The City of Savannah’s Plan is a self-funded group health plan. Quantum Health provides the coordination of benefits, and HPI is the claims administrator. The primary Preferred Provider Organization (PPO) Network for the City of Savannah is The Care Network (TCN) which utilizes the St. Joseph’s / Candler Clinics and Hospitals.
|Medical Plan Coordinated By:
|Quantum Health Care Coordinators:
|Benefit Administrator Claims:
|Health Plans, Inc. (HPI)
P.O. Box 5199, Westborough, MA 01581
|The Care Network (TCN)
Healthcare can be confusing, Quantum Care Coordinators are here to make it easier. Turn to your Care Coordinators for help with items such as:
- Nurse Support
- Claim Questions
- Patient Advocacy
- In-Network Provider Assistance
- Anything That Can Make the Healthcare Process Easier
Members may contact a Quantum Health Care Coordinators, Monday - Friday from 8:30 AM to 10:00 PM, to help with any questions you might have about your benefits. Care Coordinators can also help you find a provider, order a new ID card, and even transfer you to a nurse for questions about your treatment plan.
Visit the MyQHealth Member Portal at: www.cityofsavannahhealthplan.com or download the MyQHealth App at Apple iOS App or Google Play App to access your health plan benefits, ID cards, provider listings, chat with a care coordinator and more.
Medical Plan Benefits Summary
The City offers two medical plan options to meet your individual needs. Both plans include free preventive care services (with in-network providers only) and a four-tier prescription drug plan.
Medical Plan Premiums
Sav4Health Medical Premium Incentive Program
The City is committed to supporting employees who take the steps to achieve a healthier lifestyle. Employees that complete all four (4) SAV4Health activities by November 15th will receive an estimated $1,000 reduction in annual medical premiums.
Four (4) Simple Steps To Earn The Wellness Incentive
- Complete your Annual Check-Up with a Biometric Screening
- Report the Results of Your Annual Check-Up Visit and Biometric Screening
- Complete Your Health Questionnaire
- Complete a Tobacco Affidavit
Learn more HERE about the SAV4Health incentive program and how you can save an estimated $1,000 annually!
Prescription Drug Coverage MaxorPlus is the City of Savannah pharmacy drug provider; you mail fill your prescriptions at most pharmacies (Kroger, Wal-Mart, CVS, Walgreens, etc.) The formulary medication list offers a wide selection of clinically-sound, cost-effective generic and brand-name prescription drugs. The program includes a retail prescription plan and mail order for maintenance medications. At network pharmacies, your co-payment is determined by the tier on which the prescription is placed (Tier 1, Tier 2 or Tier 3). Tier 4 is for specialty drugs.
Save on Prescriptions
MaxorPlus offers a convenient, cost effective way to order prescribed long-term medications for delivery to your home through our MXP Pharmacy. Medications obtained through mail order are limited to a 90-day supply. To maximize your savings, please ask your doctor to write, submit electronically, or fax your prescription for a 90-day supply with refills up to one year. Once MXP Pharmacy has your prescription, refills can easily be obtained.
There are multiple ways to register with MXP Pharmacy. Once you receive your ID card, you can:
- Activate your mail order account at www.maxor.com/maxorplus/members. Register and link your patient profile with your first name, date of birth, member ID number and group number (which are located on your ID card).
- Call 800.687.8629 and to speak with a Member Advocate who will help you activate your mail order account. Hours of operation are Monday - Friday 7am-9pm, Saturday 8am-6pm, Sunday 9am-5pm CST
In-Network Urgent Care Centers
Urgent care clinics are well-prepared to handle a wide array of pressing, but not life-threatening, health issues. St. Joseph/Candler Urgent Care Centers, from Georgia Emergency Associates is your in-network urgent care provider. The centers provide numerous services which includes stitches, X-rays, lab work, splinting, casts, shots, and assist with diagnosing colds, infections, allergic reactions, asthma and more.
Urgent care co-pays are $15.00 (Plus Plan) or $20.00 (Basic Plan)
If you or your dependent are not experiencing a medical emergency, consider visiting a St. Joseph’s/Candler Urgent Care Center. For your convenience, most centers are open on evenings and weekends and now offer virtual visits. To find a location near you or to schedule a virtual visit, go to www.sjcurgentcare.com.
How Do I Get a Replacement ID Card?
Call the Care Coordinators at 866.360.7926 or visit your member portal at www.cityofsavannahhealthplan.com.
Why Did I Receive this Bill?
All members and dependents will receive an Explanation of Benefits (EOB) from UMR for the processing of all medical claims or you may access on www.cityofsavannahhealthplan.com. Review all EOBs before paying a bill from a provider to ensure the claim has been processed with the insurance. Review the bottom of the EOB as you may need to verify with a Care Coordinator that you do not have secondary insurance. If you need assistance or have a question about a claim, contact the Care Coordinators at 866.360.7926.
Can I use my Flexible Spending Account (FSA) medical spending to pay for prescriptions?
You can spend FSA funds on prescriptions, as well as over-the-counter medicines with a doctor's prescription or letter of medical necessity. Reimbursements for insulin are allowed without a prescription. FSAs may also be used to cover costs of medical equipment such as crutches, bandages, and diagnostic devices including blood testing devices. For the list of eligible expenses view BRi's Eligible Expense Reference List.
Why does my Prescription Require a Pre-Authorization?
Prescriptions for certain medications require a prior authorization, also known as a coverage review, to ensure the drug is safe, clinically appropriate and cost effective for your condition. The review uses both formulary and clinical guidelines to determine if the plan will pay for certain medicines. If your prescription requires a prior authorization, your doctor must submit a request for coverage review for approval.