HOW TOTAL ACCESS MEDICAL WORKS WITH INSURANCE
Total Access Medical is not an insurance plan and enrolling in the Total Access Medical program does not replace your traditional insurance plan.
Total Access Medical, LLC is the company that has designed the Total Access Medical Program and will administer certain of the non-clinical aspects of the Total Access Medical program. Total Access Medical is not a provider of medical or other healthcare services and Total Access Medical is not an insurance company.
All members of Total Access Medical are required to pay an annual fee that is paid for separately and independently from traditional insurance plans.
Total Access Medical and Commercial Insurance Plans
If you are insured by a commercial insurance plan (Blue Cross Blue Shield, Personal Choice, CIGNA, Aetna or other health insurance programs) it is recommended that you maintain your health insurance. The following services are not paid for through your annual enrollment with Total Access Medical and may require insurance or direct payment:
- Hospital Care
- Specialist Care
- Lab Services (if done outside of affiliated physician’s office)
- Prescriptions
All visits to your Total Access Medical affiliated physician are paid for through your annual membership and do not require additional insurance payment (i.e., co-pay or deductible).
Total Access Medical and Medicare
Total Access Medical welcomes all Medicare recipients. If you are a Medicare recipient and Medicare is your primary health insurer, Total Access Medical recommends you maintain your Medicare insurance.
You will need to continue to use Medicare for any visits or services that are not provided by your Total Access Medical physician (see list above).
Your Total Access Medical physician has voluntarily agreed not to be compensated by Medicare for services rendered. If Medicare is your primary insurance, your only expense will be the Total Access Medical program fee. You will not be billed for individual office visits / procedures by a Total Access Medical physician. Additionally, you will not be responsible for any Medicare co-pay or deductible when you visit your Total Access Medical physician. (You will be responsible for co-pays or deductibles if you are in need of medical services outside of your affiliated physician’s medical office).
Total Access Medical and HMO and POS Plans
Total Access Medical accepts all HMO/POS (point-of-service) patients as a non-HMO/POS provider. As an out of network provider for all HMO/POS plans, Total Access Medical affiliated physicians have voluntarily agreed not to be compensated by HMO/POS plans for services rendered. If your primary insurance is HMO/POS, your only expense will be the Total Access Medical program fee.
You will not be billed for individual office visits/procedures by a Total Access Medical affiliated physician. Additionally, you will not be responsible for HMO/POS co-pays or deductible payments when you visit your Total Access Medical affiliated physician. (You will be responsible for co-pays or deductibles if you are in need of medical services outside of your affiliated physician’s medical office).
Please consult with your Total Access Medical affiliated physician regarding referrals to medical facilities outside of the Total Access Medical office.
Total Access Medical and Consumer Directed Health Plans
If you are covered by a Consumer Directed Health Plan including a Health Savings Account, a Health Reimbursement Arrangement or a Flex Spending Account, some or all of your annual fee may be reimbursable. Please consult a Total Access Medical representative and your Human Resources department for details on reimbursement arrangements.