Page 4-5 - aspire_member_guide

Basic HTML Version

A step-by-step guide to choosing the Enhanced plan
If you choose to stay in the Enhanced plan, you and your covered spouse need
to complete the following steps by the end of the qualification period.*
Step 1. Complete and submit your Member Qualification Form.
Schedule an appointment with your personal care physician (PCP). If you
don’t have a PCP, you can choose one by logging in at
and selecting
“Find a Doctor/Facility.”
Be sure the form is completed in full and submitted before the end of the
qualification period. Either you or your doctor can submit the form, but please
keep a copy for your records. If your doctor submits the form for you, you are
responsible for ensuring that we receive the form on time. You can view your
status anytime by logging in at
* If there are circumstances that make it difficult for you to complete any of the required steps
for the Enhanced plan, please call Customer Service at (888) 819-2540. We’ll work with you
confidentially to find the best solution for you. See Notice of Reasonable Alternatives.
Step 2. Score at least 80 points on your Member Qualification Form.
Points are assigned based upon meeting specific wellness targets or by
participating in health improvement programs. To qualify for the Enhanced
plan, you will need to meet the wellness targets listed on the Member
Qualification Form to earn 80 points. If you do not or cannot meet the
wellness targets, you still may be able to meet the program requirements by
working with your doctor.
If you’re not willing to commit to lifestyle changes or work with your doctor to
meet the 80-point program requirements, you will be moved to the Standard
plan with higher out-of-pocket costs.
Step 3. Complete your Health Risk Assessment.
To help you understand your health risks, complete the free confidential online
SUCCEED® Health Risk Assessment. It takes about 20 minutes to complete.
To find the assessment, log in at
using your health plan ID number
and password, then select the Health Risk Assessment link from the Quick
Links section. If you have not registered yet, select Register Now. After
registering you will be redirected to the
homepage to log in.
The personal health information you enter online in the assessment will not be
shared with any other party without your specific consent, as required by law.
At the end of your qualification period, if you and/or your covered spouse
have not completed the three steps to qualify for the Enhanced plan, you will
automatically be placed in the Standard plan with higher out-of-pocket costs.