| |  |  |  Pacificare HMO PlanWhen you enroll in the PacifiCare HMO, you agree to use only PacifiCare doctors, facilities and medical groups for all of your medical care. You must choose a Participating Medical Group (PMG), and Primary Care Physician (PCP) to manage your care. PacifiCare covers most services at 100%, with no deductible, as long as you use providers who belong to your PMG. You pay an office visit copayment and there are no claim forms. Emergency room services require a copay per visit. This copay is waived if you are admitted to the hospital.
* Note: Any care you receive without approval from your PCP is not covered.
Prescription Coverage: Copayments are $5 for generic, $15 for brand-name, and $25 for non-formulary prescriptions. Mail-order services are available for two times the regular copay for a 90-day supply. The link to the PacifiCare HMO website is below. This link allows you to access your healthcare information, and provides information regarding prescriptions and health & wellness programs.Website: PacifiCare HMO website. |
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