WellPath Health Insurance Company
The WellPath Health Insurance Company offers coverage to people living in North Carolina and South Carolina. Residents of these states can choose from a variety of health insurance options offered by WellPath.
WellPath is a subsidiary of Coventry Health Care, Inc., and serves the needs of more than 160,000 policyholders (click here to read the full Coventry Health Insurance review). Coventry Health Care is a large company providing benefits to subscribers in all parts of the United States. It covers more than 4.6 million plan members. Coventry Health has been included on lists of top performing companies by Fortune 500, Barron’s 500 and the Wall Street Journal.
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WellPath Health Plans
One of the coverage options available to WellPath policyholders is a Health Maintenance Organization (HMO) model. An HMO has the advantage of being an economical choice for policyholders who want to get coverage at an affordable price. Plan members pay a set amount each month for their medical coverage, and this rate stays constant no matter how often they need care during the month.
People who are considering an HMO model for their medical care need to understand that in return for a fixed rate each month, they are giving up some choice over where they can get treatment. An HMO client must designate a doctor to be their primary care physician. Visits to a specialist require a referral from this doctor. Medical care must be provided by doctors and hospitals within the HMO’s network of providers to be covered under the plan.
A Preferred Provider Organization (PPO) is also a form of managed health care. The difference between it and an HMO is that a PPO has a group of doctors and hospitals in its circle of providers who agree to provide services to a specific group of people. The plan may be available to employees of a particular company or companies or an association. The healthcare providers agree to provide services to the pool of plan members at a reduced rate. The company or association agrees to offer incentives to members to sign up for the PPO and visit doctors and hospitals forming part of the network.
A PPO is different from an HMO; it’s not a prepaid health plan. People who sign up to be members pay for their medical care as they go. The plan reimburses them for the costs of services provided, less any copays required. The doctor may submit his or her invoice directly to the plan administrators for payment as well. The plan member is responsible for any copays required.
An advantage to choosing a PPO plan for healthcare is that plan members have more choices in which doctors and hospitals they seek treatment from. To get the maximum amount of covered care under the plan, they are asked to seek treatment from a participating doctor or hospital. Seeing a healthcare provider who is not a member of the PPO’s network of providers means that a level of coverage is offered.
Another option available to WellPath Health customers is a Point of Service (POS) plan. This option has characteristics in common with HMO’s and PPO’s. Like an HMO, there is no deductible. Plan members are required to designate one doctor as their primary care physician. Going outside of the network to seek treatment means that you will need to meet a deductible before the company will pay benefits. Copayments are also substantial for people who seek treatment from outside the plan’s network of providers. A referral is required before a plan member can consult a specialist.
WellPath Plans Offered to Medicare Recipients
WellPath offers the Advantra North Carolina PPO option to Medicare recipients. Plan members don’t need a referral to see the doctor of their choice. A copay may be required for certain services. Hospital stays are covered under the plan, with a copay required for the first 10 days of treatment. After that point, plan members are fully covered. Inpatient mental health care is also covered under this coverage option, subject to the same copay as in hospital treatment. Plan members are also covered for care provided by a skilled nursing facility, home care and hospice services.
Add-On Services Offered By WellPath Health
The WellPath Health Insurance Company also offers vision, dental and prescription coverage as an add-on to the plans it offers to consumers. Plan members who want prescription coverage can choose to receive their medications from one of a large network of chain pharmacies and independent drug stores. They can even use a mail order service for their convenience.
WellPath Health Insurance Quotes
You should certainly compare your WellPath health insurance quotes with quotes from other top companies to find the best plan. To find out more about the plan options offered by top insurance companies like the WellPath Health Insurance Company, click on the insurance quote tool at the top of this page. You will be able to find the right kind of coverage for your needs, quickly and conveniently. Why don’t you click on it right now to find out about your options and start comparing quotes from the best health insurance providers?