|
Frequently Asked Questions
You Have Questions, We Have Answers
Can I print a Member Qualification Form?
Yes. To locate the Member Qualification Form, log in to the HAP web site at www.hap.org using your HAP ID number and password. If you have not yet registered for the HAP web site, you must do that first by selecting Registration Information. After you register, log in and click on Member Health Reminders in the left menu, select your name and scroll down to the Health Engagement Program Status section to print a form.
If either my spouse or I am overweight, diabetic or have high blood pressure, will we automatically have higher copays or be exempt from the program?
No. As long as you are actively working toward a healthy lifestyle and following your physician’s treatment plan, you can qualify for the Enhanced plan.
If either my spouse or I smoke, will we automatically have higher copays?
No. As long as you agree to quit smoking and follow your physician's treatment plan. HAP will monitor your compliance with your treatment plan.
What if my spouse does not want to work toward health goals?
Both enrolled adults on a contract have to qualify for the Enhanced plan. Once they qualify, everyone covered on the contract, including dependent children, receive the Enhanced plan.
If I get married and need to add a spouse to my contract during the 90-day period or mid-year, does my new spouse have to complete the iStrive Succeed™ Health Risk Assessment (HRA) and Member Qualification Form?
If a new spouse is added during or after the 90-day period, he/she will be assigned to your benefit plan and will not be expected to complete an iStrive Succeed™ HRA or the Member Qualification Form.
What happens if I add a dependent to my contract mid-year? Do they have to meet the same 90 day requirements?
No, any dependents added to the contract mid-year will be placed in the same benefit plan as the contract holder.
If I am in the Standard plan this year, what will my copays be for the first 90 days of the next year?
For the first 90 days your copays and deductibles will be at the Standard plan level. If you qualify for the Enhanced plan during the 90-day period, you will be moved to that plan at the end of the 90 days.
Can I get an extension if I am unable to fulfill enrollment activities or can’t get in to see my Personal Care Physician (PCP) in the first 90 days?
No. Extensions are not given. Both the iStrive Succeed™ HRA and the Member Qualification Form are due within 90 days of the coverage effective date. If you have any difficulty in getting an appointment with your PCP, call HAP Client Services right away. We can help you get an appointment.
How will HAP know if I’m keeping my health commitments?
Each year you and your PCP will complete and submit a Member Qualification Form to confirm that you have reached or are continuing to actively work toward your health goals.
What if I follow all program rules and adopt a healthy lifestyle; do I need to complete the same requirements again at my group’s renewal?
Yes. In order to qualify for the Enhanced plan you and your covered spouse must complete the program requirements annually.
How often can I move between benefit plans?
You can move between benefit plans once a year. Your benefit plan will be assigned based on your (and your spouse’s) continued commitment to your health goals. Annually, you and your spouse will complete an iStrive Succeed™ HRA and submit a Member Qualification Form, signed by your PCP.
What are the differences between the Enhanced and Standard plans?
The Standard plan requires higher copays and out-of-pocket costs than the Enhanced plan.
How much will I save by qualifying for the Enhanced plan?
The Enhanced plan means lower copays and a lower deductible, if applicable. To find out what the copays and deductibles are for you, contact your employer’s human resources department or HAP Client Services.
How can I find the iStrive Succeed™ HRA on the Web site?
To find the iStrive Succeed™ HRA, you must log in to the HAP Web site at www.hap.org, using your HAP ID number and password. If you have not yet registered for the HAP Web site, you must do that first. To register go to www.hap.org and select Registration Information. After you register, log in to the HAP Web site and click on iStrive.
How will I know if I’ve completed my iStrive Succeed™ HRA or my Member Qualification Form?
Log in to the HAP Web site, then select Member Health Reminders from the left menu. Select your name, then scroll down to the Health Engagement status section to view the status of your iStrive Succeed™ HRA and your Member Qualification Form.
What if I have trouble logging in to the HAP Web site (www.hap.org)?
If you have trouble logging in, please contact Client Services toll-free at (888) 819-2540.
What should I do if I get a bill from my provider for completing my Member Qualification Form?
You should not pay your provider for completing your Member Qualification Form. If you receive a bill for the Member Qualification Form please contact HAP Client Services toll-free at (888) 819-2540. Do not pay the bill.
What if I leave the plan for a portion of the plan year (for example due to a lay-off) and decide to come back?
Members who are reinstated within 180 days (six months) or less from the date their coverage lapsed will be placed into their former benefit plan. If the lapse is more than 180 days (six months), members will automatically be placed into the Enhanced plan for the remainder of the benefit year.
What if my covered spouse or I have dual medical coverage (more than one type of coverage)? Can we still receive the Enhanced plan?
Yes. Both you and your covered spouse will need to visit your HAP PCP and complete all the steps to qualify for the Enhanced plan.
What if I have Medicare, do I have to meet Health Engagement program requirements?
- If you are actively working and you or your spouse have Medicare, you both need to meet the Health Engagement program requirements to stay in the Enhanced Plan.
- If you are retired and you or your spouse have Medicare, the person with Medicare does not have to meet program requirements, however, the non-Medicare person does need to meet Health Engagement program requirements.
- If you are retired and under 65, or have a non-Medicare spouse, both of you must meet Health Engagement program requirements to stay in the Enhanced Plan.
Why did I get a new set of ID cards?
There are a number of reasons why a member will get new ID cards. You may have gotten them because you changed your PCP, or because you were moved from the Enhanced to the Standard plan of the HAP Health Engagement Program. Please review your new cards to make sure they have the correct PCP and so that you are familiar with your copays and deductibles.
Why did I get moved to the Standard plan?
After the 90-day qualification period any member who did not meet the criteria to remain in the Enhanced plan is moved to the Standard plan. This is the way the Health Engagement Program works. You will have an opportunity to qualify for the Enhanced plan next year during the 90-day qualification period.
Should I keep a copy of my Member Qualification Form?
Yes, please keep a copy of your Member Qualification Form for your records.
I just went to my physician, do I have to go back to get the Member Qualification Form filled out?
No. Your physician has the ability to complete the Member Qualification Form online or print a blank copy of the form that can be completed and faxed to HAP. If necessary, and your physician agrees, you can mail a copy of the form to their office for completion. We will accept lab tests that have been done within the past nine months.
When can I turn in my Member Qualification Form?
If you are a current HAP member, HAP will accept Member Qualification Forms up to three months before your contract effective date. If you are joining the
Health Engagement Program for the first time, you must wait until your contract effective
date. If your HAP contract begins on January 1, you may turn in your Member Qualification Form after October 1. Remember, you must turn in the Member Qualification Form by the
end of the 90-day qualification period.
What information will be shared with my employer?
Your privacy is important to us. We will ensure that no information from your iStrive Succeed™ HRA or Member Qualification Form will be shared with your employer. HAP’s commitment to members includes ensuring the confidentiality of your personal and medical information by adhering to strict internal and external safeguards.
Note: If you are unable to meet the program requirements due to extenuating circumstances, please call Client Services toll-free at (888) 819-2540 and we will work with you to determine an alternate way to meet program requirements.
Contact Us | Privacy Statement | Legal Statement
©2008 Health Alliance Plan of Michigan |
