04/22/2013
ATTENTION ATTENTION ---> ALL SINGLE MOMS
Open enrollment for PCN (Primary Care Network) is this week -- starting tomorrow for parents and adults without kids. GO TO http://health.utah.gov/pcn/faq.html #2 TO APPLY.
Applications are only accepted during open enrollment periods. These are held when resources are available to cover more people. During a PCN Open Enrollment, there are three ways to apply:
• Apply online
• Download & print an application, then mail it. Applications will only be accepted during an open enrollment period
• Stop by your local office
How much does it cost?
• Yearly enrollment fee is $50, $25, or $15 depending on your income
• Low co-pay amounts
• The maximum amount of co-pays you will be required to pay out-of-pocket is •no more than $1,000 per person per year
• See PCN Co-Pay Summary
•American Indians/Alaska Natives do not have a co-pay when getting services •at Indian Health Services or tribal facilities.
What benefits and services are covered?
• Visits to a primary care provider
• Four prescriptions per month
• Dental exams, dental X-rays, cleanings, and fillings
• Immunizations
• Eye exam; no glasses or contacts
• Routine lab services and x-rays
• Emergency room visits (restrictions apply; see PCN Member Guide)
• Emergency medical transportation
• Birth control methods
• Insulin, lancets, test strips, syringes (for diabetes control and management)
See the PCN Member Guide: Covered Services.
What is not covered?
Hospital stays, MRI’s, CT scan, etc.; visits to a specialist such as an orthopedist, cardiologist, ear nose and throat doctor, etc. are types of services that are not covered by PCN. A Specialty Care Coordinator may be able to help you find a provider who charges a minimum co-pay for uncovered services.
What doctors, dentists and facilities accept PCN?
If you already have a primary care provider or dentist, or you find one in the phone book you would like to use, you are welcome to call them and ask if they accept PCN. Otherwise, these options below will help you:
• Online PCN Provider List
• Call 1-888-222-2542
How long can I be on PCN?
PCN reviews your enrollment every 12 months from the time you started.
At that time, PCN will send you a renewal form. If you are still eligible, you will need to pay the enrollment fee to get covered for another 12 months.
Once you become a PCN Member, you must report any changes in your information or status. You must report changes if you: get health insurance through another source, move to a new address, get a new phone number, become a full-time student, or become pregnant.
What emergency services are covered?
For medical emergencies only, PCN will cover:
• Ambulance ride
But, PCN may not always cover the following:
• Emergency Room (ER) visit
• Visit with an ER provider
See the PCN Member Guide: Emergency Care.