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Pacificare Group Information
Pacificare Provider - Doctor MD Finder
Pacificare SignatureValue®
A Health Maintenance Organization (HMO) focuses on the quality of care provided to its members - with prevention and wellness as the key components of that care. Health services are accessed through contracted primary care physicians (PCPs) who know the member's medical history and individual needs; thus a partnership is formed between the member, the provider and the health plan. HMOs offer minimal paperwork and low, predictable out-of-pocket costs. Members pay a small, predetermined copayment each time they receive health care services.
PacifiCare SignaturePOS® (POS)
A Point of Service (POS) plan offers members greater flexibility and options. POS plans combine the savings of an HMO with the flexibility of a typical indemnity arrangement. If you are looking for affordability, use the in-network option of your benefit plan. If you prefer to see a doctor who is not participating in our network, choose the out-of-network option.
PacifiCare Signature Options® (PPO)
A Preferred Provider Option is a plan which offers an even wider selection of physicians to our members. These participating providers may be primary care doctors or specialists and PPO members are free to see any of them. PPO members may also visit non-contracted providers, but at a higher out-of-pocket cost. PacifiCare SignatureOptions® is available to employer groups of 51 or more employees.
PacifiCare Signature Independence® (Indemnity)
The PacifiCare SignatureIndependence® Plan is a traditional indemnity plan. It gives you the independence to go to any doctor -- including a specialist -- without a referral.
- You have the flexibility to see any provider licensed or certified to provide covered benefits.
- You must meet an annual deductible.
- You pay your plan's coinsurance cost for all covered services.
PacifiCare Signature Freedom® (SDHP)
The PacifiCare Signature Freedom® plan is a Self Directed Health Plan, or SDHP. It is PPO-based, so you'll have access to a broad network of physicians and hospitals. PacifiCare SignatureFreedom rewards you with an annual Self Directed Account (SDA) which you can use toward certain types of preventative health care services like doctor's office visits, mammography screening, breast and pelvic exams, and more.
- You can choose any provider licensed or certified to provide covered benefits.
- You pay a lower copayment or coinsurance when you visit a doctor that is in the participating network.
- Any money from your SDA that you don't spend is carried over to the next year, allowing you to "save" for future health care expenses.
- Services not covered by the SDA, such as inpatient surgery or emergency room visits, are paid for like a traditional PPO, with yearly deductible and a charge for coinsurance.
- You have access to a complete suite of online support tools that allow you to keep track of your SDA account, claim activity, status, provider choice and health care costs.
EOC's
Individual HMO
Supplement to EOC
Pacificare & UHC Websites
"Sample" probable underwriting Pre Existing Condition form.
                 
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