Ascension_Personalized_Care_ACA_health_plan_HELP_my_Benefits_Coverage

My benefits and coverage

We want to make sure you always understand your benefits and care. We are here to make things clear and easy to use.
  • What is a Summary of Benefits and Coverage (SBC)?
    A summary of benefits and coverage (SBC) is a document that shows deductible and copay information as well as everything that is covered under the plan.
  • What is an EOB and how do I read it?
    An EOB or Explanation of Benefits is a statement that describes the costs of medical care received. It explains what portion of a claim was paid to the healthcare provider and what you will owe.  Download our Guide to Reading an EOB 
  • How do I request an EOB or plan benefits to be mailed?

    Please send us your request via email to: apcsupport@ascension.org  


    You can mail your request to:

    Ascension Personalized Care

    PO Box 1707

    Troy, MI 48099-1707

     

    Contact us via phone at 833-600-1311

  • When does my coverage of benefits begin?

    If you sign-up during open enrollment and your first premium payment has been received, your coverage will begin January 1. If you enroll during a special enrollment period, your coverage start date is based on when you choose a plan. However, you cannot use your coverage until you make your first premium payment and your eligibility is confirmed.

     

    Key dates:

    Special enrollment due to coverage loss:

    Already lost coverage: Choose a plan within 60 days after coverage has ended. Submit documents within 30 days of choosing a plan. Coverage will begin the first day of the month after you choose your plan, if the premium is paid.

    Will lose coverage in the future: Choose a plan 60 days before coverage will end. Submit documents within 30 days of choosing a plan. Coverage will begin the first day of the month after your coverage ends and you choose a plan, if your premium is paid.


    Special enrollment due to move: Choose a plan within 60 days of moving. Submit documents within 30 days of choosing a plan. Coverage will begin the first day of the next month if the plan is chosen between the 1st and 15th and the premium is paid. Coverage will begin the first day of the second month if the plan is chosen between the 16th and the last day of the month and the premium is paid.


    Special enrollment due to gaining a dependent: Choose a plan within 60 days after the event. Submit documents within 30 days of choosing a plan. Coverage will go back to the date of adoption, foster care placement or date the court order took effect if the premium is paid.


    Special enrollment due to marriage: Choose a plan within 60 days after marriage. Submit documents within 30 days of choosing a plan. Coverage will begin the first day of the month after you choose a plan, if the premium is paid.

  • Do I have coverage for pre-existing conditions?

    Yes, the Affordable Care Act requires Marketplace plans to cover all pre-existing conditions. Pregnancy and childbirth are also covered.
  • What happens to my coverage if I move out of the area?

    If you move out of the area, you will need to update your address and reapply for coverage. This will be considered a special enrollment period.
  • What happens to my coverage if my spouse and I divorce?

    The Advanced Premium Tax Credit is based on your family size and income. If you divorce your spouse, you will need to reapply for coverage under a special enrollment period. You will have 60 days from the date of the divorce to apply.