Question 1

I am a member but I do not see where I can log in on this website. Where do I find access to my member benefits, coverage, etc?

Accepted Answer

All members can log in through the member portal.

Question 2

How and when can I get in touch with customer service?

Accepted Answer

We’re here to help! Customer service can be reached at curative.com/support or through our help line at 855-428-7284 or health@curative.com.

Question 3

How can I get a new ID card?

Accepted Answer

For a new ID card, please visit curative.com/for-members/contact. Feel free to call out help line at 855-428-7284 or email us at health@curative.com

Question 4

How do I change or update my name, address, or other contact information?

Accepted Answer

Members should notify both Curative and their employer to change any important account information. To let us know, please call customer support at 855-428-7284 or health@curative.com.

Question 5

If I am discontinuing employment with my employer, will my health insurance coverage continue?

Accepted Answer

Employees often use the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) or similar state laws to continue existing health insurance coverage after termination of employment. Your employer can help you determine eligibility and navigate the process. If you are changing jobs, inquire about Curative insurance with your new employer.

Question 6

How can I cover my newborn from birth?

Accepted Answer

Congratulations on your newborn! When a child is born, they are covered automatically for 30 days. To cover afterwards, they need to be enrolled through your employer within 31 days of birth.

Question 7

Are adopted children eligible for coverage? If so, how do I add an adopted child?

Accepted Answer

Congratulations on the new addition to your family! Yes, adopted children need to be enrolled within 31 days of adoption. Please contact your employer’s HR and benefits department for adding an adopted child.

Question 8

How do I add or remove family members from my plan?

Accepted Answer

To add or remove family members, please visit your employer’s enrollment system. All enrollment changes must go through your employer’s HR and benefits department as they will determine whether a family member can be added or removed and any cost share changes as well as how to add or remove family members. Typically changes may be made outside of open enrollment only following special enrollment or other qualifying events determined by the employer. In that case, typically, the change to enrollment must take place within 31 days of the qualifying event and will take effect upon enrollment, but may be backdated to the first of the month or date of the event. Please first contact your employer to make changes to your plan.

Question 9

What is a Baseline Visit?

Accepted Answer

To get the most out of your membership, every member is encouraged to participate in a Baseline Visit that can be used to tailor an individualized plan for finding services from Curative and network providers. By doing so, you are eligible for the full benefit of $0 co-pays and deductibles as long as you stay in-network. The Baseline Visit is a meeting with a Curative Clinician to onboard you to the Curative Health Plan, understand your health goals and how we can best work with you to meet your current and future health care needs. The Baseline Visit will also include an Evaluation of Preventive recommendations indicated by the United States Preventive Services Task Force (USPSTF) and evaluate whether your immunizations are up to date, all designed to keep you healthy.

Question 10

Why should I get a Baseline Visit?

Accepted Answer

The individualized attention from the Baseline Visit focuses on your complete wellbeing and how to get help from your health plan’s benefits and resources. The Baseline Visit can provide you with information to help you understand your current health and potential risks, and may also be used to offer you services or resources through the health plan. By collaborating with your provider to focus on your physical, mental, social, emotional, and environmental health, you are in greater control of your health care outcomes.

Question 11

What happens if covered members do not receive a Baseline Visit?

Accepted Answer

We encourage all members to complete their Baseline Visit! If members do not complete a Baseline Visit within 120 days after enrollment, they will be responsible for the deductible and coinsurance listed in the Benefits Booklet for both medical services and pharmacy.

Question 12

What is Curative’s Care Cost Estimator?

Accepted Answer

As part of an effort to reduce health care costs, the federal government has rolled out a series of regulations related to providing more transparency around how much insurers and members pay for specific procedures. One of the requirements under Transparency in Coverage (TiC) regulations is to provide an internet-based tool to allow members to look up prices for procedures in their area. Curative’s Care Cost Estimator tool enables members to compare prices of 500 medical procedures among providers in the Austin area. The TiC tool can be found on the member portal.

Question 13

I am a new Curative health plan member. Before receiving my ID card, I needed to go to the doctor, and my physician required me to pay for the appointment out of pocket. How do I submit a claim?

Accepted Answer

Most claims will be processed through your provider. If you need to file a claim individually, claim forms will be available through our customer service line: 855-428-7284. Upon receipt of your member ID, ask your provider to resubmit your claim to Curative and once paid, your provider can refund any additional out of pocket costs. Your member information will also be available on the Curative portal upon enrollment, and can be used if you need a prescription prior to receiving your physical card.

Question 14

Where do I file a claim for medical care received outside the United States?

Accepted Answer

At this time, no services outside of the United States are eligible for coverage. If a member is traveling outside of the United States, it is in their best interest to buy a travel plan for that region. For more information, please contact member services at 855-428-7284.

Question 15

How do I receive medical care and prescriptions outside of the Austin area?

Accepted Answer

If you need to receive medical care or prescriptions when outside the Austin area, you can reach out to member services for further clarification on your coverage options at 855-428-7284.

Question 16

Who do I contact when I have billing questions, need to get claim forms or talk to if a claim has been rejected?

Accepted Answer

Members can reach out to member services at 855-428-7284.

Question 17

I was denied coverage, a claim, or received an erroneous charge on my Explanation of Benefits (EOB), whom do I contact?

Accepted Answer

Members can reach out to member services at 855-428-7284.

Question 18

Are there any health services that require prior authorization (PA)?

Accepted Answer

Prior authorization (PA) is a utilization management process used by some health insurance companies in the United States to determine if they will cover a prescribed procedure, service, or drug. For Curative, there is a list of services that require PA in the Benefits Booklet. drugs that require prior authorization are listed here. This list will also be available to providers through their provider manual. Network Providers are responsible for contacting Curative for PA when required.

Question 19

What are the steps required to obtain prior authorization (PA)?

Accepted Answer

Typically, providers request PA. Network Providers are responsible for contacting Curative. For out-of-network providers, the provider must submit the request for PA. A standard state form can be submitted via fax or they can use the Curative form. This information is available in the provider manual that will be available on our website. For Pharmacy PAs, providers will submit a form to the Pharmacy Benefits Managers for review. A list of drugs requiring PA are available here.

Question 20

Does Curative’s health plan cover the cost of blood work?

Accepted Answer

We are happy to cover the cost of blood work, as long as it is medically necessary as stated in the Benefits Booklet.

Question 21

I’m working with an out-of-network lab. Do I have out-of-network lab coverage?

Accepted Answer

Curative’s Benefits Booklet will explain coverage for out-of-network labs, including deductibles and co-insurance.

Question 22

What percentage of in-network diagnostic laboratory services are covered by my plan?

Accepted Answer

If deemed medically necessary and the Baseline Visit is completed, these services will be covered with $0 out-of-pocket costs.

Question 23

What does Curative’s health plan cover?

Accepted Answer

Please visit curative.com for coverage details.

Question 24

What would be deemed a preventive service?

Accepted Answer

We believe preventive care is a crucial part of overall health and offer preventive services as detailed in our benefits booklet and aligned with the United States Preventative Health Services Task Force. Preventive care helps detect or prevent serious diseases and medical problems before they can become major. Annual check-ups, immunizations, as well as certain tests and screenings, are a few examples of preventive care. This may also be called routine care.

Question 25

What copays and deductibles are included with Curative’s health plan?

Accepted Answer

Please see the benefit summary in the benefit booklet.

Question 26

Does Curative’s health plan cover dental and vision?

Accepted Answer

Curative’s health plan currently does not cover dental and vision, but we are working to offer these services in the future.

Question 27

Does Curative’s health plan cover orthodontic care?

Accepted Answer

Curative’s health plan currently does not cover orthodontic care, but we are working to offer these services in the future.

Question 28

Does Curative’s health plan cover acupuncture and massage?

Accepted Answer

Acupuncture is covered for musculoskeletal diagnoses. While Curative’s insurance does not cover massages, massage services are planned to be available at the Curative Commons.

Question 29

Does Curative’s health plan cover mental health services?

Accepted Answer

Curative believes that mental health and physical health are deeply intertwined. Mental health services are covered for office visits, and inpatient and outpatient services, just as they would any other medical services. All inpatient and certain outpatient treatment for behavioral health should be Prior Authorized by calling Curative Member Services at 855-428-7284. For more information, please visit the Benefits Booklet.

Question 30

How do I know if I need a referral to see a specialist?

Accepted Answer

At Curative, we don’t require referrals for specialist visits.

Frequently Asked Questions for Current Members

General Member Services

Claims and Billing

Coverage

Pharmacy

Frequently Asked Questions for Current Members

General Member Services

Claims and Billing

Coverage

Pharmacy

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