FAQ: Members Frequently Asked Questions

FAQ

Members Frequently Asked Questions (FAQ)

General

Fees & Discounts

Providers

Emergency & Hospital

Who is AmeriPlan?

AmeriPlan is a Discount Medical Plan Organization (DMPO). We arrange for our members to have access to medical, dental, vision, chiropractic and pharmaceutical providers who have agreed to offer their services at negotiated discounts off their usual and customary fees.

How do I use the program?

Within 10-14 days of receipt of your application at corporate headquarters in Plano, TX, you receive your Membership Identification card(s). Your Membership Guide and Temporary Card is located in the AmeriPlan App. Present your Membership ID card to any AmeriPlan provider and you will be eligible to receive discounted fees. You pay the provider at the time of service.

What is the waiting period?

There is no waiting period before you can start using the Dental Plus program! And, there are instant savings, no paper work to fill out, and no limits on visits to your providers! However, you must allow 3 business days after the activation of your Deluxe Plus membership to begin using the Hospital Advocacy program!

Are ongoing dental/medical problems (conditions) included?

Since AmeriPlan is not insurance or a health organization, all ongoing medical/dental problems (conditions) are accepted except for orthodontic treatment in progress.

Do members receive a fee schedule?

Yes, for dental care. Dental fees vary by area.

Will the member's privacy be protected?

AmeriPlan is compliant with all HIPAA regulations.

How much discount do Dental Plus members get on dental fees?

Members can save 20% - 65% on all restorative and cosmetic work (fillings, crowns, braces, etc.) and up to 80% on preventative work (teeth cleaning, x-rays, etc.) performed by a general dentist. Specialist fees are discounted up to 25%.

How is the discount calculated?

The rates that the provider charges are determined based upon either a set fee schedule that the provider has contracted, or as a percentage off of their billed charges. In general, discounts will vary between 15% and 50%. Labs and diagnostics will have discounts of up to 80%.

How much is the program membership fee? How do I pay?

The Dental Plus membership is only $19.95 per month each for an entire household! Deluxe Plus is $39.95 per month. TeleHealth is $9.95 per month. A household membership includes all residents in the household including parents, children, relatives, significant others and all permanent residents of the household! Monthly payments are made only by debit or credit card. Invoicing is done only for annual memberships paid one year in advance.

How much more do the Pharmacy, Hearing, and Vision programs cost?

All these services are included in both Dental Plus and Deluxe Plus for the $19.95 (Dental Plus) or $39.95 (Deluxe Plus) monthly fee. The Prescription Drug program is included in all memberships.

Who are the Medical, Dental, Prescription Drug, Vision and Chiropractic Care providers?

AmeriPlan has assembled one of the largest networks of providers in the country and we are constantly adding to this base. Our network has tens of thousands of medical practitioners and more than 100,000 dentists and 12,000 vision care providers, approximately 56,000 pharmacies and more than 7,500 credentialed chiropractors.

How do I locate an AmeriPlan provider?

There are two ways to locate a provider:

The mobile AmeriPlan App has maps with provider locations and driving directions.
Provider Search.
Call Member Support toll free at 800-647-8421.

How do I use the AmeriPlan Prescription Program?

We use a Pharmacy Discount Prescription Program located at the Rx Free Drug Card Website.

Try Our Prescription Lookup Rx Tool »

Are providers reimbursed by AmeriPlan for their services?

No. As with all of our health programs, the provider receives the full discounted fee from the member at the time services are rendered.

Why would a medical professional participate in the AmeriPlan Consumer driven Health Care Program Dental Plus and Deluxe Plus?

There are many reasons. Some of the most important are:

Care and treatment are put back into the healthcare provider's hands.
The provider gets paid at the time of care. Many insurance plans take up to 120 days for payment.
Office administrative costs are reduced. No paperwork to complete, file and follow up on.
Providers may receive a net increase in revenue to the practice versus insurance (HMO or PPO).
The provider is part of an affiliation of like-minded professionals, without being "under the thumb" of managed care.
AmeriPlan provides members with quality, discounted healthcare.

Can the AmeriPlan programs be used with Medicare/Medicaid?

No. By accepting Medicare or Medicaid, physicians are paid a discounted amount; they cannot further discount their fees by accepting AmeriPlan.

Can AmeriPlan programs be contracted on an annual basis and cancelled at any time?

Yes.

Does an AmeriPlan program include hearing tests and hearing aids?

Yes. Hearing Services will be included in the Dental Plus program.

Can the AmeriPlan programs be used in conjunction with health insurance plans?

Yes, but it is at the healthcare provider’s discretion whether to accept both. A member's insurance should always be the primary form of payment. Some insurance plans require providers to agree to provide services at already discounted rates. If this is the case the provider is unable to further discount the fees and the AmeriPlan discount will not be applied.

Are there programs for emergency services?

Yes. Emergency services may or may not be contracted with the AmeriPlan Deluxe Plus program. Depending on the extent of the charges, these services may be eligible for the Hospital Advocacy Program.

Can you briefly describe the Hospital Advocacy Program?

The Hospital Advocacy program is designed to help members with their medical bills whenever a single hospital visit totals $1,500. (For the insured, this means the amount you are personally responsible for, aside from your deductible.) Charges can be incurred from multiple providers. The patient advocate negotiates on behalf of the patient and pursues a wide range of options, from government entitlement programs to payment plans. There is a waiting period of three business days from the active date of your membership to utilize this program.

Does the AmeriPlan member have a choice of which hospital will be used?