Overview
FlexCare includes everything available in KeyCare and adds access to specialist visits, in-person urgent care, laboratory services, and X-rays.
For many members, FlexCare provides access to the healthcare services most commonly used throughout the year, while maintaining predictable costs for routine care and prescriptions.
What's Included With FlexCare?
FlexCare includes:
Preventive Care
Primary Care Visits
Specialist Visits
Urgent Care Visits
Laboratory Services & X-Rays
Prescription Drug Coverage
Virtual Urgent Care
Virtual Behavioral Health
Preventive Care Coverage
Preventive care services are covered when received from participating providers. These services help identify health concerns early and support ongoing wellness.
Examples include:
- Annual wellness visits
- Preventive screenings
- Immunizations and vaccines
- Well-woman visits
- Well-child visits
- Recommended cancer screenings
Preventive care is included in all available plans.
Primary Care Visits
FlexCare includes visits with a primary care physician.
Your Cost
$25 Copay Per Visit
Primary care providers can help with:
- Routine healthcare needs
- Minor illnesses
- Preventive care follow-up
- Prescription management
- Ongoing health concerns
Specialist Visits
Unlike WellCare and KeyCare, FlexCare includes access to specialist care.
Examples of Specialists
- Cardiologists
- Dermatologists
- Orthopedic specialists
- Gastroenterologists
- Pulmonologists
- Endocrinologists
Your Cost
Specialist visits are subject to a PHCS network discount. The provider's charges are reduced through the network, and you are responsible for the remaining balance after the discount is applied. Discount amounts vary by provider.
Urgent Care Visits
FlexCare includes coverage for in-person urgent care visits.
Your Cost
$50 Copay Per Visit
Urgent care may be appropriate for:
- Flu symptoms
- Ear infections
- Minor injuries
- Sprains
- Minor burns
- Stitches
- Non-emergency illnesses
This benefit is not available under WellCare or KeyCare.
Laboratory Services and X-Rays
FlexCare includes access to laboratory services and X-rays through participating providers.
Examples include:
- Blood tests
- Diagnostic lab work
- Routine diagnostic testing
- Standard X-rays
Your Cost
These services are subject to a PHCS network discount. The provider's charges are reduced through the network and you are responsible for the remaining balance after the discount is applied.
Important Note
FlexCare includes standard laboratory services and X-rays, but advanced imaging such as MRI scans, CT scans, and ultrasounds are generally not covered.
Prescription Drug Coverage
FlexCare includes prescription drug benefits through the PureRx program.
Prescription Copays
| Drug Tier | Member Cost |
|---|---|
| Tier 1 | $15 |
| Tier 2 | $30 |
| Tier 3 | $50 |
| Tier 4 | $75 |
Covered medications are determined by the plan formulary.
Virtual Urgent Care
FlexCare includes unlimited access to virtual urgent care through Recuro.
Your Cost
$0 Copay
Members can connect with licensed healthcare providers 24 hours a day through:
- Video visits
- Phone visits
- Secure messaging
Common conditions treated include:
- Colds and flu
- Allergies
- Rashes
- Respiratory infections
- UTIs
When medically appropriate, prescriptions can be sent directly to your pharmacy.
Virtual Behavioral Health
FlexCare includes virtual behavioral health counseling through Recuro.
Your Cost
$0 Copay
Members can schedule appointments with licensed counselors for support with:
- Anxiety
- Depression
- Stress management
- Grief and loss
- Relationship concerns
- Anger management
Psychiatric services may be available at an additional cost.
Services Not Included Under FlexCare
While FlexCare includes more healthcare services than WellCare and KeyCare, some services remain excluded.
Examples generally include:
Hospital Services
- Hospital admissions
- Inpatient care
- Observation stays
Emergency Services
- Emergency room visits
- Ambulance transportation
Major Procedures
- Surgery
- Transplants
Advanced Imaging
- MRI scans
- CT scans
- Ultrasounds
These services are generally not covered under the FlexCare plan.
How To Access Your Benefits
Find A Provider
Use the PHCS network through MultiPlan to locate participating providers.
Access Virtual Care
Virtual Urgent Care and Virtual Behavioral Health services can be accessed through:
- The HealthWallet mobile app
- Recuro Health
Fill Prescriptions
Present your ID card at participating pharmacies to access your prescription benefits.
Quick Summary
Included
✓ Preventive care
✓ Primary care visits ($25 copay)
✓ Specialist visits (network discount)
✓ Urgent care visits ($50 copay)
✓ Laboratory services (network discount)
✓ X-rays (network discount)
✓ Prescription drug coverage
✓ Virtual urgent care ($0 copay)
✓ Virtual behavioral health ($0 copay)
Not Included
✗ Hospital services
✗ Emergency room visits
✗ Ambulance services
✗ Surgery
✗ MRI scans
✗ CT scans
FlexCare expands coverage beyond routine doctor visits by adding specialist care, urgent care, and diagnostic services, providing access to many of the healthcare services members commonly use throughout the year.