Medical Benefits

Your medical benefits plan operates under a Transparent Open Network. It’s the most effective tool in helping to control the rising cost of healthcare. As a member you’ll have a fully transparent, comparable and predictable view of lower and fair costs of care. You’ll also have more freedom in how you use your medical benefits. You can see any health provider who accepts the plan, and they’ll be paid a pre-defined amount for each service to make things easier.

To find a provider who accepts our plan, call Apostrophe at (866) 810-7766 Monday through Friday 8am-6pm local time. Assistance is available on-call for weekends.

2020 DBM Global Medical Plan on the Transparent Open Network

Preventive Care and Services

100% covered (no charge)

Primary Care Physician Visit

$25 copay

Specialist Visit

$50 copay

Urgent Care

$75 copay

 

 

Annual Deductible (Individual/Family)

$2,500/$5,000

Out-of-Pocket Maximum (Individual/Family)
Including medical and prescription drug copays

$4,250/$8,500

Coinsurance (Member/Plan)

20%/80%

Diagnostic Tests and X-rays
Imaging (CT/PET scans, MRIs)**
Outpatient Surgery**
Hospital Stay**

$0 copay at a Center of Excellence (COE)*
You pay 20% after deductible everywhere else

Emergency Room

20% after deductible

Maternity Services

20% after deductible

Mental Health and Substance Abuse

20% after deductible

*For more information on COE, visit my.apostrophe.health
**Pre-authorization may apply

2019 DBM Global Medical Plan on the Transparent Open Network

Preventive Care and Services

100% covered (no charge)

Primary Care Physician Visit

$25 copay

Specialist Visit

$50 copay

Urgent Care

$75 copay

 

 

Annual Deductible (Individual/Family)

$2,500/$5,000

Out-of-Pocket Maximum (Individual/Family)
Including medical and prescription drug copays

$3,750/$7,500

Coinsurance (Member/Plan)

20%/80%

Diagnostic Tests and X-rays
Imaging (CT/PET scans, MRIs)**
Outpatient Surgery**
Hospital Stay**

$0 copay at a Center of Excellence (COE)*
You pay 20% after deductible everywhere else

Emergency Room

20% after deductible

Maternity Services

20% after deductible

Mental Health and Substance Abuse

20% after deductible

*For more information on COE, visit my.apostrophe.health
**Pre-authorization may apply

Frequently Asked Questions

Do I need to be preauthorized?

Preauthorization process
When you or a family member are advised that non‐emergency care is needed by your physician, it is your responsibility to immediately contact Apostrophe at (866) 810-7766. Apostrophe will provide guidance on Centers of Excellence and/or alternative options when appropriate.

What healthcare procedures require preauthorization?

Preauthorization is generally needed for diagnostic services such as MRI’s, inpatient and outpatient surgeries, specialty drugs, non‐ER hospital services and continuing care services.

How long does preauthorization take?

You are required to provide a minimum of 14 days notification for all non‐emergency care or procedures. It’s best to call Apostrophe as soon as your physician recommends a procedure.

What happens if a procedure should have been preauthorized, but wasn’t?

In non‐emergency cases, you will be responsible for additional costs if the procedure wasn’t preauthorized.

Is there a Center of Excellence (COE) for imaging or lab services?
Yes, Greenimaging is set up as a COE for imaging and can be reached at (844) 968-4647. LabCorp is the COE for lab services.
I’m now eligible for Medicare, where can I get more information?

For further guidance regarding Medicare you can contact Brian Bailey at brian@baileybilyeu.com or (480) 704-1008.

Is there a preferred vendor for Durable Medical Equipment?

As you have the option to shop with any vendor, please note that Apostrophe does have a direct contract with EdgePark. You may contact Apostrophe Member Care team directly at (877) 632-0831 and they will order and pay for your supplies. You will be billed your member responsibility by Apostrophe the following month and may make payment arrangements.

Also, for glucose monitoring supplies, Apostrophe recommends ADW https://adwdiabetes.com/category/diabetes-supplies as a vendor.

Contact Us

Apostrophe is your first point of contact for all your health needs and insurance-related questions.

Member care is on-call to help you 8:00 am – 6:00 pm

Call or text: (866) 810-7766 | Email: hi@apostrophe.health