AmeriCorps VISTA FAQs (Using your plan)

Below are some frequently asked questions about the AmeriCorps VISTA Health Benefit Plan. This list of FAQs is an overview of the benefit and should not take the place of the Member Health Benefit Guide. For a complete list of covered and non-covered services, please refer to the AmeriCorps VISTA Health Benefit Member Guide.

General Healthcare and Health Benefits Overview/Questions:

Is the AmeriCorps plan considered health insurance?
I currently have health insurance, should I keep it?

AmeriCorps VISTA Health Benefit

Coordination of Benefits with Other Insurance or Other Health Plans:

Where do I indicate my other insurance information?
Does that mean I am supposed to be using my other insurance whenever possible?

Healthcare Cards:

How do I get an AmeriCorps VISTA healthcare ID card (or a new card if I’ve misplaced mine)?

Customer Service:

Who do I contact if I need assistance with a healthcare question or questions about my AmeriCorps VISTA Health Benefit?
Can I update my address or change my name through my MyIMGVISTA account?
Do you have Spanish services if I have questions?

Preferred Providers:

What is a Preferred Provider Network (PPO) and why is it important to me?
If a doctor refuses appointments for new patients, what should I do?

Pre-Existing Conditions:

What is a pre-existing condition?
Why are pre-existing conditions not covered?
Does pre-existing also mean acute onsets of conditions that you were treated for in the past but are not having symptoms of or being treated for when entering the program (such as the flu or urinary tract infections - UTIs)?
Pre-existing Conditions and Medications:

Prescription Coverage:

Does International Medical Group pay for 100% of our prescriptions?
Are we allowed to obtain medication for a pre-existing condition?
Are medications covered for pre-existing diabetes, like insulin?
Are we really required to use a mail order pharmacy for routine prescriptions?
Is birth control covered?
Are over-the-counter (OTC) drugs covered?
Is the flu vaccine covered?

Women’s Health:

Is a routine GYN visit covered?
Is a bone mineral density test covered?
Is a mammogram covered?
Will a mammogram be covered at 35 if you have a family history of breast cancer?
Would we have to pay out-of-pocket first (and submit a claim) to see an OB/GYN for our one allowed routine visit?
I went to an OB/GYN appointment and the doctor ordered a blood test because I have had a history of anemia (the physician wanted to check for it); would that be covered?
I went to an OBGYN and the doctor wanted to see me again to go over my results; will that be covered?

Dental Care:

Is there coverage for dental care?

Vision Care:

Is there coverage for vision care?

Service Related Injuries and Workers Compensation:

Am I covered by worker’s compensation?
What if I become injured or ill while on the job?
Is post-injury physical therapy covered?

Miscellaneous Health Benefit Questions:

Are urgent treatment centers considered the same thing as an emergency room?
Is a physical covered by the health benefits?
Are alternative treatments, like acupuncture, covered?
Can I see an allergist (I am constantly sick with allergies)?
If I extend my service (or sign up for another term of service), do the health benefits start over?

Medical Claims and Bills:

How do I access my EOBs (Explanation of Benefits)?
What is the difference between a medical claim and a bill?
How are my medical bills paid?
Who do I call if I have questions about the health benefits plan?
Who is responsible for my health care and for the bills I have?

Denied Claims and Appeals:

I went to the doctor and now I’m getting a bill, what should I do?
What happens if I go to the doctor and the claim is denied by International Medical Group?
What happens if the health benefits plan won’t pay after my appeal?

Hospital Pre-Certification

The AmeriCorps NCCC Health Benefit only requires precertification for inpatient hospitalization. Pre-certification is not a guarantee of benefits or payment; it is a way to document the medical condition meets medical necessity for admittance to the hospital.

Hospital Pre-Certification:

Why is precertification required for hospitalization?
What is outpatient and inpatient?
What was the limitation on hospitalization?
How do you call ahead of time for hospitalization if it's an emergency?

Cobra/Coverage Continuation:

Am I eligible for COBRA?