Individual & Family Plan Members
Understanding Your Plan
Understanding your plan
No matter what kind of health care you need, it is important to check what your plan covers. Your benefits differ depending on the type of plan you have. A referral or prior authorization may be needed before some services will be covered by your plan. Your Quartz ID card will state what kind of plan you have. Be sure to check coverage before getting medical care other than from your PCP.
How health insurance works
Understanding your health care bill
Care you need, when you need it
Accessing care
Quartz wants you to receive the care you need, when you need it. You may need different types of care depending on your situation. Below is a summary of how to access care depending on your needs:
|
|
Virtual Visit
|
Telehealth
|
Primary Care
|
Urgent Care
|
Emergency Care
|
|---|---|---|---|---|---|
|
What is it?
|
An on-demand appointment with a health care provider via your smartphone, tablet, or computer
|
A scheduled appointment with your usual provider during clinic hours; not in person — either a video chat or phone call
|
Regular, non-emergency care by appointment; face-to-face interaction with your provider, in their clinic or office |
In-person, walk-in care at designated locations, usually with extended hours
|
24/7 in-person care, when help is needed right away to prevent an adverse health outcome
|
|
When is it open?
|
24/7
|
Normal clinic hours
|
Normal clinic hours
|
Extended hours
|
24/7
|
|
What’s the cost?
|
$ |
$$ |
$$ |
$$$ |
$$$$ |
|
When should I use it?
|
For urgent, non-emergency symptoms, like: cough, headaches, nausea, rashes, sore throat, sprains
|
For service outside of the clinic, including: routine visits, surgery follow-ups, mental health services, screenings
|
For in-clinic services, such as: routine checkups, annual physicals, preventive screenings, vaccinations, non-urgent injuries and illness
|
For health issues or injuries that need prompt attention but are not serious enough for emergency, such as: cuts, scrapes, and bruises; sprains and strains; ear pain or infection; rashes and insect bites; sore or strep throat
|
For serious and/or life-threatening situations, like: chest pain or heart attack, numbness or weakness on one side or stroke symptoms, shortness of breath, major illness, traumatic injury |
|
How do I get access?
|
Set up an account ahead of time so you’re prepared to log in if you become sick or injured. Learn more on our Digital Tools page |
Call your provider’s office to see if a telehealth visit is right for you. If so, they’ll schedule a time and give you connection instructions.
|
Call your primary care provider or clinic to schedule ahead of time.
|
Call your primary care provider or clinic first, day or night, to identify the best course of action. They will advise you if you should go to urgent care.
|
Call 911 or go to the nearest hospital emergency department for immediate help.
|
Qualified Health Plan Transparency of Coverage
Unsure what healthcare services will cost you? Quartz is happy to honor the “Transparency of Coverage” rule by providing details and information to help you better understand your coverage, cost-sharing, benefits, and more.
Contact us
We’re here to help you find the right plan option that works for you and your family. Please call Quartz Customer Success at (800) 362-3310, or if you have worked with an agent in the past, reach out to them with any questions on your Quartz plan options.