Important information regarding your Healthplex dental plan
Member FAQs
Here are the frequently asked questions by our customers. Can’t find the answer you’re looking for? Please reach out!
How much does USFHP cost?
The annual enrollment fees for 2024:
Family: $726 (2 or more) Individual $363 (Group A)
Family: $879 (2 or more) Individual $438.96 (Group B)
You may pay all at once or choose to pay quarterly with no additional charges. Your first enrollment fee payment is due upon enrollment. Enrollment fees are subject to change annually.
There are no deductibles to meet with USFHP, and there are no waiting periods. After your enrollment fee, if any, your only costs are the relatively small co-payments you pay when you receive medical services. Many services – such as annual physical examinations, child care, vision, and hearing testing require no co-payments at all.
When will the enrollment fees be due, if applicable?
All enrollees must pay their applicable enrollment fees in accordance with the government’s calendar year. The enrollment fee, for retirees who do not pay for Medicare Part B coverage, is due by the first day of the new enrollment year (January 1st) for members who chose to pay annually or by the first day of the enrollment quarter for those who choose to pay quarterly (January 1st, April 1st, July 1st, and October 1st).
If you are a new applicant, your initial payment for your enrollment fee must be included with your initial application.
Who is eligible for USFHP?
Visit our eligibility and enrollment page to find out more!
What happens if my military status changes during the middle of the plan year?
When you retire and change your status from active duty to retiree, you will have to pay the applicable enrollment fee. The fee will be prorated based on the date of your retirement. Active duty sponsors who retire can join USFHP anytime.
How does USFHP compare to TRICARE Prime?
USFHP offers the same benefits and cost structure as TRICARE Prime. In addition, USFHP offers:
- Value – Minimal costs to members and low fee
- Convenience – We offer a large network of healthcare providers with accessible locations and hours
- Quality – Comprehensive healthcare provided by the best providers and hospitals in the country
- Choice – Members select physicians and healthcare sites
- Enhanced Benefits – Choice of one of the three enhanced benefits (Eyeglasses, Preventive Dental Services, Gym Reimbursement)
- Integrated Health Services: includes Chiropractic Care (12 Visits), Acupuncture (6 Visits), and Massage Therapy (6 Visits)
What if a member moves to a different state during our plan?
If you have an address change, please notify us (800-241-4848 (TTY:711) or usfamily@svcmcny.org) to update your record and confirm if US Family Health Plan provides coverage in your area.
What happens if I become ill in another country?
If you travel outside of our coverage and need medical attention, you have access to urgent/emergency care.
What should I do if I have Other Health Insurance (OHI)
If you have OHI, please contact customer service to update your record and set the appropriate coordination of benefits.
Where can I find out more about my billing and account information?
For access to your detailed claim(s) information, make PCP changes, submit claims/member reimbursement, member ID cards and more, please register for member portal access https://member.usfhp.net
How can I get a new ID card?
To print an ID card or request a replacement card, please visit our Member Portal. We also offer a mobile app for quick access to your ID card at your fingertips! Search the Apple App Store or Google Play Store for the USFHP Member app.
I’m having issues getting into the Member Portal?
If you would like to learn more about how to use the new portal, we offer a self-help tutorial on the bottom of the Member Portal login page. For further assistance, please contact Customer Service at (800) 241-4848 (TTY:711).