How Does the PPO Network Work?
This plan allows members to select any dentist of their choice. When services are provided by an in-network provider, out-of-pocket costs will generally be less than if performed by an out-of-network provider. Services performed out-of-network will be paid based on fee schedule given for each procedure.
In-network benefits are administered by providers who participate in our nationwide argusChoice PPO network. This network encompasses dentists in any of the following networks: DenteMax, Maverest, Connection Dental, Premier, TDA and Healthmart. The argusChoice PPO network has more than 275,000 access points across the United States. When verifying coverages and networks with providers, members need to refer to all the networks listed above.
Out-of-network benefits may also receive applicable network discounts from providers in networks under an agreement with NovaNet, a national network program.
What is a Network Dentist?
Network dentists agree to accept argusChoice PPO’s discounted fees as payment in full for covered services. Non-network dentists can charge you more. This means you will lower your out-of-pocket expense using a network dentist.
You can receive care from any licensed dentist. But your benefits may differ and your out-of-pocket costs could be higher with a non-network dentist.
Locate Participating Providers
Visit https://argusdental.com/find-a-provider and select argusChoice PPO network to locate participating providers.
Health Care Discounts Disclosure
Not available in AK, OK, UT, VT, WA. If you move to one of those states, your discount medical benefits will terminate.
The discount medical, health, and drug benefits of this Plan (The Plan) are NOT insurance, a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members' payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment and supplies from providers in The Plan. You may call (214) 436-8882 or email customerservice@premierhsllc.com for more information or visit myhealthaccountmanager.com for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement.
Note to MA consumers: The discount plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.
HDCP1018-7
Health Care Discounts Disclosure
Not available in AK, IL, OK, UT, VT, WA. If you move to one of those states, your discount medical benefits will terminate.
The discount medical, health, and drug benefits of this Plan (The Plan) are NOT insurance, a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members' payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment and supplies from providers in The Plan. You may call (214) 436-8882 or email customerservice@premierhsllc.com for more information or visit myhealthaccountmanager.com for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement.
Note to MA consumers: The discount plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.
This membership plan includes the First Health Limited Benefit Network. Members have access to a premier national network, which offers:
Broad Access - Choice of nearly 5,100 hospitals, 110,000 ancillaries and more than 695,000 healthcare professionals.
Great Discounts - With average savings of 32-52%** for the most commonly used medical providers/services, Health Depot members benefit from lower out-of-pocket costs through the First Health Network.
Consistent Quality - As a PPO network accredited by the National Committee for Quality Assurance (NCQA), First Health is known for network stability. In fact, 99 percent of our hospitals and 94 percent of our physicians are retained year after year.*
Find In-Network Providers and Facilities
First Health has made finding a health care provider even easier! With the improved Provider Online Search tool, you can quickly and easily locate network providers and make educated health care choices. Go to www.firsthealthlbp.com and follow the steps below to search for a provider and create a provider directory.
If you need more help, select “Contact Us” on the lower left side of the web page to submit an online request. First Health’s Customer Service team will get back to you within 48 hours. Or, you may call (800) 226-5116 Monday through Friday from 8 a.m. to 8 p.m. (Eastern Time). Identify yourself as a health plan participant accessing First Health Limited Benefit Plan Network.
Confirm Participation in the First Health Network
Always check with the provider’s office before scheduling an appointment or getting services and confirm that they are still a participating provider in the First Health Limited Benefit Plan network. Participating physicians, hospitals and other health care providers are independent contractors. They are neither agents nor employees of First Health. The availability of any particular provider cannot be guaranteed. Provider networks are subject to change.
* Network statistics as of December 2017 First Health Data Warehouse.
** Savings shown represent average savings achieved from actual claims data set representative of 12 months of claims history. Discounts do not account for any savings based on benefit plan design or member responsibility. Actual discounts vary by provider and specific geographic locations.
First Health is a brand name of First Health Group Corp. First Health Group Corp. is an indirect, wholly owned subsidiary of Aetna, Inc.
How to Use Your Vision Plan
Using a vision plan administered through MESVision® is easy . . .
Just follow these three simple steps:
1. Select a provider.
Select a participating vision care provider by using the MESVision® provider search feature on our website at www.MESVision.com. Obtaining services from a Participating Provider will maximize your benefits.
2. Make an appointment.
Make an appointment with the Participating Provider of your choice and inform them of your vision coverage.
3. You’re done!
Your participating vision care provider will take care of the rest. The Participating Provider will contact MESVision® to verify your eligible benefits and submit a claim for services covered by your plan.