General FAQs
Q: How does HealthFlex Limited Benefits work?
A: You will be mailed a membership guide within 3 to 5 business days of activating your membership. Your membership guide will provide you with a Member Identification Card as well as, an explanation of each of the discount program's features and a certificate of insurance for your insurance benefits.
Q: When can I start using HealthFlex Limited Benefits?
A: As soon as you receive your membership guide, which includes your Identification Card, you can use the discount program's features and services. Your insurance coverage begins on the date described in the certificate of insurance included in the membership guide.
Q: What if I'm not satisfied with HealthFlex Limited Benefits?
A: If you are not completely satisfied, you may cancel your membership by returning your member ID cards to the address shown in the membership agreement in your membership guide. If you cancel within the first 30 days of membership, you will receive a full refund of your membership fee. The one-time set-up fee is non-refundable, except in those states where refund provisions are specified by state law. If you cancel after the first 30 days, your membership will end at the end of the period for which you have paid and you will not be billed further; the set-up fee and the previously-paid membership fees are not refundable.
Q: If I have a change in my membership information, what do I do?
A: Contact Member Services at the toll-free number on your member ID card and we will update your information.
Limited Group Accident and Health Indemnity Insurance Coverage FAQs
Q: Who is eligible for coverage?
A: Any individual under age 65 (and their eligible dependents under age 65, if family program is elected) who are able to engage in substantially all of the usual activities of a person in good health of like age and sex and not confined in a Hospital or rehabilitation or rest facility.
Q: Who are eligible dependents?
A: Members and lawful spouse; In most states, Members unmarried children-natural, adopted or stepchildren up to age 18 (or up to age 23 if a full-time student); Children who are over the age of 18 who become physically or mentally incapable of self-support prior to reaching age 18 and while covered under these plans. (Dependent children definitions may vary by state.)
Q: Can members use any hospital or doctor?
A: Yes. Covered Members and dependents can use any hospital or doctor. (However, you do need to use the Medical Discount Program's participating providers in order to receive program discounts.)
Q: Are Pre-Existing Conditions covered?
A: Yes. However, in the first 12 months of enrollment, members may not use the insurance benefits of the HealthFlex Limited Benefits program for a pre-existing condition. (However, members do have access to the Medical Discount Program's services and discounts beginning with the membership effective date, regardless of any current health conditions.)
Q: What is a Pre-Existing Condition?
A: Pre-Existing Condition means: (a) the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care or treatment within a one year period preceding the effective date of the covered person's insurance; or (b) a condition for which medical advice or treatment was recommended by a doctor or received from a doctor within a one year period preceding the effective date of the covered person's insurance.
Medical Discount Program FAQs
Q: I have called a few doctors I found using the Provider Search on your website and they said they had never heard of The HealthFlex Limited Benefits Plan or the HealthFlex Medical Discount Program. Why don't they know who you are?
A: Participating providers do not contract directly with The HealthFlex Limited Benefits Plan, the HealthFlex Medical Discount Program, or National Discount Healthcare Solutions (NDHS). They contract with networks which in turn contract with NDHS to provide access to discounts for our HealthFlex Limited Benefits Plan members. Your membership guide and Member Identification Cards, which include the appropriate network names, will have the necessary information for the participating provider to give you access to the discounts.
Q: How much can I expect to receive in discounts?
A: There are many factors involved in determining the discounts you may receive, which vary based on the terms of each participating provider's agreement with the network. Common factors may include the provider category (physician, dentist, chiropractor, etc.), which participating provider you select within that category, whether the provider is a specialist, the nature of services or type of prescription drugs you receive, the provider's normal or usual charges, the provider's geographic location and the type of facility where you receive services. Your total savings will vary depending on the type and extent of services you receive from participating providers.
Q: How do I know which providers will honor the program discounts?
A: Call the toll-free number found on your Member ID Card to locate a participating provider near you or click on 'Provider Search' on the menu on this website. Participating providers are subject to change at any time without notice to Members.
Q: What if I have a current health condition?
A: There are no restrictions on access to discounts just because you may have a current health condition. As a member, you will receive access to all applicable discounts. However, services in progress or already completed before your membership is effective are not discounted. (Please note: in the first 12 months of enrollment, members may not use the added, separate HealthFlex Limited Benefits insurance benefits for a pre-existing condition. See the Limited Group Accident and Health Indemnity Insurance Coverage FAQs above for the definition of a pre-existing condition.)
Q: Do I have to fill out any paperwork to get the discounts?
A: No. Just follow the instructions in your membership guide to let the participating provider know you are entitled to the discounts. (For many types of services, you'll simply show your Member ID Card.) You'll pay the provider directly, at the discounted price, at the time of service.
Q: Do I have to pay the discounted rate at the time of service?
A: Yes. All participating provider charges are due and must be paid in full at the time of service unless you make other arrangements for payment with the provider.
Q: Can I access my program discounts and services as often as I want?
A: Yes, you can access your program discounts and services as often as you want. (Please note: There are limits on each of the added, separate HealthFlex Limited Benefits insurance benefits, as explained in the Certificate of Insurance provided in your membership guide.)
Q: Why would a provider be interested in participating in the program?
A: When discounts are offered, consumers can more easily afford the cost of healthcare services. Providers see this as an opportunity to acquire new patients and increase their practice.
Q: Do I have to wait until I get my Identification Card or can I get the discounts now?
A: You must wait until you receive your Identification Card before accessing any discounts. The participating provider will need to see your card to verify your membership and to obtain certain information from the card.
Q: I am traveling or have moved and need a provider list for my current area. What do I do?
A: Contact Member Services. We will update your information (if you have moved) and help you locate providers in your current area.
Q: My doctor is not in your list of providers. Can I add my doctor?
A: As a member, you may request that your provider be contacted to see if he or she would like to participate in the program. If your provider is invited and chooses to join, you'll get access to discounts from your provider once his or her participation becomes effective. However, there is no guarantee that your provider will join or will continue participating.
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