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Frequently Asked Questions

Select a Topic

  • Am I allowed to change my Primary Care Practitioner?
  • Are referrals ever needed?
  • Are routine eye exams covered?
  • Are routine wellness exams covered?
  • Are there co-pays for office visits?
  • Can women choose an OB/GYN as a Primary Care Practitioner?
  • Does NHP apply pre-existing limitations?
  • How are late enrollments handled? Are there any situations where late enrollments are allowed?
  • How long are college students eligible for coverage? What if they are not a fulltime student but still financially dependent on the parents?
  • Is a referral and an authorization the same thing?
  • Is Durable Medical Equipment (DME) such as a wheelchair covered?
  • Is oral surgery a covered benefit?
  • Is there a co-pay for Emergency Room visits?
  • Must I choose a Primary Care Practitioner?
  • What are the prescription drug co-pays?
  • What if a member disagrees with a denial or partial denial of a claim or authorization?
  • What if a member has two health insurance policies?
  • What if I receive medical care out of the service area and the facility requires me to pay for my services?
  • What is the difference between an Internal Medicine Doctor and a Family Practice Doctor?
  • What provider choices are available to me?
  • Who is considered an eligible dependent?
  • Will dependents who are away at college have any coverage if they get sick or injured?
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HMO plans underwritten by Network Health Plan. POS plans underwritten by Network Health Insurance Corporation, or Network Health Insurance Corporation and Network Health Plan.