Members FAQ

Below are a list of questions we hear most often. If you have a question that is not listed below, feel free to contact us.

Will my insurance pay for all of the services my doctor orders?

Benefit plans are tailored to individual employers; therefore, various employer groups will have different levels of benefits. Your physician will not know what services are covered for each individual employer, as such,  verify your specific plan benefits before any procedure or medical test is performed.

How can I know if my doctor is a Health Partners physician?

Use the Provider Search tool to see if your physician is a participating member of Health Partners and/or HP2. Always remember to call your physician’s office to verify.

What if I need to see a specialist?

You may choose to see any provider in the network without a referral.  However, your primary care provider can make some helpful suggestions as to which type of specialist you need to see.

Please keep in mind that visiting an out-of-network provider could cost you more money. If you need a specialist that does not participate in the Health Partners network, call your employee benefits representative.

What about hospital coverage?

Both in-patient and out-patient hospital care requires pre-authorization for payment. Confirm your visit has been authorized prior to procedures to  maximize the  amount of benefits under your plan.  The insurance company will decide if your hospital visit is necessary and appropriate care, your physician may be required to provide documentation.  It is in your best interest to confirm that a referral is secured prior to your admission.

What do I do in an emergency?

If you have an emergency dial 911 or go to the nearest emergency room. Most plans expect you or a family member to contact your insurance carrier as soon as you are able or within 24 hours of your admission. This number should be listed on your ID card.

What if I am out of town and need to see a physician?

Health Partners is a local network; however, some employers have arranged for statewide coverage.  In this case, your employer will have information available for you regarding preferred providers, outside of the network.

If you need to see a doctor while you are out of town, call the number on your ID card first. Advise them of your need to see a physician and verify your coverage. The doctor’s office may file a claim and bill you for the balance, or they may require to pay at the time of service. If you pay for the visit up front, you will need to submit a claim for reimbursement.  This may just be a copy of your receipt, or it may require medical notes from the visit.

What about organ transplant services?

Health Partners offers you access to today’s most innovative and technologically advanced options for organ transplants. Should you or a family member be in need of this service, you will be able to access the organ transplant network; a team of highly respected medical professionals in Atlanta. Please contact the number on your ID card if you have further questions.

What if I am dissatisfied?

You have a right to express dissatisfaction or concern about the services provided and to receive answers to your questions. To ensure that your concerns receive our fullest attention, please call customer service at 770-219-6600 or you may submit feedback on our Contact Form here.  Member satisfaction is very important to us, we will respond to you as quickly as possible.

What if I also have Medicare?

As a general rule, if a Medicare patient has other coverage, Medicare is the secondary payer. There are some exceptions to this rule, contact Medicare for clarification.  www.cms.gov