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PPO

The HealthPlus PPO offers In-Network and Out-of-Network health care coverage benefits that will support a subscriber’s healthcare needs, regardless of where they live, work or travel.

The PPO offers subscribers the following:

Benefit Information  

The HealthPlus PPO ID card highlights important information providers will want to utilize at the point of contact.

  • Front of the card includes: copay information, as well as individual and family deductibles and In and Out of Network Coinsurance.
  • Back of the card reflects: important Prior Authorization information, claim submission address, telephone numbers and the networks subscribers are covered through, when traveling outside of the core service area.

Subscriber benefit summaries, are available for review by providers while checking eligibility on our secured,on-line provider service center. Viewing benefit summaries will assist the provider in better understanding the benefits available to the subscriber, as well as the level of reimbursement that should be collected by the provider, at the time services are rendered.

Claim Submission  

  • Submit in-network claims directly to HealthPlus, as noted on the back of the card.
  • Out-of-Network claims maybe submitted by the provider, on behalf of the subscriber, however, they are not required to do so, as the subscriber is responsible for ensuring claims are submitted to HealthPlus, as noted on the back of the card.

For more information about the HealthPlus PPO plan, please contact HealthPlus Customer Service at (888) 212-1512.