PLAN C
HEALTHSHARE CONNECTION
PLAN A + PLAN B = PLAN C
PLAN C
FREE Annual Preventative Health & Wellness Check
Prescription Discount Card
In-office Copay Program
- Doctor’s Visits
- Urgent Care
- Physical Therapy
- Specialists Visits
- Chiropractic
- Out Patient Testing
- Dental
- Vision
Total Telehealth Package Through Lyric Including
- Online Primary Care Physician
- Online Urgent Care
- Online Mental Health Therapy
- Online Dermatology
- Care Navigation
- 24/7/365 Phone or Video Appointments
- Prescription Writing As Necessary
Hospital Treatments And Services
- In-patient Procedures
- Out-patient Testing
- Emergency Room
- Acute Hospital Care
- Sub-acute Health Care
- Covid-19 Care
- Maternity (See Conditions)
- Surgeries
Medical Therapies
- Speech Therapy
- Respiratory Therapy
- Physical Therapy
- Occupational Therapy
Ambulance Services
Home Healthcare
Accident Care
Physician’s Services
Limb Prosthetics
Chiropractic Treatments
Request a Quote
ADDITIONAL FEES
(per member, per month)
SMOKING / VAPING FEE
$75
ADULT CHILD DEPENDENT FEE
$50
ADDITIONAL DEPENDENT FEE
$25
** PLEASE REFER TO THE MEMBERSHIP RESOURCE GUIDE FOR SPECIFICATIONS REGARDING TREATMENT OPTIONS
This plan is offered to include unlimited annual medical needs with a non-shareable amount of $1500 per need.
Members must only pay their non-shareable amount of $1500 for the first 3 (individual member) or 5 (family plan) needs.
FREE TOTAL TELEHEALTH BY LYRIC 24/7/365
BEHAVIORAL HEALTH AVAILABLE FOR A MINIMAL COPAY
ADDITIONAL FEES
SMOKING/VAPING FEE: A $75 fee will be assessed per member, per month for any smoking or vaping members. This total will be added to your monthly billed fees.
ADULT CHILD DEPENDENT FEE: A $50 monthly fee will be assessed for any adult child dependents on a family plan if they are not enrolled in college or a trade school. Adult children are defined between the ages of 18-26. All child dependents must be unmarried to qualify as a dependent on a family plan. Verification may be requested.
ADDITIONAL DEPENDENT FEE: HealthShare Connection Family Plans are available for up to 5 members. Additional legal dependents can be added to a family plan for $25 per month, per additional dependent.
HOW DOES IT WORK?
Plan C introduces this comprehensive benefit plan as a viable
alternative to traditional health insurance for today’s modern
healthcare user. With the combination of Plan A and Plan B, members have coverage options for their immediate healthcare needs such as telehealth, in-office doctor’s visits, dental, vision and Urgent Care needs. These services can be utilized with NO DEDUCTIBLE and just a simple, low co-pay.
Additionally, members have access to shared membership funds available for larger, more expensive medical needs. This portion of the membership provides payment for services such as hospitalization, emergency room services, accident care, and more. The larger medical expense claims may be subject to a Non-Shareable Amount of up to $1500 per need. This amount can be lessened by the combined payments made by the member and HSC towards the medical need. Please see the Member Resource Guide for more information.
HSC COST-SHARING PROCESS
Member has a large medical expense relation to a new injury or illness:
IN-OFFICE COPAY PROGRAM
| COVERAGE | COPAY | COVERED BILLED CHARGES |
|---|---|---|
| General Office Visists | $25 | Up to $1000 |
| Specialist / Behavioral Health Office Visit | $25 | Up to $1000 |
| Chiropractic / Physical therapy Office Visit | $25 | Up to $1000 |
| Urgent Care Visits | $50 | Up to $2000 |
| Lab Work | $25 | Up to $2000 |
| Out-Patient Testing | $200 | Up to $2000 |
| Dental | $25 | Up to $1500 |
| Vision | $25 | $100 Office & $100 Glasses |
PREVENTATIVE WELLNESS CHECK
COVERED SERVICES
COVERED PREVENTATIVE SERVICES
ALL ADULTS
- Blood pressure screening
- Cholesterol screening
- Type II Diabetes screening
- Diet counseling
- Syphilis screening
- HIV Screening (ages 15-65)
- Sexually transmitted infection
prevention counseling - Tobacco use screening for all adults
and cessation interventions for tobacco users - Alcohol misuse screening and counseling
- Tuberculosis screening
- Depression screening
- Aspirin use for adults ages 50-59 to prevent CVD and colorectal cancer
- Colorectal cancer screening for adults 45-75 years
- PrEP (pre-exposure prophylaxis)
HIV prevention medication for HIV Negative adults at high risk
- Immunizations: (Varicella, Hepatitis A&B, Shingles, Influenza, Measles, Mumps, Tetanus, Rubella, HPV, Meningococcal, Pneumococcal, Diphtheria, Pertussis)
- Abdominal aortic aneurysm one-
time screening for men ages 65-75 - Fall prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over
- Statin preventive medication for adults 40-75 years at high risk
- Obesity screening and counseling
- Lung cancer screening for adults 50-
- 80 years at high risk for lung cancer
- Hepatitis B screening for people at
high risk - Hepatitis C screening adults 18-19
years
COVERED PREVENTATIVE SERVICES
WOMEN’S SERVICES
- Birth control (see prenatal/postnatal below)
- Bone density screening for women over 65 years or women 64 years and younger who have gone through menopause
- Breast cancer genetic test counseling (BRCA)
- Breast cancer screening mammogram every 1-2 years for women 40 years and older
- Breast cancer chemoprevention counseling
- Cervical cancer screening (Pap smear)
- Chlamydia infection screening
- Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant
- Domestic and interpersonal violence screening and counseling for women
- Gonorrhea screening
- HIV screening and counseling
- PrEP (pre-exposure prophylaxis HIV prevention medication for HIV-negative women at high risk
- Sexually transmitted infections counseling
- Tobacco use screening and interventions
- Urinary incontinence screening for women yearly
- Well-woman visits
COVERED PREVENTATIVE SERVICES
PRENATAL / POSTNATAL SERVICES
- Breastfeeding support and counseling from trained providers, and access to breastfeeding supplies for pregnant and nursing women
- Birth control including: diaphragms, sponges, birth control pills and vaginal rings, intrauterine devices (IUDs, Plan B® and ella®, sterilization procedures, patient education and counseling
- Folic acid supplements
- Gestational diabetes screening for women 24 weeks pregnant or later or higher risk
- Gonorrhea or Syphilis screening for women at higher risk
- Maternal depression screening for mothers at well-baby visits
- Pre-eclampsia prevention and screening
- Rh-incompatibility screening including follow-up testing
- Expanded counseling for pregnant tobacco users
- Urinary tract or other infection screening
COVERED PREVENTATIVE SERVICES
NEWBORN SERVICES
- Bilirubin concentration screening
- Blood screening for newborns
- Fluoride varnish for all infants and children as soon as teeth are present
- Gonorrhea preventive medication for the eyes
- Hearing screening
- Hemoglobinopathies or sickle cell screening
- Hypothyroidism screening
- Immunizations: (Varicella, Hepatitis A&B, Flu Shot, Inactivated Poliovirus, Measles, Mumps, Tetanus, Rubella, HPV, Meningococcal, Pneumococcal, Diphtheria, Pertussis, Rotavirus, Haemophilus flu type b)
- Phenylketonuria (PKU) screening
COVERED PREVENTATIVE SERVICES
ALL CHILDREN SERVICES
- Alcohol, tobacco, and drug use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Blood pressure screening for children
- Depression screening beginning routinely at age 12
- Developmental screening for children under age 3
- Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders
- PrEP (pre-exposure prophylaxis) HIV prevention
- medication for HIV-negative adolescents at high risk
- Sexually transmitted infection prevention counseling and screening for adolescents
- Tuberculin testing
- Fluoride supplements
- Hearing screening for children and adolescents as recommended by their provider
- Height, weight and body mass index (BMI)
measurements taken regularly - Hematocrit or hemoglobin screening for all children
- Hepatitis B screening for adolescents at higher risk
- HIV Screening for adolescents at higher risk
- Lead screening for children at risk of exposure
- Obesity screening and counseling
- Oral health risk assessment, 6 months to 6 years
- Vision screening
- Well baby and well-child visits
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Of Doctors Conveniently Located Near You!
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Locate A Medical Provider In The PHCS Network
Of Doctors Conveniently Located Near You!