Advantage Cross

DOCTORS, CLINICS & PROVIDERS


How can I find out if my doctor is part of Advantage?
Go to www.preferredone.com/hc/find-a-doctor or call PreferredOne Customer Service at 763-847-4477. Advantage offers three different networks to choose from, so make sure all of your doctors, clinics and hospitals are listed in the network you select.

Can I still use the Be Well Clinic if I enroll in Advantage?
Yes. Regardless of which Advantage network option you choose, you can continue to use the Be Well Clinic and pay no copay or deductible for medical services. Regular copays apply to prescription drugs.

Does my prescription drug benefit change if I enroll in Advantage?
No. All county health plans have the same co-pays and list of covered drugs.

What happens if I see a provider outside of my network?
Each of the Advantage options has a comprehensive network of physicians, clinics and hospitals. When you need care, your physician will look first for a specialist within your network. If you are referred to an out-of-network specialist, contact your network [link to contact page] to confirm the referral. You will need a written referral from your network physician before you make an appointment with the specialist to ensure your care is covered at the in-network level.

If you do not have a written referral, you can still access care outside of your network. There is a $1,500 deductible and 70% coverage for out-of-network covered services. The out-of-pocket expenses for out-of-network covered services do not count toward the in-network out-of-pocket expenses.

Is alternative medicine, such as acupuncture and chiropractic care covered?
Yes. Make sure to review the list of providers in each Advantage network to determine the network that includes your desired provider. Acupuncture and chiropractic care is available at the Be Well Clinic to all covered Hennepin County employees and adult dependents with no co-pay or deductible.



ENROLLMENT


When I enroll in Advantage, do I have to pick one doctor or clinic?
No. You do not need to pick one doctor or clinic, but you must pick a network. Each of the Advantage options has a comprehensive network of physicians, clinics and hospitals, and you have access to all the providers in the network you choose.

Can I change my health plan election mid-year?
No. Your next opportunity to change your election will be in next year’s open enrollment.

I am going to enroll in Advantage. I currently see a physician who is not part of the network I plan to choose. How can I get my records transferred?
Your new clinic can assist you with the transfer of your medical records, or you can call the concierge line of your Advantage network:
Advantage-Fairview/North Memorial/HealthEast 612-672-2952
Advantage-HealthPartners/Park Nicollet 952-967-7108
Advantage-Hennepin County Medical Center/NorthPoint 612-873-5700

How does PreferredOne fit into the Advantage plan?
PreferredOne is the organization that administers the plan. They are not a healthcare provider. They are a healthcare insurance company that manages and administers healthcare plans for many different organizations, including all four of the Hennepin County plans. The Advantage plan is exclusive to Hennepin County employees, but is administered by PreferredOne.

My doctor or clinic has never heard of Advantage? Why?
Advantage is the name of the insurance plan that is only available to Hennepin County employees. The name of the insurance you carry is PreferredOne. Your doctor or clinic should be familiar with PreferredOne insurance.

Are online healthcare services available through Advantage?
Yes. Each network offers online services where you can receive medical advice. All online visits are free for common, non-urgent conditions.



FAMILY & TRAVEL COVERAGE


Do all family members need to be in the same plan and network or can each member choose?
All family members must be enrolled in the same health plan and same network option.

What if I have a student in college in another state?
College students living outside of the area may access the MultiPlan PHCS Health Directions Network. Care delivered through this national provider network will be covered as “in-network” benefits. This network has almost 900,000 contracted providers across the country.

Does Advantage have coverage for preventive dental for children?
Yes, the Advantage preventive dental benefit for children.

Do I have coverage if I am traveling?
Yes. You have access to the MultiPlan PHCS Health Directions Network. Care delivered through this national provider network will be covered as “in-network” benefits. This network has almost 900,000 contracted providers across the country.

If I add a dependent in the middle of the year due to a qualifying event, can I change my health plan election?
No. While you can add dependents to your existing plan during the year, you may only change plans during open enrollment.

I spend winters outside of Minnesota. If I enroll in Advantage, what will my coverage be?
You have access to the MultiPlan PHCS Health Directions Network. Care delivered through this national provider network will be covered as “in-network” benefits. This network has almost 900,000 contracted providers across the country. However, if you permanently move outside of Minnesota, you must enroll in the Standard plan.



REFERRALS & OUT-OF-NETWORK COVERAGE


What if I need to see a specialist?
Each of the Advantage options has a comprehensive network of physicians, clinics and hospitals. When you need care, your physician will look first for a specialist within your network. If you are referred to an out-of-network specialist, contact your network to confirm the referral. You will need a written referral from your network physician before you make an appointment with the specialist to ensure your care is covered at the in-network level. The out-of-pocket expenses for out-of-network covered services do not count toward the in-network out-of-pocket expenses.

If you do not have a written referral, you can still access care outside of your network. There is a $1,500 deductible and 70% coverage for out-of-network covered services received.

Is there any out-of-network benefit coverage in Advantage?
There is a $1,500 deductible and 70% coverage for covered services. The out-of-pocket expenses for out-of-network covered services do not count toward the in-network out-of-pocket expenses.