Frequently Asked Questions

1. Where can I call with questions about my health insurance benefits?
Customers of American Medical Security Life Insurance Company (AMS) and PacifiCare Health Systems LLC (PacifiCare) may call toll free (800) 232-5432 and follow the prompts you hear for more assistance.


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2. Does American Medical Security offer phone assistance to the hearing impaired?
Hearing impaired callers may contact us through their local relay systems. We also have a telecommunications device for the deaf (TDD) that allows us to communicate with the hearing impaired.


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3. Who is PacifiCare Health Systems, LLC (PacifiCare)?
PacifiCare and its subsidiaries are wholly owned by UnitedHealth Group Incorporated — a diversified health and well-being company. PacifiCare offers individuals, employers, and Medicare beneficiaries a variety of consumer-driven health care and life insurance products.


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4. Who is American Medical Security (AMS)?
AMS is a wholly owned subsidiary of American Medical Security Group, Inc., which in turn is a wholly owned subsidiary of PacifiCare, which in turn is a wholly owned subsidiary of UnitedHealth Group Incorporated. AMS underwrites, markets, and administers health-care benefits and insurance products for families and individuals. The company serves customers by working with professional, independent agents and quality health-care providers.


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5. What is a preferred provider organization (PPO)?
A PPO is a network of credentialed doctors, clinics, hospitals, and other health-care facilities that are contracted to provide medical services at negotiated fees.

PPO benefit insurance plan designs usually cost less than traditional or indemnity insurance plans while providing coverage for eligible expenses no matter what qualified doctor you select. With an insurance plan using a PPO, if you visit a PPO network provider, you may reduce your out-of-pocket expenses.


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6. How do I find PPO doctors and hospitals?
The name of your PPO network is listed on your identification (ID) card below the claims mailing address. If your insurance plan does not use a provider network, the ID card does not list a network.

To find a PPO network provider, call customer service at (800) 232-5432 and follow the prompts you hear or use the online Doctor & Provider Lookup. Always verify with your providers on the day of your appointment that they’'re contracted with your PPO network. A provider's contract status can change at any time. We review claims according to the provider’s contract status on the day services were provided.


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7. Can I view claim status online?
Current American Medical Security and PacifiCare customers, and customers who register while their coverage is active, can view claim status online in the Customer Center. To access this information, register today!

Once registered, you can view your medical and dental claims. You may need to register twice and create a separate user name and password for the medical ID and dental ID.


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8. What if I forget my Customer Center password?
Your Customer Center password is at least six characters long, begins with a letter, and uses at least one number. If you forget your password, select "Forgot Your Password?" and then use the question and answer you created to log in. Once you've logged in, you can change your password in "My Profile."


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9. Where can I find prescription drug information?
For prescription benefit information, call the prescription drug benefits team toll free at (800) 232-5432. Press 1 when you hear the prompt and then enter Ext. 16400. You can also find prescription drug information online by visiting the Web site of Prescription Solutions, the pharmacy benefit manager. Current customers can log into a secure area of the Web site to find detailed prescription drug information, order prescriptions 24 hours a day, view prescription drug lists (formularies), research health topics, and request information directly from Prescription Solutions.


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10. What are the differences between brand-name and generic prescription drugs?
The main difference between generic and brand-name prescription drugs is the cost. The Food and Drug Administration (FDA) must inspect and deem generic drugs to be equally effective to brand-name drugs. The same FDA quality and safety requirements must be followed for generic and brand-name drugs.


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11. What is a deductible?
A deductible is the amount of a covered medical expense that must be paid by the member before the insurer begins to pay benefits. (Deductible may be lifetime, plan year, calendar year, or per service as stated in your insurance Certificate, Contract, or Policy.) Only covered expenses are applied to satisfy the deductible.


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12. What is a copayment?
A copayment, or copay, is a fixed amount that a member pays toward each provider service or visit. The copay is paid to the provider and does not track toward your out-of-pocket expenses (deductible or coinsurance).


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13. What are out-of-pocket expenses?
Out-of-pocket expenses are covered expenses that a member pays to the provider.


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14. What is an Explanation of Benefits (EOB)?
After reviewing claims we receive, we send the member and the provider an EOB. It explains what benefits are available according to the member's Certificate, Contract, or Policy.


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15. How do I update or change the information on my identification (ID) cards?
If you're a PacifiCare or AMS customer, submit a name change in writing by fax to (920) 661-3681

or send it to:

American Medical Security
Attn: Administration
P.O. Box 19032
Green Bay, WI 54307-9032

Some other changes may be made in the Customer Center, or you can call customer service toll free at (800) 232-5432, Ext. 15305.


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16. What is a Health Savings Account (HSA)?
An HSA is not insurance. It’s an account with pre-tax advantages. It can be used to pay for unreimbursed medical expenses. The federal government determines what qualifies. Qualifying expenses can include charges for dental, vision, and alternative medical treatments along with deductibles, copayments, and other out-of-pocket expenses that the individual or family is financially responsible for.

If you have a high-deductible health plan and have set up an HSA, you can contact your financial institution or access the IRS Web site for information about administration and reimbursements.


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17. Where can I send my health insurance payments?
American Medical Security and PacifiCare members should send their payments to one of the addresses below.

PLEASE WRITE THE GROUP NUMBER ON THE CHECK.

Mail payments to one of the addresses below if you are in Arizona, Colorado, Kansas, Nevada, New Mexico, Oklahoma, Texas, or Utah.
Regular mail:

American Medical Security Life Insurance Company
P.O. Box 78548
Phoenix, AZ 85062-8548

Overnight delivery or express mail:

American Medical Security Life Insurance Company
Attn: Automated Lock Box
1820 E. Sky Harbor Circle South
Phoenix, AZ 85034-9700

Mail payments to one of the addresses below if the location of the business is in any other state. Please write the group number on the check.
Regular mail:

American Medical Security Life Insurance Company
P.O. Box 9001004
Louisville, KY 40290-1004

Overnight delivery or express mail:

American Medical Security Life Insurance Company
Attn: Automated Lock Box
6716 Grade Lane Building 9
Louisville, KY 40213

18. What are the AMS department fax numbers?