Frequently Asked Questions 

Who is AmeriPlan®?  

AmeriPlan® is a Discount Medical Plan Organization. We
arrange for our members to have access to dental, vision,
chiropractic pharmaceutical and medical providers who have
agreed to offer their services at negotiated discounts off their
usual and customary fees.  


How much discount do Dental Plus™ members get on
dental fees?  

Members can save 25% - 65% on all restorative and cosmetic
work (fillings, crowns, braces, etc.) and up to 80% on
preventative work (teeth cleaning, x-rays, etc.) performed by
a general dentist. Specialist fees are discounted 15% to 25%.


Are ongoing dental/medical problems (conditions)
included?  

Since AmeriPlan® is NOT INSURANCE OR A HEALTH
ORGANIZATION, all ongoing dental/medical problems
(conditions) are accepted except for contracted treatment
plans including orthodontic treatment in progress.


What is the waiting period, deductible, etc.?  

There is no waiting period before you can start using your
plan! And, there are no deductibles, no claim forms to fill out,
and no limits on visits to your providers!


How much is the program membership fee? How do I
pay?  

The Dental Plus™ membership is only $19.95 per month for
an entire household! A household membership includes all
residents in the household including parents, children,
relatives, significant others, and all permanent residents of
the household! Monthly or quarterly payments are made only
by electronic bank draft or credit card. Invoicing is done only
for annual memberships paid one year in advance.


How much more do the Pharmacy, Vision, and
Chiropractic programs cost?  

The Prescription Drug, Vision, and Chiropractic programs
included with the Dental Plus™ membership at no extra cost!


Who are the Medical, Dental, Prescription Drug, Vision,
and Chiropractic Care providers?  

AmeriPlan® has assembled one of the largest networks of
providers in the country, and we are constantly adding to this
base. Our network has tens of thousands of medical
practitioners, almost 30,000 dentists, more than 12,000 vision
care providers, some 50,000 pharmacies and more than
7,500 credentialed chiropractors.


How do I use the program?  

Within 10-14 days of receipt of your application at corporate
headquarters in Plano, TX, you receive a Member Information
Guide, Membership Identification card(s), and a Dental,
Pharmacy, Vision, and Chiropractic Care Directory. Present
your Membership ID card to any AmeriPlan® provider and
you will be eligible to receive discounted fees. You pay the
provider at the time of service.


Can I purchase the medical plan without including the
Dental Plus™ program?  

Yes


Can the medical plan be used in conjunction with
health insurance plans?  

Yes, but it is at the physician's discretion whether to accept
both. As with our Dental Plus™ plan, a member's insurance
should always be the primary form of payment.


Will my medical plan members receive a discount?  

All members should receive a minimum 15% discount.


Why would a medical professional participate in the
AmeriPlan® Consumer Driven Health Care Program?  

There are many reasons. Some of the most important are:

1. Patient care and treatment are put back into the
physician's hands.
2. The provider gets paid at the time of care. Many insurance
plans take up to 120 days for payment.
3. Office administrative costs are reduced. No paperwork to
complete, file and follow up on.
4. Providers may receive a net increase in revenue to the
practice versus insurance (HMO or PPO).
5. The provider is part of an affiliation of like-minded  
professionals, without being "under the thumb" of managed
care.
6. AmeriPlan® provides members with quality, discounted
healthcare.



an you briefly describe the Hospital Advocacy
Program?  

The Hospital Advocacy program is designed to help members
with their medical bills whenever a single hospital stay totals
$2,500. Charges can be incurred from multiple providers.
The patient advocate negotiates in behalf of the patient
advocate and pursues a wide range of options, from
government entitlement programs to payment plans.


How is the discount calculated?  

The rates that the provider charges are determined based
upon either a set fee schedule that the provider has
contracted, or as a percentage off of their billed charges. In
general, discounts will vary between 20% and 50%. Labs and
diagnostics will have discounts of up to 80%.


Are the medical programs contracted on an annual
basis and cancelable at any time, like Dental Plus™?  

Yes


How do I locate an AmeriPlan Health® provider?  

There are three ways to locate a provider:

1. A dental, vision, prescription and chiropractic directory of
providers is included in your member information guide.
2. A provider locator is available at
ameriplanusaprovidersearch.com.
This is particularly useful for medical providers.
3. Call AmeriPlan Health® customer service at 800-647-8421.



Can the Medical Program be used with
Medicare/Medicaid?  

No. Medicare does not allow their providers to charge a
Medicare patient a different price.


Are doctors reimbursed by AmeriPlan® for their
services?  

No. As with all of our health programs, the provider receives
the full discounted fee from the member at the time services
are rendered.


Can members downgrade from AmeriPlan Health® to
the Dental Plus™ Program?  

Yes


If the doctor's office has lab facilities, can these be
utilized rather than having to go to another lab?  

Yes. The lab services will be billed up to a 40% discount.


Do members receive a fee schedule?  

No. Fees will vary by zip code.


Do members receive a separate card for the Medical
Program?  

Yes. Approved household members receive four (4) cards;
two AmeriPlan Health® ID Cards and two Dental Program
cards.


Are there programs for emergency services?  

Yes. Emergency services may or may not be contracted with
the Medical Program. Depending on the extent of the
charges, these services may be eligible for the Patient
Advocacy Program.


Will maternity be included?  

All medical needs are included as long as we have contracted
providers offering this service.


Will the member's privacy be protected?  

AmeriPlan® is compliant with all HIPPA regulations.


Does medical include hearing tests and hearing aids?  

Yes. Hearing Services will be included under our Ancillary
Services providers.


Does the member have a choice of which hospital will
be used?  

Yes. The Patient Advocate will negotiate with any hospital of
the member's choice.