Download AmeriPlan Healthcare

DISCLOSURES TO CONSUMERS:
These discount medical plans are NOT health
insurance or a MediCare Prescription Drug
Plan. Membership in these programs entitles
you to discounts for certain medical services
and prescription drugs by providers who have
agreed to participate in these discount
programs. These programs do NOT make
payments directly to the providers of medical
services and prescription drugs. The programs’
members are obligated to pay for all healthcare
services, but will receive a discount from those
healthcare providers who have contracted with
these discount programs. The name, address
and specialty of the discount medical and
prescription drug program providers in your
service area are available before purchase and
upon
request
by
logging
on
to
www.ameriplanusaprovidersearch.com or call
the AmeriPlan® Consumer Information Center at
1-800-647-8421.
AmeriPlan® Corporation
5700 Democracy Drive Plano, Texas 75024
A Discount Medical Plan Organization
For more information,
contact AmeriPlan Healthcare® Associate:
Appointment Time/Date
49 95
$
Date __________________________________
Per Month
Family Plan
Time __________________________________
Cell#___________________________________
page 1.
©
2011 AmeriPlan® Healthcare Corporation. All rights reserved.
6.11
page 2.
Dental
Doctors
Dental:
•
MORE THAN 30,000 DENTAL PROVIDERS
NATIONWIDE
•
NO LIMIT ON VISITS OR SERVICES
•
ONGOING DENTAL PROBLEMS ARE
ACCEPTED, (Except Dental and Orthodontic
treatments in progress)
•
INSTANT SAVINGS
•
NO AGE LIMIT
•
NO PAPERWORK
•
NO WAITING PERIOD
•
ORTHODONTICS (braces) AND COSMETIC
DENTISTRY INCLUDED
•
SPECIALISTS INCLUDED, (where available)
•
YOU CAN CHANGE DENTISTS
AmeriPlan®
Fees
•
NO WAITING PERIOD
•
NO PRE-AUTHORIZATION FOR TREATMENT REQUIRED
•
NO PAPERWORK
•
INSTANT SAVINGS
•
SPECIALISTS INCLUDED, WHERE AVAILABLE
•
ALL ONGOING MEDICAL PROBLEMS ARE ACCEPTED
•
COSMETIC SURGERY INCLUDED, WHERE AVAILABLE
•
NO AGE LIMIT
Example of savings on the most procedures in
a general physician’s* office (family physician) and
laboratory fees:
Example of savings on the most
utilized dental procedures:
Sample General
Dental Office
Dentist Procedures*
Fees**
Up To
In office appointments:
AmeriPlan ®
Savings
Up To
Sample General
Physician Procedures*
and Lab Sevices
New Patient
Intermediate Visit
$32
$13
73%
81%
D0210 - Intraoral Complete Series $167
$50
70%
$46
61%
X-Rays
Cleaning
D1110 - Regular Teeth Cleaning
$117
(Light Scaling & Polishing)
AmeriPlan®
Savings
Up To
$227
$110
51%
$170
48%
Established Patient
Limited Visit
$136
Intermediate Visit
$204
$72
$109
47%
46%
$89
$35
71%
$39
$27
30%
Exams
$120
$ 68
AmeriPlan®
Fees
$331
Extended Visit
D0150 - Initial Oral Exam
D0120 - Periodic Oral Exam
Physician*/Lab
Fees **
Up To
Laboratory Fees
Lipid Panel
(Cholesterol, HDL, LDL, Triglycerides)
Fillings
Amalgam Filling (Silver Colored)
D2140 - 1 Surface
Composite Filling (Tooth Colored)
D2330 - 1 Anterior Surface
$182
$45
75%
$209
$70
67%
CBC (Complete Blood Count)
* Specialists’ fees will be slightly higher.
** Physicians fee reference 2011.
**Different fees may apply in different areas of your state.
Root Canal (Excluding Final Restoration)
D3310 - Anterior
D2750 - Porcelain Crown
$933
$375
$1,408
$ 550
60%
56%
(w/High Noble Metal)
* Current Dental Terminology © 2011 American Dental Association,
All Rights Reserved
**National Dental Advisory Service 2011
Different fees may apply in different areas of your state
For the appropriate fees for your area, go to
Orthodontic Treatment (Braces*)
by General Dentist
D8080 - Child (under age 19)
D8090 - Adult (age 19 and over)
$6,205
$6,518
$2,250
$2,400
www.ameriplanusaprovidersearch.com or call
1-800-647-8421
64%
63%
**Different fees may apply in different areas of your state.
page 3.
AMERIPLAN HEALTHCARE IS NOT INSURANCE
page 4.
AMERIPLAN HEALTHCARE IS NOT INSURANCE
Prescriptions Drugs
AmeriDoc
Telemedicine:
Prescriptions:
•
AROUND THE CLOCK PHYSICIAN ACCESS, FOR THE
ENTIRE HOUSEHOLD
•
•
CONVENIENT QUALITY CARE, IS ONLY A CLICK OR A
CALL AWAY
•
•
NATIONWIDE CONVENIENT ALTERNATIVE TO IN-OFFICE
DOCTOR VISITS 24 HOURS A DAY, 7 DAYS A WEEK
MORE THAN 56,000 PARTICIPATING RETAIL AND
INDEPENDENT PHARMACY LOCATIONS NATIONWIDE*
Save 10% - 85% on most brand name and generic prescriptio
drugs**
Save on over the counter medications, smoking cessation
aids and diabetes supplies
•
•
Mail order pharmacy option available
It’s like having a doctor in the family.
•
INFORMATION MEDICAL CONSULTATIONS are
UNLIMITED by telephone or e-mail for medical information
and general advice
•
DIAGNOSTIC CONSULTATIONS 4 PER YEAR FOR UP TO
5 IRS DEPENDANTS IN THE HOUSEHOLD by telephone or
e-mail for evaluation DIAGNOSIS AND PRESCRIPTION
MEDICATION then only $35.00 per diagnostic consultation
•
Call or email a physician 24/7, without long waits at the
doctor’s office
•
Obtain information, recommendations, and prescription
medication, when appropriate
•
Store and share your medical history and personal health records
•
No enrollment periods, insurance forms, or denials based on
pre-existing conditions
Pharmacy discounts are NOT insurance services or a MediCare Prescription
Drug Plan and are NOT intended as a substitute for insurance.
*Discounts are available only at participating pharmacies.
**You may not receive a savings on some high-volume or maintenance type drug
since these medications may have already been reduced at the pharmacy level.
Medical Services
Medical Services:
Additional Medical Services
Hospitals
Hospital Advocacy:
•
National diagnostic imaging and radiology network that
provides discounts of up to 70% on all imaging and
radiographic services, such as MRI’s and Cat-Scans
•
Substantial discounts on all laboratory services of up
to over 80% on all lab tests, such as lipid panels, blood
tests and comprehensive metabolic panels
•
A nationwide network of hearing care professionals
comprised of top researchers, technology providers
and patient practices
•
Discounts of up to 50% on LASIK Vision at a nationwide
network of Board Certified Ophthalmologists
•
Industry leader in providing individuals and families
with discounted diabetic testing supplies. Stop paying
high costs
•
And many more needed medical services
• When you are hospitalized and the anticipated charges
exceed $2,500.00 an advocate will be assigned to you
page 5.
•
The advocate will negotiate the best discount on the
hospital bill and work out a payment plan on the
balance
•
Historically the average discounts negotiated have
been greater than 80% off of the hospitals total charges
•
Depending on your financial situation, and if you are
eligible, your advocate will apply for financial
assistance from various groups to pay off the hospital
balance, on your behalf
•
Throughout the process your advocate will keep you
updated on the status of your case
•
There is only a three business day waiting period from
the active date of your plan to utilize this program
AMERIPLAN HEALTHCARE IS NOT INSURANCE
page 6.
AMERIPLAN HEALTHCARE IS NOT INSURANCE
Plan Features
Vision
Vision:
•
MORE THAN 12,000 OPTICAL PROVIDERS NATIONWIDE
•
SAVE FROM 20% TO 60% on all frames,
lenses, tints, scratch-resistant coatings and ultra-violet
protection
Program features:
• NATIONWIDE NETWORK OF PROVIDERS
•
INSTANT SAVINGS
•
SAVE FROM 10% TO 50% on ophthalmology eye exams,
and LASIK surgery with certain providers in selected markets
•
NO AGE LIMITS
•
SAVE FROM 10% TO 20% ON CONTACT LENSES
(excluding disposable) at participating retail locations
•
NO PRE-AUTHORIZATION FOR TREATMENTS REQUIRED
•
SPECIAL SAVINGS FROM 10% TO 40% ON
REPLACEMENT CONTACT LENSES. Including daily wear,
extended wear, disposable, tinted, bifocals and gas
permeable*
•
NO LIMITS ON NUMBER OF VISITS
•
SPECIALISTS INCLUDED, WHERE AVAILABLE
•
CHANGE PROVIDERS AS DESIRED
•
NO PAPERWORK
•
EVERYONE LIVING IN THE HOUSEHOLD INCLUDED FOR
ONE LOW MONTHLY FEE
•
PLUS MUCH, MUCH MORE!
•
ADDITIONAL DISCOUNTS on designer non-prescription
sunglasses with the world’s largest online optical store**
•
30-DAY UNCONDITIONAL money-back guarantee on
all merchandise
*Mail order only
**Internet program only
Chiropractic
$
Chiropractic:
•
•
•
•
•
4995
Per Month
Family Plan
MORE THAN 7,500 PARTICIPATING DOCTORS
FREE INITIAL CONSULTATION
50% SAVINGS on all diagnostic services and required x-rays
30% SAVINGS on treatment and most other services
NO LIMIT on number of visits
Podiatry
Podiatry:
Foot and ankle specialists provide comprehensive management,
through medical or surgical methods, of a wide variety of
problems that affect foot and ankle function
Page 7.
AMERIPLAN HEALTHCARE IS NOT INSURANCE
page 8.
AMERIPLAN HEALTHCARE IS NOT INSURANCE
5700 Democracy Drive
Plano, Texas 75024
AmeriPlan Healthcare® Membership Application
Member Information
First Name
MI
Date of Birth of Applicant
Male/Female
IBO #
Last Name
Residence or Work Telephone
Alternate Telephone
Mailing Address
Apt.#
City
State
Last Name
Date of Birth
Household Members
First Name
Zip
LIST
ADDITIONAL
HOUSEHOLD
MEMBERS ON A
SEPARATE SHEET
OF PAPER.
E-MAIL ADDRESS
By submitting your enclosed check or credit card information you are authorizing an ongoing monthly draft. If you are not satisfied within 30 days of receiving your membership
cards, you may cancel and receive a refund of the membership fee paid, except the one-time registration fee. All cancellations require a 30-day written notice. Cancellation
notifications may be sent by mail, fax or email to [email protected].
AMERIPLAN HEALTHCARE IS NOT INSURANCE
I WANT TO PAY MY MONTHLY MEMBERSHIP FEE BY:
BANK DRAFT: Enclose your check for payment and a voided check if paying
monthly by bank draft.
CREDIT CARD:
Card #
Visa
MasterCard
AmerPlan Healthcare®
Monthly Individual Fee:.........................$49.95
Discover
American Express
Expiration Date
One-Time Registration Fee..................$30.00
NON-REFUNDABLE
X
TOTAL AMOUNT DUE
$79.95
SIGNATURE FOR CREDIT CARD OR BANK DRAFT
AMP014R (6/11)
MONTHLY PAYMENTS MUST BE MADE BY ELECTRONIC BANK DRAFT OR BY CREDIT CARD.
page 9.
If your application is processed between the 4th through the 18th of this month, your first draft will be on the 18th of next month, and each month thereafter.
If your application is processed between the 19th of this month through the 3rd of next month, your first draft will be on the 3rd of the following month, and each month thereafter.
AmeriPlan Healthcare®
A subsidiary of AmeriPlan® Corporation has designed a medical program specifically for business
owners and employees at highly discounted rates. We understand the need to provide employers
and their employees with medical access that is affordable as well as beneficial.
• NO QUALIFYING FOR
EXISTING CONDITIONS
• NO WAITING PERIODS
• NO LIMITS
• NO EXCLUSIONS
• NO DEDUCTIBLE
AmeriPlan® Corporation...the nation's premier Discount Medical Plan Organization, saving its
members hundreds of millions of dollars in discount healthcare benefits since 1992.
AmeriPlan® is the largest discounted fee-for-services program of its type in the country. Our track
record of success in providing access to affordable discount healthcare speaks for itself. We know
our business.
Members and providers...the AmeriPlan® network is strong and growing!
30,000 + Dental Providers
60,000 + Medical Providers
7,500 + Chiropratic Providers
56,000 + Retail Pharmacies
12,000 + Optical Providers
4,000 + Hearing Care Providers
Are you following the latest trends and statistics?
AmeriPlan Healthcare® is positioned within the marketplace to take advantage of the biggest
demand for our type of healthcare in decades...7 out of 10 Americans are uninsured or underinsured. For AmeriPlan Healthcare® members and providers, this presents the opportunity
of a lifetime!
Page 10.
AMERIPLAN HEALTHCARE IS NOT INSURANCE