What is Fitness First Healthcare? Is Fitness First Healthcare a Healthcare Network? Why would a doctor or provider want to be in the network? I have a history of health problems. Can I still participate? Should I cancel my insurance? How can I use this program with my medical insurance? Who qualifies as my dependents? Is there a limit to the number of dependents I can have? What is my effective date after I enroll? How soon will I receive my membership handbook and membership cards? Can I use the Fitness First Healthcare benefits before I receive my member ID cards? Are there any waiting periods? How do I pay for my membership? Can I send in my payment every month? How do I locate a provider in my area? Can I get a printout of the doctors in my area? What if I can’t locate a provider in my area? How does a Provider Nomination work? Why has my doctor never heard of Fitness First Healthcare? What do I have to do at the doctor's office?  What is Medical Re-pricing?  If I sign up for more than one program, do I have to pay an enrollment fee for each program? Can I change from one program to another? Can I cancel my membership at any time?  Can I get a refund when I cancel? Are there any claim forms to fill out? How do I file a claim? Do I have to pay any deductibles?  How much do I pay at the doctor?  What happens when I go into a hospital? What if I go to the Emergency Room? What if I can’t pay my bill on time? What types of dental discounts can I expect? What vision care discounts are available? What about chiropractic and alternative medicine? I used my card but didn’t get a discount on my prescription. Why not? It looks like there are two different Pharmacy Programs. Is this true? Is there a limit to the number of times I can use my benefits? Do I have to pay any co-pays? How much do I have to pay at the dentist? What if a provider does not honor a discount? Can I make payment arrangements to pay off my hospital bill? How is it possible to offer some limited insurance benefits without a license? If I move or am traveling to another state, can I still use my benefits? What happens if I leave my employer? Who do I call if I have more questions?     What is Fitness First Healthcare?  Fitness First Healthcare is a healthcare savings program. We have contractual arrangements with nationwide networks of healthcare providers who offer our members preferred rates and/or percentage discounts at the time of service. We are also affiliated with a benefits Association, giving our members access to limited insurance benefits through master policies issued to the Association. Fitness First Healthcare is NOT a major medical insurance plan or policy. Is Fitness First Healthcare a Healthcare Network? No, Fitness First Healthcare is not a medical or healthcare network. Fitness First Healthcare has contractual affiliations with different networks through a third party. The network providers that you access are not directly contracted to Fitness First Healthcare. Refer to you membership materials to identify the different affiliated networks, and study your membership ID card to identify the different network logos. Why would a doctor or provider want to be in the network? Providers want to be "on the list" so they can build their client/patient base. Because they are paid at the time of service, they do not incur the usual administrative costs associated with claim forms and following-up on unpaid accounts. Statistics show that 33% of all claims are not paid to providers despite the follow-up. Often providers must wait 90 to 120 days even for the paid claims. So, by offering our members a discount when they pay at the time of service, the providers increase their immediate cash flow and reduce collection expenses.   I have a history of health problems. Can I still participate? Yes. Everyone is accepted for membership regardless of any prior health condition. However, some of the limited insurance benefits available through the Consumer Assistance Services Association do not cover any injury or illness that occurred or manifested itself prior to your membership becoming active. Should I cancel my insurance?  No, do not cancel your insurance. Fitness First Healthcare is NOT a comparable replacement for traditional or major medical health insurance. You may, however, be able to use certain Fitness First Healthcare benefits with your traditional insurance program. How can I use this program with my medical insurance?  It is possible that Fitness First Healthcare might complement your insurance program. In other words, the two programs might work together. Generally, if you are receiving care that is not covered by your insurance program, or if you have high deductibles to meet before your insurance takes effect, you can use your Fitness First Healthcare membership in place of the insurance.  However, since there are many different types of insurance programs, you should ask your representative to assist you in evaluating how your program would work with Fitness First Healthcare. Who qualifies as my dependents?  Your spouse and all unmarried children under age 18, or under 23 if they are a full-time student, are included in your membership. Is there a limit to the number of dependents I can have?  There is no limit. Eligible dependents include your spouse and all unmarried children under age 18, or under age 23 if they are a full-time student. What is my effective date after I enroll?  Your effective date  will either be the 15th of the current month or the 1st of the coming month, whichever is next based on the day your enrollment is received by Fitness First Healthcare. How soon will I receive my membership handbook and membership cards? Expect to receive your member handbook and ID cards within about 10 business days after your  enrollment is processed by Fitness First Healthcare. This is usually the first day of the month following your enrollment in the Fitness First Healthcare program. For example, if you completed your enrollment and it was submitted to Fitness First Healthcare on May 12th, your Effective Date would be June 1st. Can I use the Fitness First Healthcare benefits before I receive my member ID cards?  Do not schedule any appointments prior to receiving your membership materials. It is important that you review these materials in detail so the program will work efficiently for you. If you do not receive your ID cards and other materials within 10 business days after your effective date, please call Member Services to report this. Should you suffer an unexpected illness or injury prior to receiving your member materials, please notify Member Services so they may assist you. Are there any waiting periods?   Other than waiting for your effective date and member ID cards, there is no waiting period before you can begin using your program!  However, the Dental Indemnity benefit has 90 day waiting period for basic procedures and 24 months for major procedures. How do I pay for my membership?  Your credit card or bank account (checking or savings) will automatically be charged every month. You also have the opportunity to pay on an annual basis. Can I send in my payment every month?  No. In an effort to keep costs down for all our members, Fitness First Healthcare does not send out monthly invoices or accept monthly payments by mail. How do I locate a provider in my area?  Start with a "Provider Search" at www.fitnessfirsthealthcare.com. THEN CALL MEMBER SERVICES AT 866-954-2461 TO VERIFY THAT A PROVIDER YOU SEE ONLINE IS STILL ACTIVE IN THE NETWORK. Can I get a printout of the doctors in my area?  The best way to obtain the most current list of participating providers is to visit our website at www.fitnessfirsthealthcare.com and print out whatever you need from our Provider Search page. What if I can’t locate a provider in my area?  You can use our Provider Nomination Form to nominate a provider for participation in the network. You can obtain a form by calling Member Services at 866-954-2461. How does a Provider Nomination work?  Always talk with the provider prior to nominating him or her. Then complete the Provider Nomination form and submit it to Member Services. They will forward it to the appropriate network, according to your membership program. From that point forward, the NETWORK, not Member Services, will communicate with the provider, inviting them to become a participant. It is the provider’s choice to accept or reject the invitation from the network. Be aware that the nomination and application process can take several months, and that neither Fitness First Healthcare nor Member Services has a way to track the progress. Why has my doctor never heard of Fitness First Healthcare? First of all, always verify with Member Services that your doctor is active with the network, and remember that Fitness First Healthcare is NOT the network. Your doctor does not have a direct contract with Fitness First Healthcare. Your doctor has a contract with the national network identified on your ID card (example: "Galaxy"). Refer to your membership manual and ID card to identify the network. What do I have to do at the doctor's office?  Prior to going to the doctor, please call Member Services to locate a participating provider in your area or to verify that your doctor is in the network. Member Services will call the doctor’s office in advance of your appointment to answer any questions they may have regarding your program. At a doctor’s office, present your ID card with the appropriate network logo on it and tell them you are eligible for "re-pricing." Your card instructs them to call Member Services at 866-954-2461 for the re-priced amount or if they have any questions. What is Medical Re-pricing?  Your medical bill will be "re-priced" or discounted according to the contract your doctor has with the network. At your appointment, the office staff will call Member Services at 866-954-2461 to have your bill re-priced. You then pay the re-priced amount at the time of service. With this benefit you can expect to save 10%-30% and sometimes more. If I sign up for more than one program, do I have to pay an enrollment fee for each program?  No, not if you sign up for both programs at the same time. However, if you enroll on one of the Select Programs and then sign up for the Rx Advocacy Program later, you are responsible for the Registration Fee on each program. There is also a $10 administrative fee if you should choose to change your program at some point. Can I change from one program to another?  Yes. Simply request this in writing. There is a $10 "Change-Fee" associated with any program changes to cover administrative costs and send out new membership materials. If you are changing to a higher-priced program, you will also pay the difference between your current program and the new program plus the $10 Change Fee. Can I cancel my membership at any time?  You can cancel your membership in writing (email, fax, USPS) at any time. We must receive the request at least 10-days prior to your next scheduled payment in order to stop that payment. Can I get a refund when I cancel?  Your one-time registration fee is nonrefundable. However, if you decide to cancel your membership within 30 days from the date of your enrollment, Fitness First Healthcare will refund your monthly membership fee. Otherwise, any payments already made are nonrefundable. Are there any claim forms to fill out?  Most of the time you will simply pay a reduced fee at the time of service, and there is no claim for this. However, if your program includes limited insurance benefits (refer to your membership manual) you may need to fill out a form to file a claim. How do I file a claim?  Contact Member Services to request a claim form. Complete the form and return it according to the instructions provided. Do I have to pay any deductibles?  If your Fitness First Healthcare program includes the Accident Medical Benefit, then you have a $100 deductible per occurrence for this benefit. Also, there is a $50 annual deductible per person for the Dental Indemnity benefit. Otherwise, there are no deductibles, and you may begin saving with Fitness First Healthcare as soon as your membership is active. How much do I pay at the doctor?  Some benefits, such as Dental Discounts and Vision Discounts have published fee schedules. Others have a published percentage of savings. However, with the Medical Re-Pricing benefit it is difficult to predict the amount of savings in advance, since amount of savings will depend on the contract between the provider and the network, and the charges will vary depending on the procedures performed. However, usually the savings for most services will be 10%-30%. What happens when I go into a hospital?  For SCHEDULED hospital stays, you must Pre-Certify through Member Services in order to receive the preferred network rates. You may be required to pay a deposit before the scheduled hospital stay. The deposit will be credited toward you bill. You must pay you total bill within 30 days or you may forfeit the savings you receive on the re-priced bill. If you cannot pay the total bill within 30 days, contact the billing office to see what payment arrangements might be available. What if I go to the Emergency Room?  If the hospital is "in-network" you will pay the preferred network rates. Also, if the ER visit is due to accidental injury, you may qualify for an insurance reimbursement, depending on your program. What if I can’t pay my bill on time?  Do not hesitate to contact the billing office at the facility that is billing you. You may be able to arrange other payment options and still receive the network discount, but this is entirely up to the healthcare provider, not Fitness First Healthcare or the network. What types of dental discounts can I expect?  You can save up to 50% on dental care through a nationwide network of over 22,000 participating dentists. What vision care discounts are available?  You should expect to save 5%-50% on a wide variety of vision services and products offered through over 18,000 participating vision centers across the country. What about chiropractic and alternative medicine?  As a member, you can expect to save up to 30% of reasonable and customary charges through one of the largest integrated networks of chiropractors and other top qualified alternative medicine providers in the nation. I used my card but didn’t get a discount on my prescription.  Why not?  Pharmacies are in constant competition with one another and often sell drugs as "loss-leaders", meaning they sell them at or below cost, to attract customers to their store. This is especially true for popular brand-name drugs. If the pharmacy has already discounted the drug, you will pay which ever price is lower. It looks like there are two different Pharmacy Programs. Is this true?  Yes, there are two different pharmacy programs. The Rx Discount and Mail Order program is included in Fitness First Healthcare’s Select Programs. Save up to 30% at retail outlets and up to 40% through mail order with this program. We also offer as a separate membership on our Rx Advocacy Program which has a 4 tier prescription program. This program offers our members the opportunity to pay just $10, $20 or $40 for select generic and brand name drugs, and receive discounts on others. You can do a drug search and get pricing information for this program on our website. Is there a limit to the number of times I can use my benefits?  No, there is no limit. We encourage you to use your Fitness First Healthcare membership as often as you can. If your program includes limited insurance benefits, be aware that these benefits may have a "per occurrence", deductible or annual limitations. Do I have to pay any co-pays?  No, there are no co-pays with Fitness First Healthcare. You are expected to pay 100% of your re-priced or discounted bill at the time of service. For example, if you have a doctor’s office visit which is $85 and the repriced (discounted) bill is $60, then you would need to pay the $60 before you leave the doctor’s office. If your Fitness First Healthcare program includes limited insurance benefits, you may then be able to file a claim. Refer to your membership manual for more information. How much do I have to pay at the dentist?  Your Dentist will charge you based on a fee schedule. Refer to the sample fee schedule in your member manual. You may also call the number listed in your manual for specific fee information for you zip-code area and the procedures that you are going to have done at the dentist. What if a provider does not honor a discount?  Firstly, remember to always call Member Services at 866-954-2461 prior to an appointment to verify that a provider is active with the network. However, if you are at your appointment and the office has questions, ask them to call Member Services. Can I make payment arrangements to pay off my hospital bill?  Sometimes providers will agree to a payment program, but if you do not pay in a timely manner you may forfeit the preferred network rates. How is it possible to offer some limited insurance benefits without a license?  Fitness First Healthcare is not an insurance company, and we do not sell individual insurance programs or policies. As a member, you are affiliated with the Consumer Assistance Services Association. Because of this membership, you have access to certain limited insurance benefits through Master Policies issued to the Association. If I move or am traveling to another state, can I still use my benefits?  Yes, you can use Fitness First Healthcare while traveling anywhere in the US. If you move, contact Fitness First Healthcare administration through Member Services at 866-954-2461 to change your address. What happens if I leave my employer? If your current employer is providing Fitness First Healthcare as a benefit and you leave your job, contact Fitness First Healthcare through Member Services at 866-954-2461. You simply need to inform them that you need to change your payment option and they will make the necessary payment arrangements with you for future monthly payments. If this is done prior to your the end of your employment period, you should experience no interruption in your benefits and no increase in your monthly payment! Who do I call if I have more questions?  Call Member Services at 866-954-2461.