Coverage Overview

SelectMed offers affordable daily medical coverage to fit the health needs of the average consumer. Thee plan levels are available: Base, Pro, and Max. All three levels cover ACA-mandated Wellness and Preventive services at 100% with in-network providers, including but not limited to: annual physicals, immunizations, well woman exams and mammograms. SelectMed is available to all consumers in 46 states (not available in AK, HI, MA, NH) through a Limited Partnership.

The SelectMed Base plan coverage is limited to ACA-mandated Wellness and Preventive services.

The SelectMed Pro plan offers 5 Primary, Specialist, and Urgent Care doctor visits per plan year, formulary generic prescription coverage for up to 12 prescriptions per plan year, and diagnostic labs and testing.

The SelectMed Max plan offers unlimited doctor visits, unlimited prescription coverage including formulary brand prescriptions in most states, diagnostic labs and testing, as well as outpatient CT/MRI/PET scans, Mental & Behavioral Health, Rehabilitation and Habilitation services.

Product Details

SelectMed is a single employer, self-funded group health plan made available to consumers through a Limited Partnership. Joining the Limited Partnership is required to purchase the product. As part of the enrollment process, enrollees will receive an email with the required documentation to join the Limited Partnership, which is to be electronically signed and returned by the enrollee.  Enrollment becomes final after the documents have been submitted.

SelectMed offers In-Network coverage only. The network provider is First Health PPO, one of the largest provider networks in the country. Click here to find a provider in the First Health PPO network.

The third party administrator for claims is HMA. The member ID card will show the phone number and address to which claims should be submitted on the back side.

Enrollment First, Inc. administers benefits for the Limited Partnership. Enrollees can contact Enrollment First for assistance pertaining to: enrollment, billing, eligibility, plan coverage, and member support. To reach Member Services, please call 866-816-6786 Monday-Friday, 8:00a-7:00p EST.

 

FAQs

  • How do I enroll?
    • Enroll online using the specialized enrollment link provided by your broker. This link will take you to an enrollment portal that simulates an online shopping experience. Simply choose your plan level, “add to cart,” then “proceed to checkout.”
    • Please remember that enrollment will not be finalized until you have joined the Limited Partnership.
  • What is the Limited Partnership?
    • America’s Consumers & Affiliates, LP holds the contract for this group health plan. To learn more about the Limited Partnership, click here.
  • How do I join the Limited Partnership?
    • The Limited Partnership joinder agreement documents will be emailed to you 30 minutes after enrolling through the portal. Signing and submitting these documents will join you to the Limited Partnership. If you miss the initial email, a reminder will be sent 2 days later. A final reminder will be sent 5 days after enrollment, and the documents will expire 7 days after enrollment.
  • My Limited Partnership joinder documents have expired. Can I still finalize my enrollment?
    • Yes. You will need to have a new set of documents emailed to you. Call Member Services for assistance.
  • Will my coverage be effective if I do not join the Limited Partnership?
    • No. SelectMed is only available to partners of the Limited Partnership. Coverage does not become effective until you have completed the Limited Partnership joinder documents.
  • When will my plan be effective?
    • Effective dates are available the first of the month after enrollment is finalized. (Eg. enrollment on January 31st becomes effective February 1st.)
  • I have enrolled. When will I get my ID card?
    • ID cards are sent to the email address that the primary subscriber entered at enrollment. The card will arrive by email in the last week of the month prior to the effective date. If you have not received your ID card at this time, please check your spam folder or call Member Services¬†to request a replacement.
    • Please note: if you have not completed the Limited Partnership joinder documents emailed to you after enrollment, your enrollment could not be finalized; therefore, your ID card was not sent. If you need the documents to be re-sent, please call Member Services.
  • Who handles claims?
    • HMA is the claims administrator. The phone number and address to which claims should be submitted is on the back of your member ID card.
  • Where can I find an In-Network provider?
  • How can I contact Member Services?
    • Member Services can be reached Monday-Friday, 8:00a-7:00p EST at 866-816-6786. Members can contact Member Services for questions or assistance pertaining to enrollment, billing, eligibility, and plan coverage.