Your Guide to Custom Build Major Medical Plan ACA Alternative

What is a Fixed Benefit Health Plan?

This type of health plan covers you in specific instances, allowing you to choose any doctor of hospital without penalty. Optionally, you can also access the PHCS Multiplan Network for great savings without any additional cost.

• In-patient hospital visit

• Outpatient surgery

• Skilled nursing assistance

• Doctor visits

• X-Rays & labs

• Prescription medication

What Does Critical Illness Entail?

This type of coverage protects your financial security (as well as that of your loved ones) in the event of a critical illness, such as cancer, stroke, or heart attack. These types of events can put a financial strain on your family, so this coverage provides benefits for things such as deductibles, rehabilitation, treatments that aren’t covered by your existing insurance, prescriptions, and even bills, expenses, and wages lost as a result of this illness.

What is Accident Protection?

Nobody plans to have an accident, which is why this coverage is so important. This protects you in the event of an accident, be it at home, work, or otherwise. Additionally, it provides support to your income in the form of disability coverage as you work toward recovery.

Why Would I Need Dental, Vision, or Hearing Coverage?

While these may seem like more minor concerns on a grander scale, these types of coverage will help you stay healthy in all facets, and protect your overall health. In addition, they are essential to your overall quality of life. And good news—these plans are lower than they ever have been before.

What is Minimum Essential Coverage?

This coverage takes care of the basics, like preventative and wellness services. With this coverage, you do not pay a deductible, a co-pay, or out-of-pocket costs for these kinds of important services—like screenings, counseling, vaccines, and more.

Why Do I Need Prescription Drug Coverage?

One of the largest health care costs is for prescription drugs, and the prices are steadily growing. We can help you customize this coverage to your needs and help you save a great deal of money so you never have to worry about being able to afford your much-needed medication.

Healthcare Resources & Shopping Guides

An Overview

When considering where to get the best care at the best prices, there are a few basics to keep in mind.

Hospitals are Expensive

By far, hospitals are the most expensive place to receive most types of care. Sometimes, hospitalization may be necessary; however, to save money, often times it is more beneficial to receive care elsewhere. You will receive the same standard of care, but at a much lower cost. (Ex: Elective surgery, lab work, blood work, etc.)

Avoid the ER Whenever Possible

Because a hospital visit can be so costly, unless you are experiencing a TRUE emergency, it is usually better to forego an ER visit unless absolutely necessary. Alternatives include Teladoc, as well as walk-in or urgent care clinics.

We recommend considering these two above points when reviewing the resources below.

Comparison Shopping is Key

Listed below are some resources we’ve collected and categorized so that you can do your research and make comparisons based on your needs and budget.

General Services

• HealthCareBlueBook.com Discover what a fair price should be for most types of services.
• MDSave An online marketplace where you can select the services you need individually for a price that is pre-negotiated—whether you have insurance or not. Prices may vary by area or region.
• Healthcost Learn more about itemized costs for various services.
• Pratter Designed to empower consumers, this site provides transparent medical cost information as well as savings by comparing prices for some of the most common procedures, from doctors visits to MRIs.
• Pricing Healthcare An independent online marketplace for direct-pay healthcare with the overall goal of improving US healthcare and lowering costs across the board. Providers of all types can advertise options here.
• New Choice Health NewChoiceHealth.com is a free, consumer-focused healthcare marketplace where consumers can shop for common medical procedures.
• FAIR Health A site that is dedicated to providing transparency about costs by an independent, not-for-profit organization.
• Guroo An independent, nonprofit research organization created by the Health Care Cost Institute (HCCI).
• MediBid An online marketplace providing samples of savings they have provided for various procedures and surgeries, with a focus on quality, value, and consumer choice.

Surgery

• CMS Medicare Price Tool Medicare patients can use this tool to view price differences for various surgical procedures.
• Surgery Center of Oklahoma: Oklahoma City, OK A leader in providing fully transparent pricing for a variety of surgical procedures.

Prescription Drugs

• Manhattan Life included savings This discount service is included with your Manhattan Life Fixed Benefit plan.
• ScriptSave This discount service is included with your Philadelphia American Fixed Benefit plan.
• GoodRx Millions of prices and discounts from pharmacies and other manufacturers are collected weekly, to save you money at the pharmacy.
• CleverRx Save money on prescription drugs through this invite-only app.
• Pharmacy Checker Find the lowest prices on prescription medication at both licensed U.S. and international pharmacies.
• PharmStore Purchase a large range of safe, affordable medication from pharmacies worldwide, whether it is a prescription or over-the-counter medication.
• Total Care Mart A prescription referral service
• Drug Mart Direct A prescription referral service
• Blue Sky Drugs Based in British Columbia, Canada; online generic pharmacy for access to generic and non-prescription medication to customers worldwide.
• OneRx Real-time prescription savings information.
• RxCut Find lowest prices on prescription medications through this site, which integrates with Google Maps.
• Rx ‘n Go Save money on 90-day generic maintenance prescriptions, delivered to your door.
• Honeybee Health Generic medications for sale via subscription service, starting with a FREE 30-day trial.

Lab & Blood Work

• Direct Labs The leader in direct access laboratory testing.
• Discounted Labs Find discounts and affordable lab work.
• Walk-In Lab Find affordable testing near you.
• Grassroots Labs Affordable testing using a network of employers, nonprofits, and more for critical lab tests (such as necessary bloodwork).
• Any Lab Test Now Alternative testing available for those with high deductible insurance or no insurance.
• Fair Price Labs An alternative lab testing service provider.

Imaging (e.g. MRI & CT) Savings Tools

• Green Imaging Get the most accurate information about a wide range of services from board-certified radiologists.
• Radiology Assist Transparent information so you can find affordable options.
• Magnetic Imaging Services One of the largest radiology services companies in the U.S.
• Colonoscopy Assist Helpful resources for self-pay/uninsured patients in need of colon cancer screening.

Telemedicine

• Teladoc Included with Philadelphia American and Manhattan Life FREE service for simple illnesses to take the place of an in-person doctor’s visit.
• United Concierge Medicine Virtual, emergency medicine available 24/7, 365 day a year.

Urgent Care & Walk-In Services

• CVS Minute Clinic Walk-in clinic inside select CVS/pharmacy® stores.
• NeedyMeds NeedyMeds is a national non-profit organization that maintains a website of free information on programs that help people who can’t afford medications and healthcare costs.
• SolvHealth Find convenient care close to you.

Outpatient Mental Health Services

• TalkSpace Telemedicine specific to mental and behavioral health needs.
• Breakthrough by MDLive Online counseling and mental health treatment.
• Remedy.me A resource and guide to Board Certified Primary Care Physicians and Licensed Mental Health Therapists.

Bill Review & Negotiation Support

• Karis360 Included with Philadelphia American and Manhattan Life. If your overall care cost exceeds $2,500, contact Karis Bill Negotiator Service for assistance in payments.
• Medical Cost Advocate Discover how you can reduce your healthcare costs.
• MedBill-IQ Reduce any out-of-pocket medical expenses through support from reviews and negotiating medical bills.
• CoPatient Reduce any out-of-pocket medical expenses through support from reviews and negotiating medical bills.

Patient Advocacy Tools & Resources

• Patient Advocate Foundation Designed for patients with chronic, life threatening and debilitating diseases to help access care and treatment recommended by their doctor.
• National Association of Healthcare Advocacy Consultants A non-profit dedicated to the development of healthcare advocacy.

Air Ambulance Subscription Services

Domestic and International

• Medjet Assist
  • Air Medical Transport Membership: Available for business or personal travel. There are two plans available for purchase for either a short-term trip or an annual membership:
  • MedJetAssistant Plan: If you are hospitalized 150 miles or more from home, Medjet will arrange air medical transport to the hospital of your choice—regardless of medical necessity.
  • MedJetHorizon Plan: Offers all benefits of the MedJetAssist plan, PLUS: Emergency Medical Cash Advance, Ground Ambulance & Specialty Hospital Transfer under 150 miles and 24/7 Travel Security and Crisis Response benefits.

Domestic Only

• AirMedCare Network An alliance of affiliated air ambulance providers, the largest of its kind in the United States.
• Life Flight Network Nationally recognized air medical transport service covering a large part of Oregon, Idaho, and Washington.