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FAQ'S
Find answers to the most commonly asked questions about our SmartHealth Diamond Program. If you do not find the answers you're looking for, please contact our Member Services for further assistance. |
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STANDARD QUESTIONS
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1. What is a discount program?
2. How do I receive my SmartHealth Diamond program discounts?
3. How can I find a doctor, dentist, eye doctor, or other provider in my area?
4. What kind of restrictions are there regarding current health conditions?
5. What types of dental discounts are included in the SmartHealth Diamond program?
6. What vision care discounts are available through SmartHealth Diamond?
7. Can I see a chiropractor if I am a member of the SmartHealth Diamond program?
8. What is the hearing program with SmartHealth Diamond?
9. How do I save on my prescriptions when going to the pharmacy? |
INSURANCE QUESTIONS
1. Who is eligible for coverage?
2. Who are eligible dependents?
3. Can members use any hospital or doctor?
4. Are Pre-Existing Conditions covered?
5. What is a Pre-Existing Condition?
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STANDARD ANSWERS
1. What is a discount program?
The SmartHealth Diamond program is not health insurance, but rather a discount program that provides members with access to discounts off the normal retail price from participating providers. Members pay the provider directly at the time of service.
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2. How do I receive my smarthealth diamond program discounts?
You will be mailed a membership guide within 5 to 7 business days of activating your membership. Your membership guide will provide you with a Member Identification Card, and an explanation of each of the services and programs within your program. Simply search for your provider, then call Member Services to verify the Providers continued participation. Then you can call to make an appointment, present your card and save!
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3. How can I find a doctor, dentist, eye doctor, or other provider in my area?
Call our toll-free number found on your Member ID Card to locate a participating provider near you, or go online to www.mysmarthealthdiamond.com\providers. Participating providers are subject to change at any time without notice to Members.
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4. What kind of restrictions are there regarding current health conditions?
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.
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5. What types of dental discounts are included in the smarthealth diamond program?
The dental program includes virtually all services, from routine check-ups, to fillings, crowns, braces and even cosmetic work. (IV sedation, experimental procedures, services in progress or already completed before your membership begins, and services outside the scope of the participating dentist’s practice are excluded.) You can visit a participating general dentist and save 28% to 50% for dental care.
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6. What vision care discounts are available through smarthealth diamond?
Save 20% to 60% at over 10,000 participating vision eye care locations nationwide. Discounted products and services include eyeglasses, contacts, prescription and non-prescription sunglasses, eye exams and corrective surgery. Our Vision Network includes ophthalmologists, optometrists, laser surgery centers, independent optical centers and national chain locations.
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7. Can I see a chiropractor if I am a member of the smarthealth diamond program?
Yes, you will receive significant discounts from participating chiropractor locations nationwide. Members will save up to 30% off usual charges on all diagnostic services and x-rays and adjustment.
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8. What is the hearing program with smarthealth diamond?
With your membership you are eligible to receive a 15% discount on Beltone hearing aids at any of their 1,800 Beltone independent locations nationwide.
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9. How do I save on my prescriptions when going to the pharmacy?
All you need to do is visit one of over 55,000 participating pharmacies including major chains. Present your card and save an average of 23% off retail on brand name prescription drugs and an average of 55% on generic medications. And you can save 5% to 50% off retail by using the program's mail order service.
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INSURANCE ANSWERS
1. Who is eligible for coverage?
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.
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2. Who are eligible dependents?
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.
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3. Can members use any hospital or doctor?
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.)
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4. Are Pre-Existing Conditions covered?
Yes. However, in the first 12 months of enrollments, members may not use the insurance benefits of the 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.)
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5. What is a Pre-Existing Condition?
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.
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Disclosures: THIS DISCOUNT PLAN IS NOT INSURANCE. THIS IS NOT A MEDICARE PRESCRIPTION DRUG PLAN*. This plan provides discounts at certain health care providers for medical services. The range of discounts will vary depending on the type of provider and service. The plan does not make payments directly to the providers of medical services. Plan members are obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount medical plan organization. Before purchase, you may access a list of participating health care providers at www.mysmarthealthdiamond.com. Upon request the plan will make available a written list of participating health care providers. You have the right to cancel within the first 30 days after receipt of membership materials and receive a full refund, less a processing fee not to exceed the amount permitted by your state. Discount Medical Plan Organization and Administrator: Amacore Group, inc., 4929 West Royal Lane, 1st Floor, Irving, Texas 75063; telephone 800-446-7142.
Note: Hospital discounts are not available in Maryland or West Virginia.
Note to Texas Consumers: Regulated by the Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711; telephone 800-803-9202 or 512-463-6599; website: www.license.state.tx.us/complaints.
Note to Utah Residents: The discount programs are not protected by the Utah Life and Health Guaranty Association.
* Medicare statements applies to MD residents when pharmacy discounts are part of the program. |
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