FAQs for Members / Employees
General FAQs
A. Free Market Administrators uses the PHCS Network, one of the largest Preferred Provider Networks of hospitals, clinics, and physicians in the USA.
Remember, to utilize your benefit plan, verify your Providers are contracted in your specific preferred provider network.
A.
- Preferred Provider Organization (PPO). The FMA Freedom Select plan utilizes the Multiplan Inc., PHCS Network for medical services.
- Offers extensive patient access to2 million network health care providers
- Offers competitive or lowest actual dollar pricing – not stated discounts
- Excludes or minimizes contract language default pricing
- Utilizes best in class providers based on value-based treatment outcomes
- Telehealth: 24 Hour Virtual Clinic allows you to reach licensed board-certified physicians. Physicians triage the patient and diagnose offering a personalized treatment plan. Physicians can prescribe medications which can be purchased at a member pharmacy.
- Pharmacy: Serve You Rx is a full-service Pharmacy Benefit Manager (PBM)
- Over 70,000+ pharmacies in the national
- Value based low net cost formulary with trends below national growth rates for the last 10
- USA based customer service representatives 24/7/365.
- Members may register for a 90-day mail order
- Dental/Vision: Careington POS Discount Dental Plans
- Careington works with 62,000+ participating dentists.
- Save 20% to 60% on most dental procedures
- Not Discount plans can be used continuously with no capped services.
- Highly selective credentialing standards
- Members may visit any participating dentist in the network at any time
- Membership extends to all members of the family, throughout all 50 states
- Careington offers Vision and Lasik services through VSP Providers
A. Free Market Administrators LLC., your contract administrator, will provide you with a medical identification card (ID card) that will include important member and plan information.
As a member, you will present your Medical ID card to a health care provider and pharmacist as you would with any other health care coverage ID card. The provider will verify for membership eligibility and provide your service. The provider will process the claim directly with the contract administrator. Most of the time you will not pay anything at point of service. Some providers on some services may request a portion of your share of the co-insurance.
ServeYouRx Pharmacy POS (point of sale) fulfill 30 day supplies. Members may register for mail-order 90 supplies.
If you are choosing to utilize your $20.00 “co-pay” benefit, remember to mention “co-pay” for limited services at your provider.
If you are intending to use your Affordable Care Act (ACA) preventative or well-being test coverage, you must verify as such and that your provider will submit the proper CPT codes. Failure to do so will result in your invoicing being submitted to reflect your regular zero deductible 50/50 co-insurance amounts due.
Fair Price Labs Inc. can reduce expensive lab readouts in certain circumstances. Members can register with Fair price Labs and present to their Provider for lab discounting beyond standard plan discounting.
Remember to verify your provider is in PHCS prior to receiving medical services.
A. Free Market Administrators (FMA) was created with over 100 years of experience health care at the Senior Executive Level. We are committed to creating value for our broad client base of both fully insured major medical and self-funded clients. FMA continues to be a critical measure for which we have maintained thehighest performance standards within the industry. FMA remains focused on not only exceeding the highest ethical standards in the industry, while upholding the utmost integrity for our clients, but also redefining the way our clients look at the world of health care benefits.
A. One factor is the FMA Freedom Select plans reside inside the private Small Business Agency CoOp non-profit corporation. Secondly, there are coverage caps and by purchasing only the amount of care you might anticipate over the year, you can save a lot on your health care coverage.
A. Enrollees evaluate the plans and select a coverage limit or “cap”. This cap represents the upper limit of care provided annually after PPO Provider discount. Supplemental benefits or catastrophic plans may be added for additional coverage.
A. There are no waiting periods on basic level benefits or preventative care benefits. However, extra (enhanced) inpatient/outpatient benefits on Plan B250 have a 60-day waiting period.
A. There are no deductibles on base plans. Plan B250 has a $20,000 deductible for use of the catastrophic plan.
A. Yes, members will have access to 24hr Virtual Clinic which allows members to call and speak to a state board certified physician who will be able schedule a behavioral health session.
Each enrolled employee and enrolled dependent(s) will have access to virtual behavioral health consultations. These consultations are offered by master-level clinicians 24/7/365. Please note each enrolled employee and dependent is eligible for up to 3 virtual consultations per plan year.
A. Instructions are outlined in the Member Portal package.
How to Access the Discount:
Step 1: To locate a participating provider, please call (800) 290-0523 or visit www.careington.com to access the online provider search.
Step 2: When scheduling an appointment, please inform the participating provider’s office you are a member of the Careington Dental Network.
Step 3: Please present your Careington ID card upon arrival to receive savings.
Step 4: The provider will collect payment at the time of service. You are responsible for paying the total bill, less the applicable savings, when service is provided.
A. If you have questions about any features, benefits, and exclusions prior to enrolling, it is suggested you contact Free Market Administrators by email at [email protected], or call the Free Market Administrators Customer Service Representatives at 888-847-3014.
Note: If you are already enrolled, please call the plan administrator customer service number located on your medical ID card.
A. The FMA Freedom Select Plans may be enrolled during your company’s anniversary designated open enrollment period.
A. Your health care plan continues coverage. Cost sharing for a member is exhausted and patient pay remains after PPO Provider discounts.
