Provider-Directed Healthcare: “Redirect Health for Preventive and Small Expenses with a Backup Plan”
Designed for our health focused Member who wants a plan that will handle everything. If you have a need for Preventive Care, Primary Care, Chiropractic, Urgent Care, Labs and even MRI’s there is only one way to access service, Redirect Health. See the Redirect “Benefits Guide”.
You’re never alone, Redirect Health assists you ever step of the way. All your healthcare needs start by calling 888-995-4945 24/7 to speak with a Redirect Professional in English or Spanish. They’ll research and set Doctor, Facility and Hospital appointments for any medical need you may have.
If your “Need” (i.e. a large medical expense) is more than the Initial Unshared Amount (similar to a deductible) you selected, Medical Cost Sharing will take over and pay the full amount at 100%.
How this Plan Option uses our Healthy Care Medical Expense Control Strategy.
The foundation of any Program designed to help CONTROL Medical COSTS should be to AVOID them, this is accomplished with Education and a Wellness Program. These Products and Services are provided by My Academy of Health Excellence and MPowering Benefits.
- The MPB 1-1-1 Access to Services Program
- MPB Member and Concierge Services
- The US Corporate Wellness Platform
- The QR for Life Code for Emergencies and Medical Vault
- The Wellfit Community (Facebook for Wellness)
- Twelve Habits of Highly Healthy People (sponsored by Mayo Clinic)
- Pharmacy Services (including World Meds, Canadian Drugs and GoodRx)
Redirect Health covers all 64 mandated preventive services required by the ACA.
- All 18 Preventive Services for Adults
- All 26 Preventive Services for Women
- All 27 Preventive Services for Children
The best way to MANAGE your money with this option is the HMA (Health Matching Account).
Once you have a “Need” these programs and technology are available to help MITIGATE the costs.
- Redirect Health $0 co-pay Primary Care anywhere with per-authorization
- Redirect Health $0 co-pay Chiropractic anywhere with per-authorization
- No cost Teladoc (Video and Telemedicine)
- 2nd MD (Second Opinion Program)
- Patient Advocacy
- Medical Tourism
We CONTAIN medical expenses with Medical Cost Sharing by Sedera Health. A Benevolence Organization of like-minded and health-focused individuals and families.
For “curative care” issues, Sedera facilitates the sharing of health care costs among its members that have medical “Needs”. A “Need” is a medical expense caused by an accident or illness above an amount you can comfortably afford to pay (I.U.A. – Initial Unshared Amount).
The Sedera community philosophy is that we’re meant to help carry one another’s burdens. Our method of sharing medical expenses among members and supporting each other along the way shows this principle in action. Services include:
- Personal Member Advisor
- Medical Bill Negotiation
- WELLNESS Platform: by My Academy of Health Excellence with Healthy Rewards Program
- PREVENTIVE Network: No network, go anywhere with pre-authorization
- PREVENTIVE Covered at 1st dollar: Cover all 64 mandated preventive services required by the ACA.
- PRIMARY Care Network: No network, go anywhere with pre-authorization
- SMALL Medical Expenses: Redirect Health
- LARGE Medical Expenses: managed with Medical Cost Sharing by Sedera Health
- I.U.A. Options: Initial Unshared Amounts available $500, $1000, $1500, $2500, $5000
- Maximum I.U.A.’s Annually: 3 per individual, 5 for all others
- Prescription Drugs Coverage – Curative Medications (Antibiotics, Chemotherapy, etc.): normal sharing rules apply
- Prescription Drugs Coverage – Maintenance Medications (Blood Pressure, Cholesterol, etc.): Sharing eligible for 1st 120 days following new diagnosis
- Pre-existing Conditions: 36 month look back, $0 coverage 1st 12 months, $15k yr 2, $30k yr 3, then unlimited.
- Maternity Benefits: $5,000 Initial Unshared Amount
- Therapies & TMJ: various range from $1.5k to $2.5k
- Psychiatric & Behavioral Health: $5k inpatient max/ need – $1.5 Outpatient max/ need
- Tobacco Use: $75 surcharge per Family Unit – plus a $25k sharing restriction for members age 50+ (conditions with restrictions; cancer, stroke, heart conditions and COPD)
- Sharing Limits: NO Lifetime Limits
- MONEY Management: HMA (Health Matching Account) optional