Frequently Asked Questions
Where can I find benefit summaries for quotes or groups?
Please see the 2024 Benefit Summaries for more information.
Can I make enrollment and eligibility changes online?
Contact PHP Sales at Sales@phpmm.org to request enrollment and eligibilty changes.
How can I find participating providers accepting new patients or with extended weekday or weekend office hours?
To find a participating doctor, visit the Provider Directory
Does PHP sell Individual Plans?
Yes - PHP has individual and family plans available both on- and off-marketplace. Please visit PHPMichigan.com/ChoosePHPmi for more information. The
2024 Individual Marketplace Plans grid will give you a good overview, and the 2024 Individual Plan Summaries allows you to review the Summary of Benefits and Coverage for each plan.
Please contact PHP Sales at Sales@phpmm.org if you have any questions.
Can employer groups pay their premiums online?
At this time, groups cannot pay their premiums online. Employer groups can send checks to the following address:
For HMO Plans:
Physicians Health Plan
PO Box 776180
Chicago, IL 60677-6180
For PPO Plans:
Physicians Health Plan
PO Box 776178
Chicago, IL 60677-6178
Can employer groups have their premiums automatically deducted from their bank account each month?
Groups can definitely set up ACH payments to PHP. Employer groups must initiate the payment through their financial institution.
For more information contact the PHP Finance Department at 888.892.0009 .
Do the maximum-out-of-pocket (MOOP) amounts shown on quotes include the deductibles?
What if I have employees residing outside of the PHP service area?
In order for your group to take part in a PHP HMO plan or a PHP POS plan, your employees must live or work within the PHP service area. PHP HMO or PHP POS members who live or work outside of the PHP service area must agree to receive services from in-network providers.
If your group has the PHP PPO product, and you have a new enrollee who lives outside of a PHP service area, please notify your PHP Account Manager so that the new enrollee can be placed in the appropriate network class to receive in-network benefits.
What if a PHP member needs to seek services while traveling out of the area?
A member who has an urgent or emergency situation when traveling outside PHP service area should visit the nearest urgent care center or emergency department, regardless of whether it is in the PHP network. Urgent Care and Emergency services are always covered under a member's in-network benefit, in all 50 states and worldwide.
What is the PHP prescription drug list?
It is a list of prescription drugs covered by a particular PHP drug benefit plan. PHP, in conjunction with its pharmacy benefit manager, CVS/Caremark, reviews its Prescription Drug Lists on a regular basis to ensure that they are up-to-date.
Are there pre-existing condition clauses in your policies?
There are no pre-existing clauses under any PHP policies.
How do I enroll a member, make a change or check the status of an enrollment or change?
You can make enrollment changes in a number of ways:
Changes may take up to 48 hours to be effective.
What if a PHP member needs Case Management services?
How do I get appointed with PHP?
Complete and return the PHP Agent Appointment packet and required documents to the PHP Sales General Inbox at Sales@phpmm.org . Upon receipt of your information you will be contacted via email with next steps. Questions regarding the appointment process can be directed to PHP Sales at Sales@phpmm.org