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Frequently Asked Questions

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General Info

What is Included Health?
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Founded in 2010, Included Health breaks down barriers to high-quality care for every kind of health need and every kind of person. With the most diverse team of doctors in the nation, we treat every member as an individual to drive better outcomes. Our fully integrated, virtual-first healthcare experience puts members first, whomever and wherever they are. Together, we’re raising the standard of healthcare for everyone.

I'm an employer, how can I offer this service to my employees?
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Included Health offers solutions for Employers, Health Plans, Consultants and Labor & Trust.  We help organizations provide better care to their members by offering easier access and fully integrated healthcare services and solutions. We’d love to help yours. Get started by telling us a little about your goals. You can also learn more by visiting our Resource Center for valuable insights, case studies and infographics to help organizations improve health outcomes for their employees.
Who can use Included Health?
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Included Health’s services are available to members and qualifying dependents who are enrolled in their employer-sponsored medical plan. Your employer provides this service so that you have access to the best medical care possible.

I have other questions, where should I go?
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If you are a current member or having difficulties with your registration, please call 855-431-5533 or email support@includedhealth.com.

If you are an employer, consultant or health plan, please visit our Resource Center or Request a Demo for more information on how Included Health can help your organization.

How does Included Health select its experts?
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Included Health contracts with experts based on many indicators of quality including their education and training, patient outcomes, and institutional affiliation. As a result, we’re able to match you with highly experienced doctors and specialists who are best suited to your personal preferences and medical needs. The experts we select work at the nation’s leading medical institutions including but not limited to University of California San Francisco, Massachusetts General Hospital, New York Presbyterian, Stanford, and Johns Hopkins.

Is my whole family covered with Included Health?
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In some cases, Included Health is available at no-cost to additional extended family members. To better understand your coverage, contact your employer or Included Health.

Do you offer language interpretation?
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Doctor On Demand by Included Health provides ASL (American Sign Language) interpretation and language translation for medical visits by appointment.

These visits are completed via Google Meet where the patient is able to connect with a licensed Doctor On Demand clinician and an interpreter.

Scheduling an Appointment:

  • Contact our Member Support team via email or phone to indicate the language needed: (800)929-0926
  • A member of the support team will assist with scheduling an appointment
  • After the appointment is scheduled, you will receive an email with verification of your appointment time and instructions on using Google Meet.

For any questions, please reach out to our Member Support team at any time. We would be happy to assist you!

How much will it cost me to see a recommended doctor?
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Typically, you’ll only pay your regular copay and office visit fees for seeing an in-network doctor. For further details, call your Personal Healthcare Team.

Open Enrollment

We may grow our family this year. What should I know about family planning during open enrollment?
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If you’re thinking about starting or adding to your family, you’ll want to compare maternity coverage across all plans to maximize your benefits and help lower costs. Check to make sure your preferred doctors and medical facilities are in-network. (Plan details can vary widely when it comes to using an independent birth center or a midwife, for example, or if you need infertility treatments.) Be sure to check if your employer offers special maternity benefits outside of your medical coverage.

Who can I include on my plan?
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In most cases, you can add a spouse to your health insurance plan. After getting married, you usually have up to 60 days to enroll in a new plan or add your spouse as a dependent.

You can also add children under the age of 26 as your dependents as long as they’re your biological, step, adopted, or foster children. Your insurance provider may need to see documentation, such as a birth certificate or proof of guardianship, to have them added to your plan. 

In most cases, you can also include other relatives as dependents under the following conditions:

  • If no one else has named them as a dependent.
  • If their gross annual income is less than $3,000.
  • If you’re responsible for providing more than half of the financial support they rely on.
Can I cancel my plan at any time?
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You can’t usually cancel your plan until the next open enrollment period unless you’ve had a qualifying life event.

What’s a qualifying life event (QLE)?
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The birth of a child, marriage, or loss of medical coverage are a few examples of a qualifying life event that may happen at any time outside the annual open enrollment period. Each employer has their own deadlines for when qualifying events need to be submitted to add new dependents, make changes or enroll. Please be sure to adhere to the specific deadlines set by your employer. Please keep in mind you should report your change to your insurance provider and through your enrollment portal as soon as possible to guarantee coverage.
Other eligible QLEs include:
  • Adoption
  • Death of a spouse or dependent
  • Job loss
  • Job change
  • Retirement
  • Reduction in work hours
  • Relocation
IMPORTANT: If you don’t experience a QLE, you’ll need to keep your insurance as is until the following open enrollment period.
What’s the difference between a health savings account (HSA) and flexible spending account (FSA)?
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Health Savings Account (HSA)

An HSA is a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. Allowed expenses include deductibles, copayments, coinsurance, and some other expenses. You’re only eligible for an HSA if you enroll in a High-Deductible Health Plan, or HDHP.

Flexible Spending Account (FSA)

An FSA is an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. Allowed expenses include insurance copayments and deductibles, qualified prescription drugs, insulin, and medical devices. You can decide how much you want to contribute to an FSA from your paycheck, up to a limit set by your employer.  

If there’s money left over at the end of the year, check the details of your employer’s plan to understand your options. 

How do copays and deductibles affect how much I have to pay out of pocket?
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A copay only contributes towards your out of pocket maximum and does NOT go towards your deductible. However, the deductible amount will contribute towards your out of pocket maximum.

What does “out of pocket maximum” mean?
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Out of pocket maximum is the amount of money that you’ll pay before the insurance plan will pay 100% of the costs for covered, in-network services. It’s also the maximum amount you can spend during the plan year. You’ll never exceed the out of pocket maximum applied to your plan.

What does “out of pocket” mean?
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Out of pocket refers to the amount of money you’re expected to pay for a given service or medication. Out of pocket costs are separate from premiums and you should expect to pay until you reach your out of pocket maximum (see below).

What’s a copay?
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A copay is a flat rate that you’ll pay for office visits or medications. This is normally charged in the office on the date of service or when you pick up your prescription.

What’s a deductible, and what’s the difference between an individual and family deductible?
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A deductible is the amount of money that you’ll pay out of pocket before the insurance plan will start covering your medical expenses. The deductible can be for either an individual or a family. When you have a family deductible, everyone in the family will contribute to your deductible.

Is an insurance plan with a smaller premium the best choice for me if I’m looking to save money?
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When shopping for a plan, keep in mind that the plan with the lowest monthly premium may not be the best match for you. If you know you’re going to need a lot of medical attention, a plan with a slightly higher premium but a lower deductible may save you more money than one with a lower premium and higher deductible.

In general, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles.

What is a premium?
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A premium  is the amount that’s taken out of your paycheck to pay for your health insurance coverage. In addition to your premium, you usually have to pay other costs for your healthcare, including a deductible, copayments, and coinsurance.

What’s the difference between an HMO, POS, PPO and HDHP?
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HMO: A budget-friendly plan

A Health Maintenance Organization (HMO) plan is one of the most affordable types of health insurance. It has low premiums and deductibles, and fixed copays for doctor visits. 

HMOs require you to choose doctors within their network. When you sign up for an HMO, you’ll need to pick a primary care physician (PCP) for your regular checkups. Your PCP has to give you a referral before you can see a specialist, such as a local dermatologist or OB-GYN. Choosing a provider who is not in your HMO’s network, or visiting a specialist without a referral from your PCP is not likely to be covered by an HMO plan and may mean significant out of pocket costs.

POS: An affordable plan with out-of-network coverage

Just like an HMO, a Point of Service (POS) plan requires that you get a referral from your PCP before you can see a specialist. But with slightly higher premiums than an HMO, this type of plan covers out-of-network doctors. Costs are higher when you use services that are out of network. So keep in mind that, even though you’ll have the option to see a doctor who’s out of network, you’ll want to stay in-network whenever possible. If you want to have both in-network and out-of-network coverage, you may want to consider a POS plan.

PPO: The plan with the most flexibility

A Preferred Provider Organization (PPO) plan has higher premiums than an HMO or POS does. But this plan lets you see specialists and out-of-network doctors without needing a referral from a PCP. Copays and coinsurance for in-network doctors are low. If you know you’ll need more specialized healthcare in the coming year and you can afford higher premiums, you may want to consider a PPO plan.

HDHP: The plan with lower monthly fees and a higher deductible

A High-Deductible Health Plan (HDHP) has a higher deductible than that of a traditional insurance plan. The monthly premium is usually lower, but you pay more healthcare costs yourself. This is because all services are out-of-pocket expenses that go towards paying off your deductible. Once that’s been paid off, your insurance company will start paying for your health expenses. Designed for people with few medical expenses, an HDHP can be combined with a health savings account (HSA), which lets you set aside tax-free money to pay for certain medical expenses.

New to Included Health?