Health Insurance

With a reputation of innovation, NetCare is committed to establishing a relationship with its customers, physicians, hospitals and group clients as trusted partners.

Customers want a choice of products and health care professionals, and they want more control over their health care decisions. Employers also want the maximum amount of cost control while also being sensitive to employee needs.

NetCare Life and Health Insurance Company has created a variety of benefit plans, various hybrid plans and riders such as dental, vision, orthodontia and other health care services that combine the attributes consumers find attractive with effective cost control techniques. Employer groups can select from basic as well as comprehensive plans to meet their specific needs. Also available are a wide range of related specialty products and other services including a Consumer Driven health Plan with a Health Savings Account (HAS) option and COBRA Administration.

• Preferred Provider Organization (PPO) Plans (Standard and Prime Plans)
• Health Maintenance Organization (HMO) Plans (Advantage HMO Plan)
• Point of Service Plans (Advantage POS Plan)
• Consumer Driven Plans (SmartChoice HSA Plan)

NetCare’s strategy is to offer a diversified mix of products that preserve member choice at competitive prices, while focusing on the development of new hybrid plans that take advantage of the best characteristics of traditional managed care and innovative open access models.

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Benefit Plan Summaries

All NetCare PPO plans share the same large provider network, meaning you have the Freedom to choose your physician and get the great coverage no matter which benefit plan you enroll under.

Please take a moment to review the benefit plan summaries and services NetCare offers to you to improve your health and lead a better life.

• No Co-payment under the PPO/POS plans for wellness and preventative benefits; $10 co-payment under the High Deductible Plans.
• Fixed co-payments for outpatient services of $10 for primary care and $25 for specialist care under the PPO/POS Plans; co-insurance of 20% under the Deductible Plans
• Fixed co-payment for inpatient hospitalization under the POS Plans; Co-insurance of 20% for inpatient hospitalization under the PPO Plans
• Fixed co-payments for prescription drugs under the PPO plans; and co-insurance under the High Deductible Plans
• Choose from a large network of providers on-island and off-island

You may click on the Benefit Plans below for more details on coverage and services:
Groups with modified benefit plans will need to call our customer service representative for details.

Guam:
Access Plan
Advantage Plan HMO (GU Asia Network)
Advantage Plan HMO
Advantage Plan POS (GU Asia Network)
Advantage Plan POS
Prime Plan (GU Asia Network)
Prime Plan (GU PI Network)
Prime Plan
Prime Reward Plan
SmartChoice 1500 Plan (GU Asia Network)
SmartChoice 1500 Plan
SmartChoice 2500 Plan (GU Asia Network)
SmartChoice 2500 Plan
Standard MOD Plan (GU PI Network)
Standard MOD Plan
Standard Plan (GU Asia Network)
Standard Plan (GU PI Network)
Standard Plan

CNMI:
Limited 8020 Plan
Limited Plan
Preferred Plan
Prime Plan
Standard Plan

Palau:
Preferred
Prime

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Health Plans

New and innovative programs to improve the quality of health care in our communities.

Managed Care Plans
Guam PPO Plans

• Access Plan
• Advantage Plan HMO
• Advantage Plan HMO (GU Asia Network)
• Advantage Plan POS
• Advantage Plan POS (GU Asia Network)
• Prime Plan
• Prime Plan (GU Asia Network)
• Prime Plan (GU PI Network)
• Prime Reward Plan
• Standard MOD Plan
• Standard MOD Plan (GU PI Network)
• Standard Plan
• Standard Plan (GU Asia Network)
• Standard Plan (GU PI Network)

CNMI PPO Plan

• Limited 8020 Plan
• Limited Plan
• Preferred Plan
• Prime Plan
• Standard Plan

KMART

Alternative Plans
Dental

• Brite Dental Benefit Sheet 2010
• Smile Dental Benefit Sheet 2010

Pharmacy
Orthodontic
Vision

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