discounts on eye examinations and surgical procedures
including LASIK (where available). |
|
|
| Q |
Does
a member need to qualify for any of the discounts or benefits
offered such as the Preferred Prescription Plan? |
| A |
No.
All discounts or benefits are available to all members,
subject to which membership is selected such as either
the Gold Membership or Platinum Membership. |
|
|
| Q |
When
is the Nurseline available? |
| A |
The
Nurseline is available 24 hours a day, 365 days a
year. |
|
|
| Q |
How
much can be saved with the Hearing Care plan? |
| A |
Through
the largest provider of hearing healthcare services and
products in North America, a member can save 30% on all
hearing exams and services and up to 50% on hearing aids. |
|
|
| Q |
Is
a member automatically covered for Basic Accidental Death
and Dismemberment Benefits? |
| A |
Yes,
a member in good standing is automatically covered at
follows:
| • |
Bronze
Membership -
Up to a principal amount of $5,000 for members to
age 70. |
| • |
Gold
Membership -
Up to a principal amount of $10,000 for members
to age 70. |
| • |
Platinum
Membership and Platinum Plus Membership -
Up to a principal amount of $25,000 for members
to age 70. |
| • |
Diamond
Membership and Diamond Plus Membership -
Up to a principal amount of $25,000 for members
to age 70. |
|
|
|
| Q |
How
does the Accident Medical Expense Benefit work? |
| A |
The
Bronze Membership offers members $1,000 maximum benefit
each accidental injury with a $100 deductible each, the
Gold Membership offers members $2,500 maximum benefit
each accidental injury with a $100 deductible each, the
Platinum and Platinum Plus Memberships offer members $5,000 maximum benefit
each accidental injury with a $100 deductible each,
and the Diamond and Diamond Plus Memberships offer members $7,500 maximum benefit
each accidental injury with a $100 deductible each.
|
|
|
| Q |
What
is the difference between Lifeguard Emergency Rescue Plan
("Lifeguard") and the Travel Assistance Plan? |
| A |
Lifeguard
provides members suffering from a "certified injury" emergency transportation by helicopter from the scene
of the accident to the nearest capable medical facility
up to $4,000 per occurrence with a zero deductible and
worldwide coverage. Travel Assistance provides members
access to a worldwide network of medical and travel assistance
personnel and emergency medical evacuation services when
traveling over 100 miles from home and suffering from
a serious illness or injury. Both Lifeguard and Travel
Assistance are subject to review by appropriate medical
personnel.
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|
|
Q |
What are the brand-name and generic drugs? |
A |
A brand-name medicine is determined by the Food Drug Administration (FDA) and protected by a trademark registration of the manufacturing pharmaceutical company. A generic medicine is a therapeutically equivalent drug as determined by the FDA. |
| |
|
Q |
Which prescription drugs are included? |
A |
The Clarity RX Preferred Prescription Plan (Economy) applies to generic prescription drugs listed on the formulary for $10 or less and brand prescription drugs listed on the formulary for $20. Generic prescription drugs on one list are priced at $3. Discounts are also available on most prescriptions not listed on the formulary. To receive benefits, you must present your Membership Card along with the physician’s prescription at a participating pharmacy and remit your payment at that time. |
| |
|
Q |
Which prescription drugs are excluded? |
A |
The Clarity Rx Preferred Prescription Plan (Economy) excludes these drug classifications: diabetic supplies, fertility agents, sexual dysfunction medications, hair replacement products, cosmetic alteration drugs, Retin-A for covered individuals over the age of 18, insulin syringes and accessories, non-legend drugs, or refills in excess of the number authorized or in excess of a month’s supply. However, Clarity Rx does offer mail order discounts on several of these drug classifications. |
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