FirstCare Company Overview As of January 1, 2019, Scott and White - - PowerPoint PPT Presentation
FirstCare Company Overview As of January 1, 2019, Scott and White Health Plan, part of Baylor Scott & White Health, acquired FirstCare Health Plans. Scott and White Health Plan and FirstCare Health Plans are pleased to offer health benefits
1
2
3
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
4
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
5
Extensive network of local options - over 1,300 primary care physicians and 2,700 specialists in 103 counties throughout Texas Urgent and Emergency care available FirstCare Virtual Care-Powered by MDLIVE available 24/7/365, $0 copay for general health services and a $20 copay for behavioral health services Talk to a Nurse—Nurse24™
Urgent and Emergency care available at same copay as In-Network FirstCare Virtual Care-Powered by MDLIVE available 24/7/365, $0 copay for general health services and a $20 copay for behavioral health services Talk to a Nurse—Nurse24™
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
6
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
Deductible $950 per individual/$2,850 per family Out-of-Pocket Maximum (includes medical/drug deductible, copayments & coinsurance) $7,450 per individual/$14,900 per family Office Visit Primary Care $20 Primary Care visits for dependents (age 19 and under) $0 Specialist $70 Inpatient/Outpatient Services 25% after deductible (member share) Preventive Care $0, with no deductible
7
For detailed plan information, please check the latest drug formulary list or contact customer service regarding any prescription changes for this upcoming year.
Deductible $150 per individual
(ACA Preventive and Preferred Generics excluded)
Rx Out-of-Pocket Maximum
Included in plan’s Out-of-Pocket Maximum
Retail 30-Day Supply
*after pharmacy deductible ACA Preventive $0 Preferred Generic $5 Preferred Brand* 30%* Non-preferred Brand/ Non-preferred Generics 50%* Specialty Medications Tier 1 and 2 Tier 3 15%* 25%*
8
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
9
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
10
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
11
12
13
14
15
Abilene Hospital: Hendrick Medical Center Other Regional Hospitals: Anson General Hospital Ballinger Memorial Hospital Coleman County Medical Center Comanche County Medical Center Eastland Memorial Hospital Fisher County Hospital Hamlin Memorial Hospital Haskell Memorial Hospital Heart of Texas Memorial Hospital Knox County Hospital Mitchell County Hospital North Runnels Hospital Rolling Plains Memorial Hospital Stamford Memorial Hospital Stephens Memorial Hospital Stonewall Memorial Hospital Throckmorton County Memorial Hospital
16
Amarillo Hospitals: Baptist St. Anthony’s Hospital (BSA) Plum Creek Specialty Hospital Other Regional Hospitals: Childress Regional Medical Center Collingsworth General Hospital Coon Memorial Hospital Golden Plains Community Hospital Hansford County Hospital Hardeman County Memorial Hospital Hemphill County Hospital Hereford Regional Medical Center Moore County Hospital District Ochiltree Hospital District Pampa Regional Medical Center Parkview Hospital Parmer County Community Hospital Shamrock General Hospital Swisher Memorial Hospital
17
Lubbock Hospitals:
Covenant Health System University Medical Center Grace Medical Center
Other Regional Hospitals:
Brownfield Regional Medical Center Cochran Memorial Hospital Cogdell Memorial Hospital Covenant Health System (Plainview and Levelland) Crane Memorial Hospital Crosbyton Clinic Hospital HealthSouth Rehabilitation Hospital Iraan General Hospital District Lamb Healthcare Center Lynn County Martin County McCamey Hospital Medical Arts Hospital Medical Center Hospital Midland Memorial Hospital Muleshoe Area Medical Center Odessa Regional Medical Center Pecos County Memorial Permian Regional Medical Center Plains Memorial Hospital Rankin County Hospital Reeves County Hospital Seminole Memorial Hospital Scenic Mountain Regional Medical Center Winkler County Memorial Hospital W J Mangold Memorial Hospital Yoakum County Hospital
18
Waco Hospitals:
Baylor Scott and White Medical Center-Hillcress Providence Health Center
Bryan/College Station Hospitals:
Baylor Scott and White Medical Center-College Station
College Station Medical Center
Other Regional Hospitals:
Burleson St. Joseph Health Center Central Texas Hospital Coryell County Memorial Hospital East Texas Medical Center – Crockett & Fairfield Falls Community Hospital Goodall-Witcher Hospital Grimes St. Joseph Health Center Hamilton General Hospital Hill Regional Hospital Huntsville Memorial Hospital Lake Whitney Medical Center Little River Medical Center Llano Memorial Hospital Madison St. Joseph Health Center Metroplex Adventist Hospital Parkview Regional Hospital Rollins Brook Community Hospital Seton Highland Lakes Texas Health Harris Methodist Hospital Stephenville Trinity Medical Center
19
For detailed plan information, please refer to the evidence of coverage and schedule of benefits.
20