FREQUENTLY ASKED QUESTIONS


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  • What is an ACO?

    ACO stands for accountable care organization. It’s a community of doctors, clinics and hospitals specifically focused on keeping you at your best health. You get the same coverage and benefits as you would from a traditional health plan, plus extra education and recommendations based on your condition, treatment plan and medications.

  • What's the difference between PreferredHealth and PreferredOne?

    PreferredOne is the company that pays your claims and makes sure your plan runs smoothly. PreferredHealth is the network of health care providers dedicated to your health.

  • What happens after I enroll?

    First, you’ll receive a welcome kit, which includes your ID cards and explains how to use your new health plan. Then, we’ll give you a call to introduce ourselves and answer any questions you may have about PreferredHealth.

  • Where can I view my claims, EOBs and plan information?

    My Account is your personal and secure web page with your claim history, deductible balances and links to all your plan features. Once you receive your ID card, go to PreferredOne.com and activate your My Account page.

  • Can I see my current doctor?

    If your doctor is in the PreferredHealth network, you may continue that relationship. If not, to receive the greatest benefit, you’ll need to choose a doctor who participates in the PreferredHealth network. We’re here to help you with that and we’ll make sure all of your records transfer to your new provider.

  • What doctors, clinics and hospitals are in the PreferredHealth network?

    Fairview Health Services (which include all HealthEast locations) and North Memorial Health are in your network. The network also includes the University of Minnesota Medical Center and the University of Minnesota Masonic Children’s Hospital. Many independent clinics are also a part of the network; Apple Valley Medical Center, Entira Clinics, North Clinics and Northwest Family Physicians to name a few. Check out our complete listing of providers at PreferredOne.com/PH.

  • How many doctors, clinics and hospitals are in the PreferredHealth network?

    You can choose from over 5,000 doctors, 1,300 clinics, 12 hospitals, online care, urgent care and a number of convenience care locations.

  • Do I need a referral to see a specialist in the PreferredHealth network?

    You may see any PreferredHealth network provider without a referral. Search the network at PreferredOne.com/PH or, if you need help finding a specialist, call 763-847-4444 or 1-844-346-4414.

  • What if I see a provider outside the PreferredHealth network?

    You can get care outside of the network, however you won’t receive the highest level of coverage and some services may not be covered.

  • Can I get care online?

    Absolutely! Log in at Oncare.org. Our clinicians are available 24 hours a day to provide a diagnosis and treatment plan. If you need a prescription, they’ll send it right to your pharmacy.

  • What about urgent care?

    The PreferredHealth network includes retail convenience clinics such as CVS, Target and many urgent care centers.

  • Where can I view my benefits (deductible, coinsurance and copayments)?

    View the Summary of Benefits and Coverage (SBC) at PreferredOne.com. After you receive your ID card and activate your personal My Account page on PreferredOne.com, you may view your policy and all your plan details.

  • Is preventative care covered?

    Yes, preventive care is covered at 100 percent.

  • Do you cover pre-existing conditions?

    Pre-existing conditions are covered. We’ll help you find network providers to continue treating your condition and transfer your records or prescriptions if necessary.

  • What happens if I need care when I am on vacation?

    In case of emergencies, seek care immediately. Your care will be covered as if you were in-network. For minor medical issues, try online care. In Minnesota, use Oncare.org.

  • What is a formulary?

    Formulary is a list of medications that are covered on your insurance plan.

  • Can I see the formulary?

    Yes, your formulary is posted on PreferredOne.com in the pharmacy section. The formulary will be posted on your My Account member portal once you are enrolled.

  • What pharmacies can I use?

    More than 70,000 pharmacies participate nationwide including major chains and independent pharmacies. You can search for network pharmacies at PreferredOne.com in the pharmacy section.

  • What if I need specialty medications?

    Specialty medicines are available through Fairview Specialty Pharmacy. Give them a call at 1-800-595-7140.