Question: What types of insurance plans prevent enrollees from participating in Yes, You Can?
Answer: HMO plans will not pay if you go to an out-of-network provider. Make sure that you receive care with an in-network provider if you have an HMO plan.
Question: How does the Yes, You Can program work?
Answer: Yes, You Can waives the difference between your in-network and out-of-network coverage. In other words, Yes, You Can removes the penalty for using Aultman Hospital as an out-of-network provider. Yes, You Can will waive a maximum of a $2,000 deductible and 30 percent co-insurance. If the in-network and out-of-network deductibles are separate, we will still only waive the $2,000 deductible maximum. The in-network deductible and co-payment amounts will continue to be the responsibility of the patient. Differences in in-network and out-of-network deductibles or co-payments greater than the program limits will be the responsibility of the patient. If you need to understand how this applies to your situation, please contact us. A Yes, You Can specialist will be happy to talk to you about your individual situation.
Question: How do I know if I am able to participate in Yes, You Can?
Answer: When you apply for Yes, You Can, a specialist reviews your individual health benefits. When this review is complete, you will receive a letter in the mail. If you are fully or partially approved, you will receive a Yes, You Can card at the bottom of your letter. This card can be shown at future Aultman Hospital visits. Once approved for Yes, You Can, you don’t need to do anything else to use the program. Your bill will be adjusted for the Yes, You Can discount after your visit. If your insurance benefits change, you will need to be re-verified for the program.
*You are eligible for Yes, You Can if your commercial health plan allows out-of-network service. You are still responsible for your health plan’s regular in-network deductibles and co-pays. People with Medicaid, Medicaid HMO, Medicare, Medicare HMOs, most commercial HMOs, other federal and state plans, Medicare supplements and auto liability claims are not eligible for Yes, You Can. Some high deductible insurance plans are not eligible.