FREQUENTLY ASKED QUESTIONS 23. What if I have Washington’s Basic Health Plan (BHP) coverage? Can I enroll in this plan? Only if you cancel your BHP coverage. You cannot have both. There is a place on the Health Benefit Trust’s enrollment application to indicate the termination date of the current coverage. 24. When will my coverage be effective?
n Individual Providers: Call the Member Resource Center at 1-866-371-3200 to determine.
n Agency Providers: Please contact your Human Resources department to coordinate your enrollment.
Group Health Specific Questions 26. What if I don’t want to see any doctors who practice with Group Health Medical Centers? If you are a new enrollee in the Health Benefits Trust effective 8/1/2012 or later, and you live within 30 miles of a Group Health Medical Center or contracted provider, your health care coverage is only for using Group Health Medical Centers or contracted providers. There is no out-of-network coverage. For all other enrollees, each time you seek health care services, you can choose to use your in-network providers, or not. Your highest level of benefits ($0 deductible) will be found using in-network providers: Group Health Physicians for the POS (Options) plan and First Choice Health Network of Providers for the PPO (Options PPO) plan. You will pay more out of pocket costs by using an out-of-network provider. For example, you will have a $500 deductible. 27. What does Group Health HMO vs. POS vs. PPO mean? If you live within 30 miles of a Group Health facility or contracted provider, and your coverage begins 8/1/2012 or later, you will automatically be enrolled in the HMO plan. If you are already enrolled, then your coverage is through the POS plan. If you live beyond 30 miles, you will automatically be enrolled in the PPO plan. In the POS and PPO plans, you have the choice of in-network or out-of-network providers each time you seek service. 28. How do I look for a provider available to me through Group Health? For POS plan (within 30 miles of Group Health facilities): On right hand side of www.ghc.org, under “Find a Doctor or Medical Facility” click on “Provider & Facility Directory”; then click on “Doctors and Other Providers”; then under “*Health plan provider network:” choose “Options PPO” or “Options Select” 64
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