Manhattan Life Member User Guide
Manhattan Life Member User Guide
Your NAHP Alternative Health Plan is simply a bundle of products that when stacked together provide comprehensive health coverage at significantly lower prices. It is NOT an “all in one” – – that is Obamacare with all its problems. Your plan includes a Manhattan Life Fixed Benefit plan combined with other supplemental plans from Manhattan Life and/or other companies on our US Supplemental Coverage page.
To get the most out of this plan, it takes a little effort on behalf of the member. It is very important that you read the Outlines of Coverage so that you better understand the coverage.
Manhattan Life Affordable Choice Fixed Benefit Plan
The Manhattan Life Fixed Benefit health plan provides you coverage for inpatient and outpatient services. You can use any provider you want, but using a network provider lowers your out of pocket costs by providing a pre-negotiated rate on services.
Manhattan Life Affordable Choice Plans PPO Network
The Manhattan Life Fixed Benefit plans allow you to go to any provider without restriction. However, these Fixed Benefit plans also include the First Health nationwide PPO Network. If you see in network providers, you are going to see significant discounts on the bills you receive.
NEW! Effective October 1, 2020, Manhattan Life will be transitioning their PPO network to the First Health nationwide PPO Network. All new policyholders whose coverage started near or after October 1st, will utilize the First Health network.
The First Health PPO Network. It is one of the most extensive PPO networks in the country. The First Health network provides access to:
More than 5,900 hospitals
- Over 125,000 ancillary facilities;
- More than 810,000 physicians and healthcare professionals with over 1.5 million service locations across all 50 states.
- Network doctors that are carefully selected to promote quality outcomes.
- No paperwork because network doctors and hospitals file claims for you.
To look up providers go to the First Health PPO network link. It is available 24 hours a day, 7 days a week. It includes the most detailed provider information available. And, it’s kept up-to-date.
Start by clicking the dot next to “First Health Network.” Then click the button that says, “Start Now.” On the next page choose the type of provider and enter your search parameters. Then click the “Search Providers” button.
For older Affordable Choice Fixed Benefit plans issued prior to October 1, 2020, here are instructions to look up providers in the PHCS/Multiplan PPO network. First go to:
- Click on “Find a Provider”
- Select the PHCS Limited Benefit network
- Find your provider
- Please let me know if you need any help!
Manhattan Life Additional Plan Information
For additional information on all Manhattan Life products, including plan brochures for Your chosen plan, go to our Manhattan Life page
Your Manhattan Life ID cards and policies will be mailed directly to you. You should receive them 7 to 10 working days after your approval date.
Manhattan Life Member Client Services Portal Information
To register and create a member account and login go to the: Manhattan Life Member Portal
The first time you visit, in the bottom right corner of the login box click “I want to register.” The box will flip around and say “New User Registration” at the top. Check the dot next to “Life and Health Policies,” and click on the “Register” button. From here follow the 5-step process to register and create your account. Once registered, you will come back to the link above to login to your account in the future.
NOTE: You’ll need your member (policy) ID number to register.
Once you login to your account you will see your policies. You will also have access to everything you need to manage your policy. You can contact Manhattan Life directly through your account, or call them at the correct customer service phone number listed. There are also claim forms to download along with instructions. See the following regarding filing claims.
Claims Filing Instructions
Information on filing claims for ALL Manhattan Life policies can be found on the Manhattan Life website as follows:
https://www.manhattanlife.com/File-a-Claim
If you are paying cash and filing for reimbursement you will simply file a claim with Manhattan Life by completing a claim form. From your Member Portal account (above) click the “Forms” tab at the top of the page. Next, click the dropdown link for the type of policy that you have. You will then see all available forms. Click on the claim form that you need to download it.
NOTE: For Affordable Choice Fixed Benefit plans click the “Health and Accident” dropdown in the Forms menu. The form you need is the “Medical Insurance Claim Form.”
As noted on the claim forms, please be sure to include the following when submitting claims:
Submit all bills related to this claim such as doctor, hospital (must include the number of days confined, if applicable), ambulance, follow-up visits, physical therapy, etc. All bills should be itemized and should include the diagnosis, services rendered, date of service and actual charges for the service.
Be sure to include your policy number on all documents.
Provide list of physicians seen in last 2 years.
Complete HIPPA form (last page of claim form)
Once you have completed your claim form, you can scan it to your computer and then use the “Easy Upload” tool that is to the right on both the “Home” and “Forms” page of your online account.
If you prefer to mail the claim form and claim information, you can mail it to:
Manhattan Life
Attn: Claims Department
P.O. Box 925309
Houston, TX 77292-5309
You can also fax the information to: 713-583-0677
Customer Service Inquiries
Affordable Choice Fixed Benefit plans:
Manhattan Life now has a dedicated Customer Service phone number, fax line, and email address for all Affordable Choice plan inquiries/requests:
Phone: (800) 877-7792, option 5
Fax: (713) 821-6518
Email: AFCService@ManhattanLife.com
The AFC Customer Service line is comprised of hand-selected representatives that have been trained to provide information on all aspects of the Affordable Choice policies, including premiums, coverage changes, application status and other information.
All Other Individual Plans:
For all other Manhattan Life plans such as the Out of Pocket Protection hospital inpatient benefit plan and the Cancer Care Plus Cancer and Dread Disease Treatment plans, all customer service and claims information is available through your member portal (above).
You can also use the following:
Phone: (800) 999-2971
Email: individual@manhattanlife.com
Additional Fixed Benefit Plan Benefits
As discussed in all previous information that I have sent, the following benefits are included within your Manhattan Life Fixed Benefit plan.
NOTE: Details on all additional benefits offered in the Affordable Choice plans are in the Ancillary Services at a Glance
Green Imaging:
ManhattanLife has contracted with Green Imaging to provide diagnostic imaging services to you at a significantly discounted rate.
For details on this program, please download the ManhattanLife + Green Imaging flyer.
For more information about Green Imaging go to our US Healthcare Resources page under the “Imaging Savings Tools.” You can also go to the Green Imaging website.
CareGuide:
CareGuide helps Affordable Choice policyholders navigate through some of the complexities that those seeking support services may face. You can download the CareGuide Summary Page.
Here are just a few highlights of the CareGuide Service:
Hospital Bill Eraser– We use our innovative technology to reduce or possibly even eliminate large hospital bills via statute-required financial assistance programs and billing error/fraud analysis.
Pricing Portal – We know the specific care costs before you step in the door with our billion-plus claim database so you are not the next victim of the broken medical billing process.
Money Map – Using our proprietary, data-driven mapping tool, we fan find and confirm low-cost providers by zip code for routine care before you are hit with an inflated price.
Lower or Eliminate Prescription Costs – We assist members with obtaining prescription coupons and getting their medications at low prices.
Telahealth Consultants:
Included with the ManhattanLife plans are telemedicine services at no additional premium or copay to use if you are sick. The benefit package telemedicine includes:
- Express Health Care- Available 24/7/365
- Dermatology- designed to help diagnose and treat minor skin conditions.
- Clinic Services- when a condition may call for more than a virtual visit, this fee for service option allows consumers to schedule a visit with a nationwide network of clinics directly through the member portal (Telahealth Consultant’s portal).
- Behavioral Health- offering confidential assessments, short-term counseling, referrals, and follow-up services.
- Healthcare Liaison- a significant role to help decode the medical landscape, this helps members save on medical and pharmacy expenses, optimize prescription prices and more.
- Health Records- access records anytime including test results, updated medications, and the availability to share information with providers, insurance carriers and family.
Prescription Discount Program:
Also included in the North American Health Plans program is a prescription drug discount benefit. Use the drug pricing tool to price prescriptions at pharmacies in your zip code. Go to http://www.findlowrx.com and click the drug pricing link.
US Healthcare Resources and Shopping Services
In addition to the information above, don’t forget to go to our US Healthcare Resources page for a detailed list of online healthcare shopping tools and resources. They include sites to help you shop for the best price (or fair price) on all different types of healthcare. There are also providers offering deeply discounted prices on multiple different types of care.
Contact Me Anytime for ANY Reason:
If you have ANY other issues or questions throughout the year, I am here to help! So, please contact me at ANY time! You can schedule a call on my online calendar by clicking the link above that says CALL ME and picking a day and time that works best for you. You can also call or text me at the number in the top right corner of this website or send me an email to robtavis@ushealthinsurancesolutions.com.