Personalized coordination to help you get the most out of your insurance + pharmacy benefits
AndHealth is committed to fully transparent costs and coverage
AndHealth provider teams + care plan treatments are covered by Medicaid, Medicare, TRICARE, Group (employer), and Individual insurance plans.
Your Patient Onboarding team & your Patient Navigator (who is part of your care team), will work closely with you throughout your relationship with AndHealth. With their deep knowledge of how to work the healthcare "system" and the details of your insurance coverage, they will work to get you the lowest costs for your prescriptions, labs, and other health needs – without any interruptions throughout your plan year.
Provider visits + care plans
A provider team is assigned to each AndHealth patient. They are dedicated to your whole person health so you can stabilize your symptoms + condition progression.
AndHealth provider visits meet you where you are depending on your needs, and may include:
- Office visits –early morning, lunch hour and evening appointments available, online or in-person
- Access to your entire care team outside of visits through SMS + phone calls
AndHealth care plans may include a combination of the below. Individual care plans vary, based on what you + your care team feel is best for you when you begin care with us:
- Medications, such as biologics or other prescriptions + no-cost medication delivery
- Nutrition support through medically tailored meal delivery
- Coaching on movement/gentle exercise, stress reduction and other lifestyle factors that can help calm inflammation
- Sleep and stress coaching with a provided wearable device
- Custom supplement plan delivered at no additional cost to you
.png "Melissa Care Plan")
COPAYS + OUT-OF-POCKET
How to estimate AndHealth care costs
Below we break down copays and out-of-pocket costs by types of visit + treatment according to type of health insurance plan.
Note that all of the below is subject to the specific details of your current health plan within your year.
Provider Visits: Copays
Rheumatologist or Dermatologist appointment
- Specialist copay as listed in your health plan for Medicare, TRICARE, and Group/Individual insurance members
- No copay for Medicaid members
Clinical Pharmacist, Nurse Practitioner, Medical Doctor appointment
- Primary care/office visit copay as listed in your health plan for Medicare, TRICARE, and Group/Individual insurance members
- No copay for Medicaid members
Health Coach appointment
- No copay
Patient Navigator coordination
- No copay
Phone Calls or SMS outreach with entire team
-
No copay
Medication: Copays & out-of-pocket
Pharmacy Refills
- Out-of-pocket costs vary according to Medicare, TRICARE, Group and Individual health plans
- No out-of-pocket cost for Medicaid members
Insurance coordination from Patient Navigator for prior authorization + efforts to ensure lowest cost via coupons, assistance plans
- No out-of-pocket cost for any patient
Prescription home delivery
-
No out-of-pocket cost for any patient
Labs + Imaging: Copays & out-of-pocket
Lab orders
- May include costs according to your Medicaid, Medicare, TRICARE, Group and Individual health plans
Visit to your home by AndHealth mobile phlebotomist to draw labs
- No out-of-pocket cost for any patient
Imaging (X-ray, MRI etc) ordered by doctor
-
May include costs according to your Medicaid, Medicare, TRICARE, Group and Individual health plans
Lifestyle Tools + Treatments: No additional cost
Meal delivery for prescribed nutrition approach, if part of care plan
- No out-of-pocket cost for any patient
Supplements custom to your needs, if part of care plan
- No out-of-pocket cost for any patient
Sleep and stress tracking wearable, if part of care plan
- No out-of-pocket cost for any patient
Smoking cessation, if part of care plan
-
No out-of-pocket cost for any patient
We accept all types of health plans - Medicaid members welcome!
Below is an estimated breakout of costs by type of health plan.
Provider visits: No copay for appointments for rheumatologist, coordinating provider, health coach, clinical pharmacist, patient navigator
Medication + orders for your condition: Provided at no cost, e.g., prescriptions, lab work, imaging (x-ray, MRI)
Treatments to improve your symptoms: Provided at no cost, e.g., nutrition programs, sleep tracking
Provider visits: Copay varies by type of Medicare or MA plan. Typically, a specialist copay is charged for rheumatology visits, and a primary care/office copay for NP/MD visits. Clinical pharmacist, health coach and patient navigator are provided with no copay.
Medication: Costs according to your health plan. If qualified after secondary insurance and drug coupons are applied, a financial assistance program is available to help with medication deductible as part of Medicare Part D plan.
Orders to track your condition: Costs according to your health plan, e.g., lab work, imaging
Treatments to improve your symptoms: Provided at no cost, e.g., nutrition programs, sleep tracking
Provider visits: Copay varies by plan type (e.g., HMO, PPO, HDP). Typically, a specialist copay is charged for rheumatology visits, and a primary care/office copay for NP/MD visits. Clinical pharmacist, health coach and patient navigator are provided with no copay.
Medication: Costs according to your health plan
Orders to track your condition: Costs according to your health plan, e.g., lab work, imaging
Treatments to improve your symptoms: Provided at no cost, e.g., nutrition programs, sleep tracking
Provider visits: One of our Care Navigators will work with you to find primary and rheumatology care on a sliding fee scale, even if you do not have an insurance plan right now. Additionally, they will help you find other assistance programs you may qualify for to help with housing, transportation, groceries and utilities
Treatments to improve your symptoms: Provided at no cost, e.g., nutrition programs, and sleep tracking
Interested & want to learn more?
Schedule an enrollment call for a personalized conversation about your Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and/or Spondyloarthritis.