Effective January 1, 2015, unless otherwise noted, the
following member benefits changes and clarifications will be implemented for
several commercial programs for Pennsylvania members:
Type of benefit/service
Plans affected
Change/clarification
Subrogation
HMO
POS ? All
DPOS ? All
Language is being updated to allow AmeriHealth to better enforce its
subrogation rights and obtain reimbursement for its costs when a third party is
involved.
After-hours/home visits ? PCP copayment
HMO ? Non-Flex only
POS ? Non-Flex only
Language indicating separate copayments for after-hours visits and home visits
has been removed from the benefits booklet and the schedule of covered
services. The primary care physician (PCP) office visit copayment will apply
for these services.
Please call Customer Service at 1-800-275-2583 with any
questions.