These clinics can provide many of the same services as at your doctor’s office, like lab work and X-rays. Urgent care centers are set up to provide same-day care for a variety of minor health conditions-from colds and rashes to muscle sprains and achy joints. Many doctors have times set aside for urgent appointments or extended hours, so you might be able to get in to see a doctor the same day. If it’s during regular business hours, call your doctor’s office first. You see your SCAN doctor for most of your healthcare, but what if you need care that can’t wait for a regular doctor’s appointment? With SCAN, you’re covered for urgent care visits but it’s good to know a few things before you go.Īn urgent care center is for the times when you need minor medical care sooner than you can get in to see your regular doctor. A prior authorization could be required for tier 3 medications.Important: If you need immediate emergency care and/or are unable to drive yourself to the hospital, call 911.Īll SCAN plans offer an urgent care services benefit. If you select a brand-name drug on the PDL, you will pay a higher copayment. If you are prescribed a brand-name drug that has a generic available, the generic must be dispensed to receive the lowest (tier 1) copayment. Generic medications on the Prescription Drug List (PDL) have the lowest copayment. Why can’t I get a brand-name drug when a generic is available?.If based on the medical record, the member meets the criteria, a prior authorization would be approved. If I’ve already been established on a medication, will it be covered?Įvery request is reviewed on a case-by-case basis.What is my financial responsibility for routine services such as office visits and physicals?. ![]() Refer to your certificate of coverage or call Customer Service for specific details about your non-network benefits. Some covered services under your non-network benefits will apply to a deductible and/or have coinsurance any deductible, coinsurance, and copays are your responsibility to pay. Generally, non-network benefits have higher out-of-pocket costs. For example, preventive services are covered only through network providers. Some services normally covered when you use your network benefits may not be covered if they are provided by a non-network provider. ![]() Are there benefit restrictions if I see a provider who does not participate with PHP?.To confirm your current provider participates with PHP, you may also call your provider’s office to verify. To search for PHP providers, visit our Provider Directory and choose "HMO/POS" as your plan. What is the preferred method of searching for a provider?.If your specialist still wants a referral from your PCP, call your PCP and tell him or her your specialist is asking for a referral. However, some specialists may still require a referral from your PCP. PHP does not require referrals to participating specialists. Do I need to get a referral to see a specialist?.For example, you can assign an OB-GYN or pediatrician to be your primary care doctor. No, you can assign your specialist as your primary care doctor. ![]()
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