Qualexa Healthcare administers Seva Care Network. Please use the link below to connect with Customer Service via live chat to discuss your health plan.
A PCP is a Primary Care Provider that provides ongoing care to their patients and can help identify, prevent, and treat illnesses or disability and provide preventive care services. Providers include Family Practitioners, General Practitioners, Internists, OBGYNs, Pediatricians, office-based Nurse Practitioners and Physician Assistants. All other Physicians are considered Specialists.
A Specialist is a provider with advanced medical training in a specific area, like Cardiologists, Endocrinologists, Orthopedics, etc.
In network is when a provider, physician, hospital, or other provider type, accepts your insurance. They are also frequently referred to as participating providers. Out of network is when the provider does not accept your insurance. If your provider is out of network, please contact Customer Service to nominate your provider.
Understanding deductibles, coinsurance and copays is important. A deductible is the portion you pay before your insurance pays. Coinsurance is your portion of the cost of a service and is generally a percentage of the amount allowed to be charged for services. It is paid after you’ve paid your plan deductible. A copay is the amount you are responsible for paying at the time the service is received.
Tiered copays vary by plan. Please contact customer service at 833-273-2253 for more information.
The out-of-pocket maximum is the maximum you could pay for covered medical services and/or prescriptions annually. This does not apply to monthly premiums, but typically to your deductible, coinsurance, and copays.
Your EOB shows you how your medical costs are distributed. It identifies a list of the services you received, costs, how expenses were divided between your provider and your copay but is NOT a bill.
The main component of the EOB provides specifics about the provider who performed the service, date, procedure type and costs.
Telehealth services vary by plan. Please contact customer service at 833-273-2253 for more information.
Please contact Customer Service at 833-273-2253 prior to travelling with specific questions.
