Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Fall 2019 | Your Story

8 Beware of fake insurance companies One way to spot fake insurance companies is by their price. Many times they offer services at prices that are much lower than some of the real insurance companies. They may even offer to cover your entire family and add vision and dental coverage for little extra cost. Dishonest insurance companies are trying to get you to buy their product by putting up flyers on bulletin boards in cafeterias or lunchrooms, calling and asking a bunch of questions, leaving a flyer on your car, using online pop-ups, and many other ways. How to know if it’s real You will get information from a real insurance company through your work, a television commercial, or an ad in a reputable magazine. Real insurance companies have a license to sell insurance from the Department of Insurance for each state that they want to sell in. The best thing you can do before you buy anything is to contact the Department of Insurance in the state you live in to make sure that the insurance company is licensed. Some ways to protect yourself ● ● Do not let anyone pressure you into buying insurance. A real company will be there to help you. They will allow you time to think about it and do the research you need. ● ● Never give out your Social Security number, bank account number, credit card number, or any other personal information until you have made sure that you are dealing with a real insurance company. Then only give them this information in their office, not over the phone or computer. ● ● Do not sign any blank forms; you never know what they will put above your signature. ● ● Talk to other insurance companies; compare the forms at both companies and what they say they are offering you. ● ● Ask all of the companies you talk to as many questions as you can. Here are a couple just to give you an idea: Your rights and responsibilities As a Presbyterian member, you have rights and responsibilities. Our partnership with you is best when we ensure your rights and you meet your responsibilities. We follow the Americans with Disabilities Act (ADA). We also follow federal and state laws as required. You can find member rights and responsibilities online at www.phs.org/pages/member- rights.aspx . NOTICE OF PRIVACY PRACTICES The notice of privacy practices describes how Presbyterian safeguards your Protected Health Information and your rights with regard to that information. You can find the “Joint Notice of Privacy Practices” at http://docs. phs.org/idc/groups/public/@ phs/@marketing/documents/ phscontent/wcmprod1029971. pdf . Who are the doctors I can see if I buy your insurance? What is covered if I go out of the country? What is covered if I go out of state? How much is my copay for an urgent care visit? Preventive Healthcare Guidelines As a Presbyterian Health Plan (PHP) member, you can benefit from preventive services. Preventive services are activities like routine checkups, screening tests and shots. These services are important because they can help you prevent a future injury or illness. Find out more about preventive services by looking at the PHP Preventive Healthcare Guidelines at www.phs.org/preventive . You can also talk with your provider about which services are right for you. If you suspect medical fraud, or need to report any fake insurance company, contact Presbyterian’s Special Investigative Unit (SIU). You can contact the SIU 24 hours a day at (505) 923-5959 or 1-800-239-3147 by leaving a telephone message on the confidential fraud hotline. Any information that you provide will be strictly confidential. When reporting suspected health insurance fraud, you may remain anonymous. You may also email the SIU at PHPFrau@phs.org .