The Fundamental Care Prime Health Plan is an expense-incurred, limited-day health benefit plan. After a copay for services, your plan pays 100% of the cost of services up to a limited number days of services for each type of service. The plan covers preventive care, office visits, urgent and ER care, lab and X-ray, diagnostic testing, and outpatient hospital services. In-hospital benefits may be purchased as an additional plan upgrade.
Your plan also provides generic Rx drug coverage; free lab work when done at approved facilities; and free access to telehealth providers.
As a member of the Prime Health Network, you’re encouraged to use your network of preferred doctors. For facilities, reimbursement is based on a multiple of Medicare allowable and member can go to any facility. In-network health care services will be provided at discounted costs. If you’re unsure of your provider choices, visit fundamentalcare.primehealthservices.com.
There is a phone number on your ID card you can call to find a preferred provider if you are out of town or there’s an emergency. See your Summary Plan Description for complete details.
Want to know more? Visit your Fundamental Care Prime Health Planinformation page.
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Four Things to Do Now
Find a Provider.If you want to use a physician in your PPO, this link will help you view your options.
Show your ID card to your provider at the time of service!
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Important Benefits of Your Plan
Activate your account to have access to Walmart Health Virtual Care. You have 24/7 access to a provider via your phone or lap top.
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Benefits That Help You Save Money
//////////Read your Pharmacy Information on Costco Health Solutions to determine where the closest pharmacy is and what prescriptions are covered.
/////////////Check out your formularylocated at and learn how to get the best value for your Rx needs.
Questions?
If you have any questions about your benefits, please call our Level Funded Advantage Service Center at 800-714-3432 or email ////////////////LFAService@cbcins.com.