For complete
details on each plan, please view the PacifiCare
plans description 
brochure.
Rates:
All
deductible options have a 12 month rate guarantee. Your
rates may also increase in the month of your date of birth,
if you are moving in to a new age bracket. For example,
PacifiCare charges the same rate for all male applicants age
30 to 34. You do not receive a rate increase for your
age during this five year period, your rates will only go up
once per year, based on PacifiCare's claims history for everyone
with similar coverage. However, when you do go to a new
age bracket (age 35 in the example above), your rates will be
adjusted based on your age. It is possible to receive
an age-based rate increase during your initial 12 month rate
guarantee period.
Preferred
rates without riders are available on our instant
quote page. Rates depend on gender, smoking status,
zip code, and health status.
The
premium can be paid via quarterly, semi-annual, or annual billing,
or a monthly bank draft or credit card. The bank draft
will occur on the premium due date each month. The initial
premium can be paid with a check or credit card.
PPO
Network:
As
a United Healthcare company, PacifiCare policy holders have
access to one of the largest PPO networks in the nation.
To view the list of providers in your area, simply visit the
Pacificare
Provider Directory.
Underwriting:
Underwriting
of your application with PacifiCare normally takes two to four
weeks, though again if medical records are ordered it could
take longer. PacifiCare is fairly strict compared to many
other companies, and often will decline an application that
other companies would accept with an exclusionary rider.
PacifiCare
performs Verification Phone Calls
(VPCs) for all applicants of individual plans.
VPCs are helpful in gathering more information about medical
conditions directly from you without necessarily requesting
medical records. This often reduces issue time and make
it easier for you to do business with PacifiCare than many other
companies.
With
every individual case submitted, after the application is entered
into the system, a VPC is made by the VPC team to the applicant.
If you do not respond from the first call or message, a second
call is made the following business day. If PacifiCare
is unsuccessful in reaching you, they will send a letter asking
you to please return their call.
To help
expedite the process, please make sure to include the following
information with your application:
- Make
sure to include a daytime phone number where you can be reached,
as well as an email address in case they cannot reach you
by phone.
- If you
are unavailable to complete the VPC, PacifiCare will leave
a file number and phone number to call PacifiCare back between
6:00AM and 6:00PM MT (limited staff only from 4:30 PM to 6:00
PM - hold time might be required).
- Please
have your medical information available for the call.
60+
Year Old Applicants
If
you are over 60 years old, you will need to have been seen by
a licensed medical physician within the past 12 months.
If you have not, you will not be considered for coverage until
the results of a complete physical exam are received, including
- Vital
signs
- Review
of bodily systems (including height and weight)
- Notation
of all medications(s) being taken
- Chemistry
panel
- Male
applicants, PSA (Prostate Specific Antigen) level
- Female
applicants, Mammogram and Pap
Full medical
records will also be requested once the updated exam has been
completed.
Effective
dates:
The
earliest your coverage can go into effect is ten days after
you have signed your application. You may request an effective
date any time between 10 and 60 days after you sign your application.
Please
note, if you are requesting an effective date of less than 21
days from the time you complete the application, you may not
receive notification of your approval until after your effective
date. If you have claims during this period, they will
be eligible for coverage if submitted after you have been approved.
Also note that you will be billed starting on your requested
effective date, even if you have not yet been notified that
you have been approved. This is very good for someone
who does not have any present coverage and would like for their
benefits to begin right away. For those who are already
covered, it is suggested that you maintain your current coverage
in force until you have received notice from either HSA
for America or directly from PacifiCare
that your coverage has been approved and is in force.
About
PacifiCare:
PacifiCare
Health Systems is a division of UnitedHealthcare. They
serve more than 3 million health plan members and approximately
10 million specialty plan members nationwide with annual revenues
of more than $12 billion.
PacifiCare
recently celebrated its 25th anniversary as one of the nation's
largest consumer health organizations, offering individuals,
employers and Medicare beneficiaries a variety of consumer-driven
health care and insurance products.
PacifiCare
has been given a rating of "A-" (Excellent)
from the A.M.
Best Company, an independent insurance rating organization.
HSA
for America is an independent authorized PacifiCare
agent. CA License #: 0E39302
