Health Plans Your Employees will Love
The high cost of traditional fully insured health insurance is rapidly increasing, which is becoming unaffordable to the small and medium group employer.
Ovation lowers the cost by combining the advantages of telemedicine, a robust pharmacy program, and a growing network of physicians with fixed rates. We do this by direct contracting and expanding relationships with additional provider networks.
Ovation Health group plans offer employers:
► ZERO deductible and ZERO copayment with our Platinum Plan; and a low copayment with our Gold Plan.
► 24/7 nationwide telemedicine provider care, and an Open Network so members may nominate their existing providers to join the network.
► Optional Dental, Vision, and Hearing benefits.
► Robust pharmacy pricing on medicines and drugs at the lowest cost with national and international sourcing.
► A Care Team with Care Coordinators to assist members with scheduling, finding providers, and authorizations, and Patient Advocates to assist members with negotiating medical costs and surprise bills.
For questions, call 866-549-4199 or contact sales@innovationshr.com.
Our Networks
Our open network structure, combined with our nationwide telemedicine network, provides more comprehensive and personalized care. Members may select from our national network of telemedicine providers, or you can invite your doctor(s) to join us.
► Open Network: Our open network flexibility allows us to easily add providers, enabling our members to keep their existing patient-physician relationships.
► Telemedicine Network: Our nationwide telemedicine network has a wide variety of physicians and specialists that may not be accessible in the individual’s local area. This online technology uses several secure encryption options to protect privacy.
Customer Care and Patient Advocacy
The Care Team is comprised of Care Coordinators and Patient Advocates. Care Coordinators help with setting appointments, locating services, and general benefit questions. Patient Advocates help with surprise medical bills, long-term medical conditions, emergency room admittance, and pre-negotiate costs for treatment and procedures. They are experts in medical administration and serve to protect members against unnecessary tests, over-payment, and high medical costs.
Each new member is assigned a personal Care Coordinator who will assist new members with finding providers or adding their current providers and reviewing any existing treatment and/or prescriptions to ensure that care is continued seamlessly and at the lowest cost.
Pharmacy Plan
Our discount pharmacy pricing is generally 10-30% lower than other discount programs. Through direct contracting with a consumer driven pharmacy program that sources on a national and international basis, Ovation ensures that members receive the lowest costs for most drugs and medicines. For specialized prescriptions, our Physician Advocates will work with compound pharmacies to lower costs.
Group Plan Options
GOLD PLAN
Coinsurance
80% Plan; 20% Member
Out-of-Pocket Limit
Individual $7,900; Family $15,500
Deductible
Individual $2,500; Family $5,000
Lifetime Maximum
Unlimited
Well Person Care/Annual Exams
Unlimited
Contracted Primary Care/Specialist – $0
Non-Contracted Primary Care Physicians – $25
Non-Contracted Specialists – $25
Diagnostic Imaging
Contracted Imaging Facility – $0
Non-Contracted Imaging Facility – $250
Diagnostic Labs
Contracted Imaging Facility – $0
Non-Contracted Imaging Facility – $50
Emergency and Urgent Medical Care
Emergency Room/Hospitalization – $500 per day
Ambulatory Surgical Center – $400
Urgent Care Clinic – $75
PLATINUM PLAN
Coinsurance
None
Out-of-Pocket Limit
Individual $6,350; Family $12,500
Deductible
Individual $0; Family $0
Lifetime Maximum
Unlimited
Well Person Care/Annual Exams
Unlimited
Contracted Primary Care/Specialist – $0
Non-Contracted Primary Care Physicians – $25
Non-Contracted Specialists – $25
Diagnostic Imaging
Contracted Imaging Facility – $0
Non-Contracted Imaging Facility – $250
Diagnostic Labs
Contracted Lab Facility – $0
Non-Contracted Lab Facility – $50
Emergency and Urgent Medical Care
Emergency Room/Hospitalization – $500 per day
Ambulatory Surgical Center – $400
Urgent Care Clinic – $75
Our Many Provider Partners
With Health Equity, our members may set up a Health Debit Card account for making cash payments to providers. This also enables employers to contribute to their employee’s account.
Stop-loss insurance catastrophic coverage plan that covers 130% of medical and hospital expenses at the Medicare rate when paid claims exceed $50,000, with unlimited coverage thereafter.
Drexi provides our members pass-thru pricing on prescriptions through a premier nationwide network of 65,000+ pharmacies.
eHome Counseling Group provides metrics-based, face-to-face video counseling services with licensed, Master level counselors and psychologists throughout the U.S.
Teladoc services are provided at a $0 copay, no additional charges, and unlimited use. Physicians are available by phone or video conference 24/7, with an average response time of 10-15 minutes.
With Doc Wellbee, members save on virtually any procedure from 25% to 65% including: exams, cleanings, fillings, braces, cosmetic treatments, and more. Pick your dentist from thousands of trusted U.S. board certified dentists and specialists nationwide. There are no claim forms, no limits, no waiting periods, and all pre-existing conditions are accepted.
Quest Diagnostics is the leading national provider of diagnostics testing. They work together with leading hospitals and health systems to create custom solutions and processes that help our members get the most from their laboratory resources.
Clinical Pathology Laboratories, Inc. (CPL) has served the medical community for more than 70 years and continues to offer the highest quality laboratory services dedicated to the individual needs of practitioners and their patients.
Green Imaging is a full service virtual medical imaging network owned and operated by board-certified radiologists, providing affordable medical imaging.
Houston Medical Imaging is an independent diagnostic facility that prides itself on the fact that it is operated by physicians. The company offers full modality medical imaging services through its six convenient locations.
Gulf Coast Cancer and Diagnostic Center has a long and continuing history of excellence in cancer diagnosis and treatment. They provide outstanding cancer care by offering the most up-to-date and efficient therapies in a compassionate setting.
Texas MRI provides professional diagnostic imaging services in a convenient, patient-oriented setting. Texas MRI has become the model for outpatient imaging throughout Texas.
