Philadelphia American Life Member User Guide
Philadelphia American 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 Philadelphia American Fixed Benefit plan combined with other supplemental plans from Philadelphia American 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. However, while it may take a little getting used to, the plan is simple and will save you a ton of money. It consists of the following:
Philadelphia American (PALIC) Fixed Benefit Plan
The Philadelphia American 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.
PALIC Additional Plan Information
For additional information please go to our Philadelphia American page. They have asked us not to leave their plan brochures on our Philadelphia American page. So, if you need another copy of your plan’s outline of coverage, just let me know and I will forward a link to download a plan brochure for your specific plan.
PALIC PPO Network
The Philadelphia American Fixed Benefit plans allow you to go to any provider without restriction. However, these Fixed Benefit plans also include the PHCS/Multiplan nationwide PPO network. If you see in network providers, you are going to see significant discounts on the bills you receive.
Beginning January 1, 2023, these plans will have access to the First Health Limited Benefit Plan network. Why First Health?
- First Health provides great savings nationwide for doctor visits, surgeries, hospitals, urgent care centers, and facilities helping members stretch their benefits further
- First Health boasts broad access in urban, suburban, and rural markets
- With over 926,000 providers, 140,000 ancillary facilities, 6,100 hospitals, and 1,500,000 service locations, nearly 96% of the U.S. population has access to a First Health provider within 20 miles
- Doctors are carefully selected by First Health based on their demonstrated history of providing quality outcomes for patients
Here are instructions to look up providers. First go to:
To begin click the green “Start now” button. From here you can search using multiple different criteria. After you enter the criteria that you want, click “Search now.” For help navigating the search tool or questions about the provider directory, call First Health at 1-800-226-5116. Please let me know if you need help!
IMPORTANT NOTE: Specified Disease existing and new business plans will use the First Health Primary Network beginning 1/01/2023. The First Health Primary Network may only be used in conjunction with Specified Disease Plans. To search for a network doctor, hospital or other health care professional visit the First Health Primary Network online provider directory at http://www.myfirsthealth.com. For help navigating the search tool or for questions about the provider directory, call First Health at 1-800-226-5116.
General and Customer Service Information
Your PALIC IDs cards and policies will be mailed directly to you. You should receive them 7 to 10 working days after your approval date. You should read your all policy information carefully.
PALIC Customer Service:
If your policy number begins with “66”: 1-888-748-3040
Press 2 for policyholder services.
All other policy numbers and inquiry types: 1-800-552-7879
Press 1 for policyholder services.
Policyholder email address: [email protected]
Online Member Portal
To register and create member account go to the: PALIC Member Portal
You’ll need your member (policy) ID number. When you register on the member portal you will see your policies.
After creating your member account, you can login at the main Member website: https://apps.neweralife.com/site/
NOTE: Philadelphia American has added several tools to help you with finding fair prices for your healthcare needs. They include Healthcare Bluebook, MD Save, ShopHealth from the Free Market Medical Association and several prescription pricing tools. From your member portal click on the “Fair Pricing” and “Valuable Member Benefits” tabs for more information.
Claims Filing Instructions
If you are paying cash and filing for reimbursement PALIC has updated the steps for this process. The current steps to filing a claim are as follows:
1. Login to your Policyholder Portal
2. From the Main Navigation menu, select Quick Request
3. In the Policy section, select the policy for which you are filing a claim
4. For Request Type, select New Claim
5. From the Patient drop down, select the policyholder you are filing a claim for
6. Select Click to upload file(s) to upload applicable document(s)
From your member portal you will find written instructions for filing a claim along with a video tutorial.
If you need assistance submitting your claim online, please contact Claims Customer Service at 1-888-748-3040 prompt 2
Following these instructions will avoid unnecessary delays in claim processing. Please provide the following information.
· An itemized statement showing the full name, address and Tax ID number of the provider of service. This itemized statement should include the patient’s name, date of service and amount charged for each service.
· The diagnosis (ICD) code for each date of service (this will be a 3 to a 8 digit code number and the procedure (CPT or HCPCS) code for each service rendered (this will be a 5 digit code number.
· An Emergency Room or Outpatient Hospital bill should include the Revenue Codes which are the 3-digit codes that indicate the charges for services rendered in each department of the hospital.
· If the claim is incurred in the first 12 months of coverage please complete the attached Claim Form and Authorization and submit with your claim. When submitting a claim that is incurred after your policy has been in force for 12 months you will not need to complete this form unless your claim is for an accident.
· If the claim is for an accident, please complete the Claim Form and Authorization. If the accident was related to a motor vehicle accident, we need a copy of the MVA Report.
· If a claim form is not required as indicated above, please make sure the insured name, the patient name and the policy number is included on all documentation submitted.
· If you are hospitalized and your confinement is expected to be for more than 3 days, please contact our Customer Service Department at the number below for assistance.
If you prefer not to email your claims information, completed Claim Forms and claims can be mailed or faxed to our offices.
Philadelphia American Life Insurance Company
Attention: Claim Department
PO Box 4884
Houston, TX 77210-4884
You can also fax your claims to: 281-368-7382
NOTE: After submitting claims, if you would like to check the status or any other claims/benefit related questions, you can email them at: [email protected]
Additional Included Benefits
As discussed in all previous information that I have sent, the following benefits are included within your PALIC Fixed Benefit plan.
Healthcare PALs – Your PAL when it comes to healthcare! To get the most out of your benefits – and avoid surprise medical bills – call a Healthcare PAL before receiving care. Our experienced team of claims professionals, nurses and care coordinators can help guide you to quality care at a fair price.
Medical Bill Eraser Powered by CareGuide – NEW! Effective 10/1/2024. This invaluable resource provides support to policyholders who find themselves facing unexpected medical expenses where they owe $2,500 or more out-of-pocket.
- A remarkable approach that has been proven to reduce medical bills by an impressive 62% on average — far surpassing the 19% average savings from our current vendor.
- Advocates who are dedicated to fighting your clients’ hefty out-of-pocket medical bills using proprietary technology and innovative negotiation techniques – often reducing or even eliminating their balance bill.
- Confidence that your clients were billed fairly and accurately for the care received.
Telemedicine – Talk to a doctor, 24/7/365, for $0 with Virtual Urgent Care! This plan includes unlimited Virtual Urgent Care visits with board certified doctors at no cost to you! Talk to a doctor, get a diagnosis, and even a prescription when needed, all within minutes. Additional telehealth services available at a special member rate include: Virtual Dermatology Care, Virtual Counseling and Psychiatric Medical Care. Please download the flyer to read about all the services offered by New Era Telehealth.
Healthcare Bluebook Concierge – NEW! Beginning May 1, 2025, Healthcare Bluebook Concierge offers hands-on, personalized support to help members find Fair Price care and bundled savings on outpatient procedures and imaging services. Unlike the self-service Fair Pricing Tool, the Concierge team provides real human guidance every step of the way.
Prescription Discount Program – ScriptSave WellRx prescription drug discount benefit. As an additional resource, this prescription savings card is provided to you in your welcome package. Easily download the app to receive instant savings on both brand name and generic prescriptions.
PAL Rx Saver Powered by Drexi
PAL Rx Saver helps you find the best price for prescription meds! That way, you’ll know the true cost of prescriptions at pharmacies closest to you – no surprises! Your PAL Rx Saver, powered by Drexi, member card is included with you plan at no additional cost. Create your Drexi member account and start saving today.
Preferred Providers for Fair Pricing – Receive quality healthcare services at a fair price through these PAL recommended consumer-first providers and facilities. In your member portal you will find links to services to help you get the best price on surgeries and other procedures as well lab work and imaging.
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 and I will call you to review your options. You can also call or text me at the number in the top right corner of this website or send me an email to [email protected].