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How Does Pacific Care Health Services Keep Such Happy Customers?


Pacific Care Health Insurance is available 24/7 and is able to process eligibility status and claim requests online at real time. This provides for increased convenience coupled with user friendliness. Moreover there is less paperwork and a much faster turn around. One can easily obtain the latest forms and access the most recent benefit plan manuals, provider handbook and referral directory. Questions are responded to immediately directly from their information source. The staff strives to be courteous, informative and supportive.


A Checking Account For Health Care


Participants are required to pay an annual deductible before benefits kick in and then a fixed percentage or coinsurance of the health care costs. However, Pacific Care Health Insurance offers participants a self directed account (SDA) option, whereby one can defray some of the cost to satisfy part of the annual deductible or other approved medical plan expenses. Thus the SDA acts as a health care checking account.


Teamwork Is The Goal As Well As The Means To Good Health Care


Both the Pacific Care HMO and PPO plans focus on quality of care, with prevention and wellness being the underline theme. With prevention and wellness, education and teamwork are of paramount importance. Each HMO member accesses health care through a primary care physician (PCP). The PCP forms a working relationship with the member, gets to know the member’s medical history, needs and preferences. The PCP in conjunction with the member selects the specialists or hospital that the participant may need. The member may choose any PCP he or she likes among a very wide directory of physicians contracted under this plan. Moreover, should the member prefer to do so he may select a PCP outside of the directory of contracted physicians for a somewhat higher out of pocket co-payment.


These options provide increased affordability, choice and flexibility while maintaining a healthy and supportive relationship between the member, his physician/ health care providers and Pacific Care. When traveling, members can visit any licensed provider in the state. Furthermore participants have the option of choosing either a general practitioner or a specialist as their primary care physician.

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