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Ask Our Specialists
How to ensure 100% coverage with Atlas America? Hi, I am considering purchasing Atlas America for my parents visit. The plan says that for In Network claims sent to Underwriters for review and paid directly to provider will be covered 100% otherwise there is a 20% coinsurance. I did check that most of the urgent care centers and hospitals in my area are covered under CMN or FirstHealth, but based on my previous experience with Patriot America (also FirstHealth), the urgent care center refused to accept it and I had to pay first, submit claim and get paid (which they did without any issues!). So if my parents visit an In Network urgent care and they do not accept the insurance and demand up front payment, would that mean that I would not receive 100% coverage but rather will have to pay 20% coinsurance? Is there any way to avoid the above and ensure that the In Network facilities will honor direct billing to First Health/CMN? 2nd Question for Mr. Narender, In 2008, I had gone for Patriot America based on your recommendation (and it worked fine except for the billing piece). I now see that Atlas America looks better with pre-existing condition coverage as well as 100% In Network coverage. Out of both of these would you recommend Atlas America for parents less than 70. I am looking to buy today so would appreciate a response. Thanks! Rajesh
1. The best way would be to try to convince them that their names comes up in the provider directory because they are part of the PPO network. Therefore, they are obligated to take the insurance and bill directly. They can consider calling the phone number on the insurance card to confirm that they are indeed in network. Atlas America insurance has CMN, First Health and PHCS. Therefore, as long as they are part of any of that, you should be fine. 2. Both are excellent plans. Due to the features you described, Atlas America would be the most appropriate choice for you. I hope that answers your questions. If you have any other questions, please feel free to contact us at any time or post them here.
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DISCLAIMER: Information presented in our Questions and Answers section is generic and was deemed to be accurate at the time of response. Please use the answers as a guide and do not make decisions based on the answers. The answers presented may be outdated and altogether inaccurate currently or not relevant as the details provided such as the insurance terms and conditions, plan benefits, eligibility and coverage may have changed. Insubuy assumes no responsibility for relying on such answers. You should review the latest certificate wording of the insurance policy (available on this website) for the product you are considering for the latest and complete details. If there is any conflict between the answers provided here and the certificate wording, the details of the certificate wording will prevail.
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