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8. AmeriPlan® FAQ

FAQ’s
Answers to commonly asked questions.

faq_q.gif Who is AmeriPlan®?
faq_a.gif AmeriPlan® is a Discount Medical Program Organization. We arrange for our members to have access to dental, vision, chiropractic pharmaceutical and medical providers who have agreed to offer their services at negotiated discounts off their usual and customary fees.
faq_q.gif How much discount do Dental Plus™ members get on dental fees?
faq_a.gif Members can save 25% – 65% on all restorative and cosmetic work (fillings, crowns, braces, etc.) and up to 80% on preventative work (teeth cleaning, x-rays, etc.) performed by a general dentist. Specialist fees are discounted 15% to 25%.
faq_q.gif Are ongoing dental/medical problems (conditions) included?
faq_a.gif Since AmeriPlan® is NOT INSURANCE OR A HEALTH ORGANIZATION, all ongoing dental/medical problems (conditions) are accepted except for contracted treatment plans including orthodontic treatment in progress.
faq_q.gif What is the waiting period?
faq_a.gif There is no waiting period before you can start using your program! And, there are instant savings, no paper work to fill out, and no limits on visits to your providers!
faq_q.gif How much is the program membership fee? How do I pay?
faq_a.gif The Dental Plus™ membership is only $19.95 per month for an entire household! A household membership includes all residents in the household including parents, children, relatives, significant others, and all permanent residents of the household! Monthly or quarterly payments are made only by electronic bank draft or credit card. Invoicing is done only for annual memberships paid one year in advance.
faq_q.gif How much more do the Pharmacy, Vision, and Chiropractic programs cost?
faq_a.gif The Prescription Drug, Vision, and Chiropractic programs included with the Dental Plus™ membership at no extra cost!
faq_q.gif Who are the Medical, Dental, Prescription Drug, Vision, and Chiropractic Care providers?
faq_a.gif AmeriPlan® has assembled one of the largest networks of providers in the country, and we are constantly adding to this base. Our network has tens of thousands of medical practitioners, almost 30,000 dentists, more than 12,000 vision care providers, some 50,000 pharmacies and more than 7,500 credentialed chiropractors.
faq_q.gif How do I use the program?
faq_a.gif Within 10-14 days of receipt of your application at corporate headquarters in Plano, TX, you receive a Member Information Guide, Membership Identification card(s), and a Dental, Pharmacy, Vision, and Chiropractic Care Directory. Present your Membership ID card to any AmeriPlan® provider and you will be eligible to receive discounted fees. You pay the provider at the time of service.
faq_q.gif Can I purchase the medical program without including the Dental Plus™ program?
faq_a.gif Yes
faq_q.gif Can the medical program be used in conjunction with health insurance plans?
faq_a.gif Yes, but it is at the physician’s discretion whether to accept both. As with our Dental Plus™ program, a member’s insurance should always be the primary form of payment.
faq_q.gif Will my medical program members receive a discount?
faq_a.gif All members should receive a minimum 15% discount.
faq_q.gif Why would a medical professional participate in the AmeriPlan® Consumer Driven Health Care Program?
faq_a.gif There are many reasons. Some of the most important are:

  1. Patient care and treatment are put back into the physician’s hands.
  2. The provider gets paid at the time of care. Many insurance plans take up to 120 days for payment.
  3. Office administrative costs are reduced. No paperwork to complete, file and follow up on.
  4. Providers may receive a net increase in revenue to the practice versus insurance (HMO or PPO).
  5. The provider is part of an affiliation of like-minded professionals, without being “under the thumb” of managed care.
  6. AmeriPlan® provides members with quality, discounted healthcare.

faq_q.gif Can you briefly describe the Hospital Advocacy Program?
faq_a.gif The Hospital Advocacy program is designed to help members with their medical bills whenever a single hospital stay totals $2,500. Charges can be incurred from multiple providers. The patient advocate negotiates in behalf of the patient advocate and pursues a wide range of options, from government entitlement programs to payment plans.
faq_q.gif How is the discount calculated?
faq_a.gif The rates that the provider charges are determined based upon either a set fee schedule that the provider has contracted, or as a percentage off of their billed charges. In general, discounts will vary between 20% and 50%. Labs and diagnostics will have discounts of up to 80%.
faq_q.gif Are the medical programs contracted on an annual basis and cancelable at any time, like Dental Plus™?
faq_a.gif Yes
faq_q.gif How do I locate an AmeriPlan Health® provider?
faq_a.gif There are three ways to locate a provider:

  1. A dental, vision, prescription and chiropractic directory of providers is included in your member information guide.
  2. A provider locator is available at www.ameriplanusaprovidersearch.com. This is particularly useful for medical providers.
  3. Call AmeriPlan Health® customer service at 800-647-8421.

faq_q.gif Can the Medical Program be used with Medicare/Medicaid?
faq_a.gif No. Medicare does not allow their providers to charge a Medicare patient a different price.
faq_q.gif Are doctors reimbursed by AmeriPlan® for their services?
faq_a.gif No. As with all of our health programs, the provider receives the full discounted fee from the member at the time services are rendered.
faq_q.gif Can members downgrade from AmeriPlan Health® to the Dental Plus™ Program?
faq_a.gif Yes
faq_q.gif If the doctor’s office has lab facilities, can these be utilized rather than having to go to another lab?
faq_a.gif Yes. The lab services will be billed up to a 40% discount.
faq_q.gif Do members receive a fee schedule?
faq_a.gif No. Fees will vary by zip code.
faq_q.gif Do members receive a separate card for the Medical Program?
faq_a.gif Yes. Approved household members receive four (4) cards; two AmeriPlan Health® ID Cards and two Dental Program cards.
faq_q.gif Are there programs for emergency services?
faq_a.gif Yes. Emergency services may or may not be contracted with the Medical Program. Depending on the extent of the charges, these services may be eligible for the Patient Advocacy Program.
faq_q.gif Will maternity be included?
faq_a.gif All medical needs are included as long as we have contracted providers offering this service.
faq_q.gif Will the member’s privacy be protected?
faq_a.gif AmeriPlan® is compliant with all HIPPA regulations.
faq_q.gif Does medical include hearing tests and hearing aids?
faq_a.gif Yes. Hearing Services will be included under our Ancillary Services providers.
faq_q.gif Does the member have a choice of which hospital will be used?
faq_a.gif Yes. The Patient Advocate will negotiate with any hospital of the member’s choice.

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