Questions You Should Ask About Your Unicare Health Plan

Q.Can I change physicians and how?
A.You can go to any participating Physician listed in the Directory at any time. Verify that the physician you are going to see is still part of the network.

Q. Can I go to any hospital?
A. When you need covered hospital care, your participating Physician will arrange for your admission to a participating hospital that your physician admits to. Your Physician will also obtain a pre-authorization from Unicare, if it is required.

This procedure helps keep your out-of-pocket costs down and helps the insurance company work with the hospital to make sure you do not receive any unnecessary medical bills. For covered hospitalizations, your hospital room, medical procedures and physician services are all included.

Q. What do I do in case of a medical emergency, while I am away from home?
A. You go to the nearest medical facility. You or a family member or a friend can notify Unicare of the emergency. They will arrange for you to get the best medical care available.

Q. Can I go out of the network?
A. Yes. The out of network benefits would apply.

Q. Do all members of the family have to use the same physician?
A. No. Each member may go to a different participating Physician (Family Practice, Internal Medicine, Pediatrics etc.)

Q. Is preventive care covered?
A.Yes. Preventive care is covered under your Unicare plans, which includes a yearly well-woman exam and well-baby care on the schedule recommended by your physician and PSA for men.

Q. What about claim forms?
A.If you use a participating physician in the network, you do not need to fill out claim forms or wait for refund checks. If you use an out-of-network physician, you will need to fill out claim forms for out-of-network care.

Q. Where do I go to get prescriptions filled?
A. You may to any major chain Pharmacy (Osco, Walgreens, etc.) in the country. A list of network pharmacies will be given to you.

Q. What is the maximum coverage I have?
A.All plans feature a $5,000,000.00 per member lifetime maximum in benefits. (See the applicable Certificate of Coverage for a specific plan, for a complete list of coverage, conditions, limitations and exclusions).