FAQ's AmeriPlan® USA - Medical Discount Plans

Members Frequently Asked Question (FAQ),

General

• Who is AmeriPlan?
• How do I use a program?
• What is the waiting period?
• Are ongoing dental/medical problems (conditions) included?
• Do members receive a fee schedule?
• Will the member's privacy be protected?

Fees & Discounts

• How much discount do Dental Plus members get on dental fees?
• How is the discount calculated?
• How much is the program membership fee? How do I pay?
• How much more do the Pharmacy, Vision, and Chiropractic programs cost?

Providers

• Who are the Medical, Dental, Pharmacy, Vision, and Chiropractic Care providers?
• How do I locate an AmeriPlan discount Health provider?
• Are doctors reimbursed by AmeriPlan for their services?
• Why would a medical professional participate in the AmeriPlan Healthcare Program?

Medical Program

• Can I purchase the AmeriPlan Healthcare program without including the Dental Plus program?
• Do members receive a separate card for the AmeriPlan Healthcare program?
• Will AmeriPlan Healthcare program members receive a discount?
• Can the AmeriPlan Healthcare program be used with Medicare/ Medicaid?
• Can the AmeriPlan Healthcare program be used in conjunction with health insurance plans?
• Does medical include hearing tests and hearing aids?
• If the doctor's office has lab facilities, can these be utilized rather than having to go to another lab?
• Can members downgrade from AmeriPlan Healthcare to the Dental Plus Program?
• Is AmeriPlan Healthcare contracted on an annual basis and cancelable at any time, like Dental Plus?

Emergency & Hospital

• Are there programs for emergency services?
• Can you briefly describe the Hospital Advocacy Program?
• Does the member have a choice of which hospital will be used?

Who is AmeriPlan?

AmeriPlan is a Discount Medical Program Organization (DMPO). We arrange for our members to have access to medical, dental, vision, chiropractic pharmaceutical providers who have agreed to offer their services at negotiated discounts off their usual and customary fees.

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 up to 25%.

Since AmeriPlan is not insurance or a health organization, all ongoing medical/dental problems (conditions) are accepted except for contracted treatment plans for orthodontic treatment in progress.

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!

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.

The Prescription Drug, Vision and Chiropractic programs are included with both the Dental Plus and AmeriPlan Healthcare membership at no extra cost!

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 and more than 30,000 dentists and 12,000 vision care providers, approximately 50,000 pharmacies and more than 7,500 credentialed chiropractors.

Within 10-14 days of receipt of your application at corporate headquarters in Plano, TX, you receive a Member Information Guide and Membership Identification card(s). 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.

No.

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.

Yes.

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Why would a medical professional participate in the AmeriPlan Consumer driven Health Care Program (AmeriPlan Healthcare)?

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.

The Hospital Advocacy program is designed to help members with their medical bills whenever a single hospital visit totals $2,500. (For the insured, this means the amount you are personally responsible for, aside from your deductible.) Charges can be incurred from multiple providers. The patient advocate negotiates on behalf of the patient and pursues a wide range of options, from government entitlement programs to payment plans. There is a waiting period of three buisness days from the active date of your membership to utilize this program.

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 30% and 50%. Labs and diagnostics will have discounts of up to 80%.

Yes.

There are two ways to locate a provider:

1) A provider locator is available at www.ameriplanusaprovidersearch.com. This is particularly useful for medical providers.

2) Call member customer service toll free at 800-647-8421.

No. Medicare does not allow their providers to charge a Medicare patient a different price.

No. As with all of our health programs, the provider receives the full discounted fee from the member at the time services are rendered.

Yes.

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If the doctor's office has lab facilities, can these be utilized rather than having to go to another lab?

Yes. The lab services will be billed up to a 40% discount.

No. Fees will vary by area.

Yes. Approved household members receive four (4) cards; two AmeriPlan Healthcare ID Cards and two Dental Plus cards.

Yes. Emergency services may or may not be contracted with the AmeriPlan Healthcare program. Depending on the extent of the charges, these services may be eligible for the Hospital Advocacy Program.

AmeriPlan is compliant with all HIPAA regulations.

Yes. Hearing Services will be included under our Ancillary Services providers.

Yes.

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