• Using a Healthcare Plan

    Healthcare is complex

    But we can help you make smart decisions with information on how insurance works, health savings accounts, how to prep for your doctor visits and more.

    How to use your Plan


    Use the information below to find out how to use your health plan and access the care you need.

    Clear Spring Health strives to increase the wellbeing of our members and one of the ways we do that is by offering reliable transportation to your medical appointments.

    Your Network

    Start by using our online tool to find an “in-network” doctor or hospital provider to partner with to help navigate your options. Our networks consist of a carefully selected group of providers in your area, who offer medical care at a lower cost than those outside of the network. Also use this tool to access clinics, urgent care centers, or pharmacies.


    Know Your Plan Details

    Take the time to review your specific plan details and disclosures to learn about when you may need a referral, approval for services, and specific benefits and coverage.

    Perks


    Your plan may offer benefits you don’t know about such a SilverSneakers gym membership or access to telehealth. Review your plan’s extra perks so you can make the most of your health insurance.

    SilverSneakers

    98Point6 Telehealth App

    Supplemental Insurance


    Most medical plans do not offer dental, vision, or hearing benefits. To access these plans, you will need to purchase supplemental plans. Regular visits to your dentist, eye and hearing doctors will help you maintain good overall health and will help catch health issues early.

    Common Healthcare Plan Terms

    Use the list of definitions below to understand the meaning of common healthcare terms.

    • Claim– A claim is another word for a bill. Your doctor or hospital will send your claim to Clear Spring Health to request payment for services provided to you. You will receive an Explanation of Benefits (EOB) showing what you may owe and what was paid.
    • Coinsurance –Coinsurance is the amount you are responsible for after you meet your deductible.
    • Copayment –A copay, or copayment is the amount you pay to a healthcare provider at the time of service. Copayments are different depending on your plan.
    • Deductible –A deductible is the amount you pay toward medical expenses before your health plan starts to pay for related costs. Check your medical plan coverage for details regarding what deductibles you have.
    • Out-of-Pocket Maximum –This is the maximum amount you’ll be required to pay out-of-pocket. Deductibles and copayments are considered out-of-pocket payments. Once you have reached your out-of-pocket maximum, your plan pays 100 percent of covered services. Check your plan for details.
    • Payment to Providers –Payments you make to your doctor or hospital is referred to as payment to providers for medical care or prescription drugs. Check with your provider to see if they accept cash, check, or credit cards.
    • Premium Payments –A premium payment is the payment you pay to your healthcare plan to keep your coverage active.
    • Provider –A provider refers to the doctor, hospital, clinic, urgent care center, pharmacy and other healthcare professionals that provide you with medical care.

    Last Updated on October 1, 2020, 8:11 am CDT

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    Clear Spring Health, PO Box 278530 Miramar, FL 33027 ©Copyright 2020 Clear Spring Health. All rights reserved.


    Clear Spring Health has a contract with Medicare to offer PPO, HMO, and PDP Plans. Eon Health has a contract with the Georgia Medicaid program and a contract with the South Carolina Medicaid program. Enrollment in these plans depends on contract renewal.

    To learn more, please call (877) 364-4566 TTY users should call 711. Our office hours are October 1 – March 31, seven days a week, 8:00 a.m. – 8:00 p.m. and from April 1 – September 30, Monday through Friday, 8:00 a.m. – 8:00 p.m. (you may leave a voicemail Saturday, Sunday and Federal Holidays).

    Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.Llame al 1-877-364-4566 (TTY: 711)