Overview
Your Health Pro consultant will be your personal healthcare advocate to help save you time, money, and frustration when dealing with healthcare matters. Your dedicated Health Pro consultant offers independent guidance to ensure you get the most from T-Mobile’s health plans, including:
- Understanding your benefits and plan details
- Finding great doctors, dentists, and eye care professionals
- Comparing prices to save money on medical care
- Reviewing your healthcare claims
- Getting help with medical, dental, and vision bills
- Researching alternatives to pay less for prescriptions
- Scheduling your appointments and transferring your medical records
Who is Eligible
Q. Who is eligible for support from a Health Pro?
A. T-Mobile employees enrolled in one or more of our health plans (medical, vision, and/or dental) are eligible.Note:Not currently available to Puerto Rico employees.
Q. Can Health Pros assist members of my household who aren’t on a T-Mobile healthcare plan?
A. Yes. Your Health Pro is also available to your household, even if your family members are not enrolledin a T-Mobile plan. “Household” is defined as your spouse/domestic partner, children/dependents under the age of 26, parents/parents-in-law. Note: Grandchildren, sons- and daughters-in-law are not eligible.
Q. When does an employee become eligible?
A. The benefit officially begins the same dayan employee’s medical/dental/vision coverage is effective. However, services from a Health Pro are available for a new hire prior to their benefits enrollment.
Q. When does the Health Pro benefit end?
A. The benefit will end the day the employee terminates all medical/dental/vision plan coverage. Any outstanding employee requests will be completedeven if the employee terminates coverage.
Q. Are COBRA enrollees eligible to use the Health Pros benefit?
A. Yes. COBRA participants are eligible and have access to Health Pros through the same dedicated phone number and email address.
How It Works
Q. Is there a cost for me to use Health Pros service?
A. No, there is no cost to you. T-Mobile pays the fee on your behalf.
Q. Which types of benefits can my Health Pro help me with?
A. Your Health Pro is an expert in medical, vision, and dental benefits, but they may also be able to help you with other benefits like Flexible Spending Accountsand our Employee Assistance Program.
Q. What services can my Health Pro provide?
A. Your Health Pro can: Help you understand your benefits and plan details. Find you great doctors, dentists, and eye care professionals. Compare pricesto save you money on medical care. Review your healthcare claims with an expert eye. Help you understand your medical, dental, and vision bills. Research alternatives to save you money on prescriptions. Schedule your appointments and transfer your medical records.
Q. How long will it take my Health Pro to respond to my request with an answer?
A. Your Health Pro is typically doing research on your behalfwith the goal of providing you accurate and thorough information, so expect them to take your request and then follow up once their research is completed. Most requests are answered by the next business day, but bill reviews and appeals often take longer. Your Health Pro will keep you updated throughout the process.
Q. Does my Health Pro need permission to speak with my doctor or insurance company?
A. Yes, in many cases you will need to fill out an authorization formgiving your Health Pro permission to advocate for you on your behalf.
Q. Will my Health Pro discuss with my physician what prescription is covered?
A. Your Health Pro will not discuss your prescriptions directlywith your doctor, but they will review your medications to determine coverage and lower-cost alternatives. They will provide you with a report of possible prescription changes that you can use to have an informed discussion with your doctor.
Q. Can my Health Pro make recommendations that apply to where I live?
A. Yes. Your Health Pro and the information they access on your behalf are available nationwide.
Q. Do I have to choose the lowest-cost option provided to me with the Cost Estimate service?
A. No!Your Health Pro is here to help you make an informed decision that is right for YOU. Your Health Pro will provide cost information to help you decide, but there is no obligation to choose the lowest-cost option.
Q. What if I would rather go to a provider my Health Pro recommends instead of the primary care physician I was referred to?
A. Your Health Pro is here to help you make the best decisions for YOU, including choosing your own provider. Most doctors are open to patients choosing their own provider—a referral is just a recommendation.
Feel free to share Health Pro recommendationswith your primary care physician.
Q. If I want to keep my current doctor for a service, can my Health Pro just compare prices where that doctor has privileges?
A. Yes. Health Pros can provide cost estimates for a procedure done by a particular provider at different facilities.
Miscellaneous
Q. Can my Health Pro assist with issues related to Elder Care?
A. Yes. Your Health Pro can help you with medical issues for your spouse, parent, or parent-in-law, so make sure to reach out to them if you are dealing with an aging parent/spouse and need help with elder care issues.
Q. Can my Health Pro assist with issues related to Medicare?
A. Yes. Your Health Pro can: Provide an overview of Medicare coverage. Recommend in-network providers. Provide cost estimates. Review any bills or EOBs processed through Medicare.
Q. Can my Health Pro assist with Long Term/Short Term Disability claims?
A. No. Health Pros are not able to assist with questions relating to Leave of Absence (LOA) claims, including getting disability paperwork completed. However, during an LOA you may still contact your Health Pro to: Help you find a specialist. Determine if something is covered under the medical plan. Deal with claims and bill paperwork.
