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Member Resources

Member Resources

Member Resources

Better Care at Your Service​

èͷ exists so everyone can get the quality care they need to live the long happy life they deserve. That’s why we don’t stop at offering health plans. We give all of our Members assistance with lowering health insurance costs through tax credits and other discounts, and we make it easy for Members to pay their premiums. As a èͷ Member, you know that you are getting the very best service any health plan can offer.

Questions? ​

Our hours of operation are
8 a.m. – 5 p.m.

Call Us:
Local: 713.295.6704
Toll-Free 1.855.315.5386

Welcome to community

Educational Presentation​​

Learn more about our Premier vs. Select plans.

  • In this presentation, you’ll learn about the differences between èͷ’s Select/Ultra Select Plans and Premier Plans.
  • Once you understand the differences, it will be easier to find the best plan that fits you and your family.

meMBER rESOURCES

My Member Account

My Member Account makes it easy to manage your health plan. From learning about your healthcare benefits to printing a temporary Member ID card, your account is available 24/7/365.

Your Health Coverage​

Thank you for choosing èͷ as your health insurance provider! Our goal is to make it easy and hassle-free to get the care you need.​

Visit our Welcome Page

Telehealth

èͷ is excited to offer you the chance to talk to a doctor within minutes by phone — at no cost to you. Learn all about our Telehealth services.​

Learn about Telehealth

Member Rights and Responsibilities

To facilitate an effective relationship between Providers and Members, it is important for èͷ Members to understand their rights and responsibilities. ​

Learn more

Marketplace Guides

Need more information? Click the corresponding link to access the Marketplace Member Guides for you.

The Provider Directory is available in paper form without charge upon the Member’s request and will be provided within five business days of the Member’s request.

Marketplace Member Guide

Find the Right Care​

We make it easy to find what you need by specialty, by plan, and by location.

Search for doctors, pharmacies, hospitals, urgent care centers, and other Providers who are in-network for our healthcare plans.

Grace Period

If you do not pay your premium on time, it’s considered late, and you enter a grace period. During that time you will still be covered, but you will have a late payment.

Watch a video or view an infographic to see how long the grace period is and what benefits you risk losing if you don’t make your payment before the grace period ends.

View the inforgraphic

Preventive Services​

All of our plans cover certain preventive medical services free of charge, meaning you won’t pay a copay even if you haven’t met your deductible. These services include vaccinations, well-woman visits, certain cancer screenings, alcohol and tobacco screenings and counseling, and much more. Visit the Preventive Care Benefits site to see what’s available to you for free. You may also download a chart to learn which screenings are recommended according to your age.

Download Chart

Pay My Bill

As a Member, you have multiple ways to make a premium payment. Pay online through your My Member Account or make a quick payment. Pay anytime by phone using our automated system.

Make a quick payment without creating an account:

Find a where you can pay your premium. Enter your zip code and select Account Number under “Ways to Pay”.

Find Answers

Visit our list of Frequently Asked Questions for answers for everything from basic health insurance terms to information about in-network and out-of-network doctors, and from deductibles and how to make payments to complicated healthcare laws.

Answers will vary for On-Exchange and Off-Exchange Members, so make sure to select the correct category. If you enrolled through healthcare.gov and/or you receive a subsidy, you have an On-Exchange health plan. If you signed up for a health plan with a broker, agent or web broker who did NOT enroll you via healthcare.gov, you have an Off-Exchange health plan.

On Exchange

Off Exchange

Advanced Premium Tax Credit​

The Advanced Premium Tax Credit (APTC) is a tax credit to lower your monthly health insurance premium. When you enroll, you will estimate your expected income for the year. If you qualify for a premium tax credit based on your estimate, you can use that amount to lower your premium. To keep the credit, you must send proof of your estimated income within 30 days.

Learn More

Cost Share Reduction​

A Cost Share Reduction (CSR) is a discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. This equals extra savings for you.

If you qualify for cost sharing reductions, you also have a lower out-of-pocket maximum, which is the most you have to pay for covered medical expenses per year before insurance pays 100%. The amount of extra savings you receive depends on your income. The lower your income, the higher your extra savings may be.

Forms

The forms on our site help us to better serve you through the sharing of up-to-date health information. Please review the forms and let us know if you have any questions.

HIPAA Authorization Form

Right to Return a Contract

Medical Claim Form

Prior Authorization

This guide does NOT identify all covered benefits. All requests for prior authorization require submission of supporting clinical records.

Prior Authorization Information

Why Choose èͷ?

As a local nonprofit health plan, èͷ gives you plenty of reasons to join our èͷ. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, èͷ is always working life forward for you and your family.

“èͷ is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”

– Cecily
Member of èͷ