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PacifiCare Health Systems
Established in 1978 and headquartered in Cypress, California, PacifiCare
Health Systems today is one of the largest providers in the United
States having a nationwide network for individuals and group members.
PacifiCare’s health plans have nearly 4 million members and
more than 9 million customers take part in specialty plan coverage.
This United HealthCare company’s core business is concentrated
in Arizona, California, Colorado, Nevada, Oklahoma, Oregon, Texas,
and Washington. The companies that are part of the PacifiCare organization
within these regions are PacifiCare Behavioral Health, PacifiCare
Dental and Vision, Prescription Solutions, and Secure Horizons Senior
Solutions. American Medical Security Group (AMS) also became part
of the group in 2004.
Many of PacifiCare's commercial health plans have received Excellent
Accreditation by the National Committee for Quality Assurance (NCQA).
The company specializes among others in behavioral health, dental
and vision, and complete pharmacy and medical management through
its wholly owned subsidiary, Prescription Solutions. The company
has about 7,500 employees spread over the nation. PacifiCare Foundation
is a nonprofit organization operated by PacifiCare Health Systems
that is devoted to charitable and educational causes that enhance
the health, wellness and welfare of individuals, families and the
public at large.
The company offers several attractive health plans for customers
keeping an eye on their various needs. Although plan specifics differ
from state to state, these are some of the main health products
that the company offers:
PacifiCare SignatureValueSM HMO: Laying more emphasis on the quality
of care provided to members, it focuses on prevention and general
wellness. Customers can directly contact primary care physicians
(PCPs), and establish a strong link with their doctors under this
PacifiCare SignaturePOSSM POS: It is a Point-of-Service option
providing maximum flexibility to PacifiCare's customers. This plan
provides HMO savings coupled with the freedom to choose either an
in-network or out-of-network approach to healthcare.
PacifiCare SignatureOptionsSM PPO: These PPO plans provide maximum
freedom in choosing a physician, as customers are allowed to see
any participating physician or specialist without any extra cost.
Members are also free to see out-of-network doctors, but at a higher
PacifiCare SignatureIndependenceSM Indemnity: This standard Indemnity
plan gives members the freedom to consult any doctor or specialist
without needing a referral. Indemnity plan members must meet an
annual deductible for coverage.
PacifiCare SignatureFreedomSM SDHP: The company’s Self-Directed
Health Plans are PPO based to allow access to the widest physician
network possible, and also the freedom of a Self-Directed Account
(SDA). This SDA functions as an 'allowance' that can be used at
the member's discretion, for preventative health services such as
doctor's visits and covered exams.
PacifiCare Health Credits. Group members can participate in this
credit-based incentive program that can begin with application to
the VirtualHealthClub. A customized fitness program and meal plan
are recommended by virtual practicing physicians, wellness experts,
and nutritionists. Credits are sanctioned for redemption on special
goods and services. Members can take part in and complete the steps
in program topics that include: smoking, diabetes, asthma, menopause,
cancer management, and heart health. One can also receive credits
by utilizing the mail order pharmacy. Other appealing options are
available at no additional fees.