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The Plan
Who can join Care Access Health Plan?
What Services are covered by Care Access Health Plan?
Do you offer Hospital Coverage?
What is the Prescription Drug Benefit?
Do you need a Social Security Number to Join the Plan?
What Counties does Care Access Health Plan Service?
Does the applicant have to live in South Florida to qualify for Care Access?
Which services require a referral from Care Access?
When are premiums due?
Is there a pre-existing clause?
Can a member or applicant nominate their physician to be a part of the Plan?
Can I enroll a child without their parents?
How can I access your Health Plan’s Drug Formulary?
How long does it take to enroll?
Group Information
Are there a minimum number of employees or members required to join this plan?
Do you have Group Rates?
How do I get a Quote?
Is there a participation requirement?
Is there a contribution requirement?
How do you look at groups in terms of acceptance?
What documents are required for new business?
Broker - Related
How do I get appointed with Care Access?
How do I get Enrollment Materials?
What are the Commissions?
Articles for Brokers
Who can join Care Access Health Plan?
Care Access provides services to both Individuals, Group of Individuals, and Groups. We are ideal for people who are uninsured, students, part-time workers, dependents, and people who have newly arrived from other countries, regardless of immigration status.
What Services are covered by Care Access Health Plan?
Care Access offers a wide range of routine, medical services with an emphasis on preventive care. Care Access covers Primary, and Specialty Care, Urgent Care, Diagnostic Services, Ambulatory Surgical Services, Chiropractic Care, Behavioral, Hearing and Vision Services, and Prescription Drugs. Hospital Services are excluded on our plan, but supplemental Hospital and Dental Coverage is available from select carriers. For a complete listing of our benefits with specific coverage amounts and co-pays, see our Schedule of Benefits.
Do you offer Hospital Coverage?
While hospital services are excluded under our plan, defined benefit and catastrophic supplemental hospital plans are available through select carriers.
What is the Prescription Drug Benefit?
Each member can receive up to $100 per month ($1,200) per year in prescription drugs. Generic Drug co-pays are as low as $7.
Do you need a Social Security Number to Join the Plan?
No. We can accept members regardless of immigration status. Coverage is based on application (Statement of Health) and underwriting assessment.
What Counties does Care Access Health Plan Service?
Care Access currently operates in Miami-Dade, Broward and Palm Beach counties. The Company plans to expand statewide.
Does the applicant have to live in South Florida to qualify for Care Access?
Yes. Applicant reside within our service area to enroll in Care Access
Which services require a referral from Care Access?
Allergy treatments, Mental Health, certain specialists, Diagnostic Services, Home Health, Ambulatory Surgical Services, Rehabilitative Services and Durable Medical Equipment require referrals from your PCP and authorization from our UM Department. Please refer to Schedule of Benefits for more specifics. BRKR-E-FAQS-11-28-05-R0 Care Access is a Pre-paid Health Plan.
When are premiums due?
This answer needs to be addressed by:
- For Individuals the premium is due on the 1st of the month for the following month’s coverage (Premiums for coverage in the month of September are due by August 1st.)
- For Groups of Individuals the premium is due on the 1st of the month for the following month’s coverage. (Premiums for coverage in the month of September are due by August 1st.)
- For Groups the premium is due by the 1st of the month for the month of coverage. (Premiums for coverage for the month of September are due by September 1st.)
Is there a pre-existing clause?
Yes. If the underwriting department considers a condition as pre-existing, certain treatments and/or medication pertaining to that condition will be not be covered for a period of up to 2 years, at the sole discretion of the plan.
Can a member or applicant nominate their physician to be a part of the Plan?
Yes. Simply fill out the provider nomination form at the back of the Provider Directory or download from our website (in the Enrollment section, under other downloads) and submit to Care Access, We can’t guarantee that a particular physician will choose to join Care Access, and of course, s/he will have to pass our Care Access requirements, but we would be pleased to notify you if s/he comes aboard.
Can I enroll a child without their parents?
Yes. We can accept children from birth, with or without their parents. Since applicants are medically underwritten each can be viewed on an individual basis.
How can I access your Health Plan’s Drug Formulary?
Each member receives a copy of the Drug Formulary in their new member welcome packet. It can also be downloaded from our website @ www.MyCareAccess.com
How long does it take to enroll?
The enrollment process will begin upon submission of a complete application/s. Processing time varies according to the type of submission.
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Individuals: Complete application must be received by CAHP by the 15th day of the preceding month prior to the effective date of enrollment.
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Group of Individuals: Complete application must be received by CAHP by the 15th day of the preceding month prior to the effective date of enrollment.
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Group: Complete application must be received by CAHP by the 20th day of the preceding month prior to the effective date of enrollment BRKR-E-FAQS-11-28-05-R0
Group Information
Are there a minimum number of employees or members required to join this plan?
Yes, the group plan is available for 10+ enrolled employees.
Do you have Group Rates?
Absolutely. Composite tiered group rates are available for groups of 10 or more.
How do I get a Quote?
It’s easy. Just send us the census for your group and we will generate a quote.
Is there a participation requirement?
Yes. CAHP has a minimum requirement of 25% at initial enrollment.
Is there a contribution requirement?
Yes. CAHP has a minimum requirement of 25% of the Employee rate.
How do you look at groups in terms of acceptance?
All groups will be accepted or declined, as a group. Care Access reserves the right to preex certain conditions for certain individuals for a period of up to 2 years.
What documents are required for new business?
Broker - Related
How do I get appointed with Care Access?
Getting appointed with Care Access is fast and easy. Simply fill out the Broker Appointment Paperwork (Broker Agreement, W-9, HIPPA Agreement, Appointment Form,and Cover Sheet) found in the Broker Kit and send in with a check for $62.10. It is generally processed within 48 hours.
How do I get Enrollment Materials?
All of our enrollment materials can be downloaded from our website or you can call customer service at 1-877-411-2247 (CAHP), Option 3.
What are the Commissions?
The Broker Commission Schedule is attached to your Broker Agreement.
Articles For Brokers
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