Frequently Asked Questions - Copay Plan through First Health

Q. What is the Copay Plan? Am I limited to a network of providers?

A. The Copay Plan is an open access plan which utilizes The Coventry Health Care National Network. It offers set copayments for network services as well as providing non-network benefits. Network providers sign contracts to provide health care services at discounted rates. Although you are not required to receive services from these providers and facilities, if you use network providers, you are not responsible for the deductible, and your out-of-pocket costs are less.

Q. What is a pre-existing condition? How long is the limitation?

A. For members participating in MCHCP’s Copay plan, a pre-existing condition is one in which you incurred medical expenses or received treatment during the three months immediately prior to the effective date of coverage. The limitation is six months for claims related to this condition.