PacifiCare
Health
Systems, a division of UnitedHealthcare,
supplies coverage for more than 3 million health plan members and nearly 10
million specialty care members nationwide. As on the nation's largest
consumer health organizations and with 25 years of business, PacifiCare offers
California individuals, employers, and Medicare beneficiaries a variety of
consumer-driven health insurance plans including specialty behavioral health,
dental, vision, and life insurance.
PacifiCare's
SignatureOptions (PPO) series offers members offer a wide range of deductibles
while the SignatureOptions (HDHP) is a high deductible plan that can be used
in conjunction with an HSA. Also offered is the SignatureFreedom (SDHP)
that offers network-based health insurance with a Self Directed Account (SDA)
and caters to individuals that lead health active lifestyles. With variable
deductibles and the option to link up health care to other financial accounts,
PacifiCare offers a variety of coverage to meet your financial needs.
You
can run an instant quote
to see detailed information about plan details, limitations, and restrictions.
Or contact us and we will help you decide on a plan
that is right for you and your family.
Rate
Information:
All
deductible options have a 12 month rate guarantee. Your rates may
also increase in the month of your date of birth, if you are moving in to
a new age bracket. For example, PacifiCare charges the same rate for
all male applicants age 30 to 34. You do not receive a rate increase
for your age during this five year period, your rates will only go up once
per year, based on PacifiCare's claims history for everyone with similar
coverage. However, when you do go to a new age bracket (age 35 in
the example above), your rates will be adjusted based on your age.
It is possible to receive an age-based rate increase during your initial
12 month rate guarantee period.
Preferred
rates without riders are available on our instant
quote page. Rates depend on gender, smoking status, zip code,
and health status.
The
premium can be paid via quarterly, semi-annual, or annual billing, or a
monthly bank draft or credit card. The bank draft will occur on the
premium due date each month. The initial premium can be paid with
a check or credit card.
Network:
As a United
Healthcare company, PacifiCare policy holders have access to one of the
largest PPO networks in the nation. To view the list of providers
in your area, simply visit the Pacificare
Provider Directory.
Underwriting:
Underwriting
of your application with PacifiCare normally takes two to four weeks, though
again if medical records are ordered it could take longer. PacifiCare
is fairly strict compared to many other companies, and often will decline
an application that other companies would accept with an exclusionary rider.
PacifiCare
performs Verification Phone Calls (VPCs)
for all applicants of individual plans. VPCs are helpful in gathering
more information about medical conditions directly from you without necessarily
requesting medical records. This often reduces issue time and make
it easier for you to do business with PacifiCare than many other companies.
With
every individual case submitted, after the application is entered into the
system, a VPC is made by the VPC team to the applicant. If you do
not respond from the first call or message, a second call is made the following
business day. If PacifiCare is unsuccessful in reaching you, they
will send a letter asking you to please return their call.
To
help expedite the process, please make sure to include the following information
with your application:
-
Make sure to include a daytime phone number where you can be reached, as
well as an email address in case they cannot reach you by phone.
- If you
are unavailable to complete the VPC, PacifiCare will leave a file number
and phone number to call PacifiCare back between 6:00AM and 6:00PM MT (limited
staff only from 4:30 PM to 6:00 PM - hold time might be required).
- Please
have your medical information available for the call.
60+
Year Old Applicants
If
you are over 60 years old, you will need to have been seen by a licensed
medical physician within the past 12 months. If you have not, you
will not be considered for coverage until the results of a complete physical
exam are received, including
- Vital
signs
- Review
of bodily systems (including height and weight)
- Notation
of all medications(s) being taken
- Chemistry
panel
- Male
applicants, PSA (Prostate Specific Antigen) level
- Female
applicants, Mammogram and Pap
Full
medical records will also be requested once the updated exam has been completed.
Effective
dates:
The earliest
your coverage can go into effect is ten days after you have signed your
application. You may request an effective date any time between 10
and 60 days after you sign your application.
Please
note, if you are requesting an effective date of less than 21 days from
the time you complete the application, you may not receive notification
of your approval until after your effective date. If you have claims
during this period, they will be eligible for coverage if submitted after
you have been approved. Also note that you will be billed starting
on your requested effective date, even if you have not yet been notified
that you have been approved. This is very good for someone who does
not have any present coverage and would like for their benefits to begin
right away. For those who are already covered, it is suggested that
you maintain your current coverage in force until you have received notice
from either eCAHealthinsurance
or directly from
Blue Shield that your coverage has been approved and is in force.
How
to Apply:
Simply run
an instant quote
and select the plan you are interested in. Then select to apply
online or download the application, fill it out and fax it in to
us. We will then stay in touch with your during the underwritting
process to keep you informed of the progress.
About
PacifiCare:
PacifiCare
Health Systems is a division of UnitedHealthcare. They serve more
than 3 million health plan members and approximately 10 million specialty
plan members nationwide with annual revenues of more than $12 billion.
PacifiCare
recently celebrated its 25th anniversary as one of the nation's largest
consumer health organizations, offering individuals, employers and Medicare
beneficiaries a variety of consumer-driven health care and insurance products.
PacifiCare
has been given a rating of "A-" (Excellent) from
the A.M.
Best Company, an independent insurance rating organization.
eCAHealthinsurance
is an independent authorized PacifiCare agent.
