Frequently Asked Questions

1. What services are discounted?
2. Are any services or conditions excluded?
3. What will I have to pay?
4. How do the physicians/providers get paid?
5. Is the hospital charge all inclusive?
6. What about Emergency Room services?
7. What is the difference between HealthCare Connect and a private insurance?
8. Is my doctor part of the HealthCare Connect network?
9. How do I qualify for HealthCare Connect?
10. How can I enroll in HealthCare Connect?
11. Will I need to bring any documents to enroll?
12. What happens if I need to see a specialist?
13. How much does it cost to join HealthCare Connect?
14. What if I have health insurance at work but it is too expensive?
15. Can I appeal if my income is over by a couple dollars?
16. What is HealthCare Connect?
17. What is Medicare allowable?
18. Will I be denied if I have a pre-existing condition?
19. Can I apply for HealthCare Connect if I have Medicare?
20. How long does it take to process an application?

1. What services are discounted?
   HealthCare Connect offers discounted services for primary care visits, specialist visits, hospitalization, outpatient hospital services, laboratory services, radiology services, dental services, pharmacy discounts, vision services.
2. Are any services or conditions excluded?
   Most medically necessary services are covered, there are no discounts currently available for substance abuse, organ transplant (see physician/provider manual for a complete listing
3. What will I have to pay?
   You will be responsible for paying the following discounts at the time services are received:
   

   Primary care visits	Rates will vary by Primary Care Provider
   Specialist visits	Office and inpatient consultations are $50.00, all other services will be discounted starting at 50% off the current Medicare allowable rate
   Hospitalization	Inpatient Stay $400-$600 per day with a $2000 maximun per stay
   Outpatient Hospital Services	Member pays 10% of the total billed charge
   Prescription Drugs	15 to 25% discount off average wholesale price (AWP). Discount will depend if brand name or generic
   Laboratory Services	50% of the current Medicare allowable if done at a Sonora Quest draw site. If done in the physician office or hospital those discounts would apply.
   Radiology Services	Services will be discounted off the current Medicare allowable rate
   Urgent Care Services	Current Medicare allowable rate

4. How do the physicians/providers get paid?
   The physicians and hospitals will be paid directly from the patient/member as services are received. If you are unable to pay for services at the time of service, you will need to make agreeable arrangements with your physician ahead of time.
5. Is the hospital charge all inclusive?
   No, the hospital charge is only for the facility fee (room and board). There will be separate charges for physician/professional fees.
6. What about Emergency Room services?
   Emergency room services are not discounted and you will need to pay for services when they are received. If you are admitted through the emergency room the hospital inpatient discounted rates will apply. We have a discounted Urgent Care network in place separate from the hospital setting.
7. What is the difference between HealthCare Connect and a private insurance?
   HealthCare Connect is not an insurance plan but, rather a highly discounted pay as you go medical program. Members pay no monthly premium only an annual enrollment fee and then low fees at the time of service.
8. Is my doctor part of the HealthCare Connect network?
   All HealthCare Connect Primary Care, Pharmacy and Hospital partners are listed on our web site (www.healthcareconnect.org). If specialty services are necessary, your primary care provider will assist you in locating and referring you to the appropriate specialist.
9. How do I qualify for HealthCare Connect?
   You must be a resident of Maricopa County, you can not be eligible for any state or federally or employer sponsored health care coverage, you must meet the income requirements. All potential members will be screened for eligibility in any of the state/federal programs (i.e AHCCCS, DES) prior to enrollment into HealthCare Connect.
10. How can I enroll in HealthCare Connect?
    You can enroll at your closest participating Community Health Center (Mt. Park Health Center, Clinica Adelante, Native American Community Health Center (Native Americans only)), you can visit our website or you call our office at (602) 288-7564.
11. Will I need to bring any documents to enroll?
    Yes, you will need to bring documents for proof of residency (a utility bill or rent receipt) and for proof of income (2 months of pay stubs or tax returns).
12. What happens if I need to see a specialist?
    When you enroll in HealthCare Connect you will be required to select a Medical Home or Primary Care provider. All your health care needs will be coordinated through them. If it is determined you need specialty services, your primary care provider will write a referral and provide you with the names of available specialists for you to seek specialty care. You will contact the specialist office and schedule the appointment. If needed, your primary care physician may assist you in scheduling specialty appointments.
13. How much does it cost to join HealthCare Connect?
    Members will pay an annual enrollment fee of $50.00 per person with a $100.00 maximum per family.
14. What if I have health insurance at work but it is too expensive?
    If your employer offers health care coverage, you as an employee would not be eligible for HealthCare Connect. However your spouse and/or dependents would be eligible.
15. Can I appeal if my income is over by a couple dollars?
    No, HealthCare Connect staff will direct you to other resources that may be available to you.
16. What is HealthCare Connect?
    HealthCare Connect is a unique, alternative health care delivery system that will allow the lower-income, uninsured residents of our community access to coordinated and affordable health care. All potential enrollees are first screened for eligibility into any of the state or federally funded health care programs such as AHCCCS or DES prior to enrollment into HealthCare Connect. All enrollees must be a resident of Maricopa County, have an income between 100 and 250% of the federal poverty level and must not be eligible for any state or employer sponsored health care coverage.
17. What is Medicare allowable?
    Medicare allowable is a guideline established by the federal government (Center for Medicare & Medicaid Services) for payment of medical services.
    
18. Will I be denied if I have a pre-existing condition?
    No.
    
19. Can I apply for HealthCare Connect if I have Medicare?
    If you have Medicare Part A only you would be able to apply for HealthCare Connect.
20. How long does it take to process an application?
    It takes 10-15 business days to process an application. Once we receive the completed application, all required documents and your enrollment fee you will be active.