If you misplaced your card you can visit your carriers website to print out a temporary card. To get a new card you may contact us or your carrier to replace the old one.

All policies include first dollar Preventive Care benefits, which means FREE to you. As long as the visit is billed as Preventive by the physician’s office and falls within the approved category you will have no charge.

ACA plans are not always more expensive.  Even though they include benefits like maternity coverage and pediatric dental, those plan designs and rates should be considered.  The ACA compliant plans can be less expensive for groups that have an older population or high claims experience.

Every insurance company offers benefits through a specific network of physicians, hospitals and other providers. Your benefits will be reduced if you use a provider that is not in the network. Each insurance company’s website offers a “Provider Search Tool.”  You can also contact your doctors’ office to find out if they are in your network. Look on your insurance card to find the website URL.

A formulary is a list of prescription medications that are covered by an insurance plan.  The medications are categorized as Tier 1 through Tier 4 with Tier 1 being the least expensive and Tier 4 being the most expensive.   Some insurance companies use more than 4 tiers.  If your pharmacy tells you that a drug is not covered, then the first step is to call the customer service number of your insurance company to find out why the medication is not covered. The most common reasons are that a drug is new and not yet on the formulary, has been replaced by a generic medication, or requires that you try less expensive medications before the more expensive one will be approved.  There is also a process where your doctor can submit a request that the medication be approved because of special circumstances.

Coverage can vary from one insurance company to another, so check it out before you travel. It is typical for US based coverage to provide benefits for emergency services only when you are out of the country. It is wise to purchase a travel policy that provides additional medical insurance benefits plus coverage for other expenses you might incur if a medical event happens while you are traveling. Benefits such as emergency travel home or evacuation expenses may be available on travel policy. The cost is minimal and provides valuable benefits when something unexpected happens.

Give our office a call and we can assist with researching the formulary of your prescribed medication.  Also suggest to contact your prescribing doctor to find other alternative medications that may be covered.

An EOB is an Explanation of Benefits. It explains how the insurance company processed your claim.

This is not an unusual situation for doctors offices and pharmacies to deal with at the beginning of the year. Call ComPro we will help you get the information that is necessary for you to go ahead and get your medical services taken care of.

SBC stands for Summary of Benefits & Coverage.  This is a required form by the ACA.  It explains the benefits of your plan in layman’s terms.  It also provides two examples of how claims will be paid for specific situations.