Another similar question we get is “what’s the catch?” There is none. We first entered this business with our health plan, designing it from scratch to make it more relevant to small business owners and their needs. As a PEO, we use size and scale to improve affordability while also offering other important services to make work less work for business owners like payroll and HR. No catch, we’re just different than any PEO around.
The process is similar to seeing a specialist. You should seek a referral from you virtual Primary Care Provider to see an in-person primary care doctor. Copay or Coinsurance costs for seeing the in-person primary care doctor would apply.
Note: Since primary physician is your VDPC, you'll still need to consult them for confirmation on any referrals recommended by the in person primary care physician that you see in a one off capacity.
We’re able to offer more affordable premiums because we’ve built everything from scratch. We don’t have the massive legacy processes and departments of a traditional health insurance company. We’re allowed to offer year round sign-up, and we think it’s a great thing for our members.
At this time Decent does not offer dental, vision, or life although we do have partners who offer policies that we can get your company set up on. Please ask either your broker or your Decent representative for options.
Yes, all of these are covered 100% and can be taken care of at your DPC provider's office. We encourage you to get your flu shot or any vaccinations, and we will work directly with your doctor to have them paid for.
All of the plans that Decent administers are categorized as POS (Point of Service). This is a hybrid of sorts between an HMO (Health Maintenance Organization), which generally has a small network and no out of network benefits, and a PPO (Preferred Provider Organization) which offers more flexibility on which providers you can see but generally comes with higher premiums. We’ve designed our POS plans to have the best of both - low premiums with a provider network you’ll love.
Decent is administering a health insurance plan for the Texas Freelance Association (TFA). The Texas Freelance Association has filed and had approved 5 different Multiple Employer Welfare Arrangements (MEWAs) with the Texas Department of Insurance which has allowed them to construct specific risk pools to serve certain industry subsets in the state of Texas.
In order to qualify for health benefits, members must demonstrate that they are in or serving the following industries:
Food and Beverage
At this time individuals and companies from other verticals are not eligible for the plans but we're working with the TFA on ways to expand access currently.
We are proud to have St. David’s Healthcare, Seton, and Baylor in our provider network. Our members can receive services at all of these organizations' facilities, including their hospitals, emergency care, rehab centers, and outpatient surgery centers.
If your specialist is not covered and you see them, the service would be covered under out of network benefits (less coverage). However, we are happy to reach out to add them to our provider network! Feel free to your doctors information with us (firstname.lastname@example.org), and we’ll have our contracting team reach out to them.
If you’re enrolled in one of Decent’s virtual plans, then unlimited access to your virtual primary care doctor is included and comes at no additional cost to you! It’s critical that you download and activate your account in the MedLion Clinic phone app as this is the only way to interact with your assigned physician. On your first date of coverage, you’ll receive a welcome email from MedLion Clinic with instructions. Follow this guide for additional assistance and let us know if you have any questions--our friendly Customer Service Ambassadors are standing by to help.
Start by working with your selected Direct Primary Care (DPC) doctor. For lab-work: your physician will send the referral to Clinical Pathology Laboratories (CPL). For high-tech radiology, diagnostic testing, or a specialist visit: they will FAX the referral to 512-729-7178 or securely email it to email@example.com. From there, our friendly Customer Service Ambassadors will notify you of an in-network option near your address and submit the referral documentation to the provider for scheduling. Please note that while all specialist visits require a referral from your DPC, Urgent Care and Emergency Room visits do not require a referral, nor do routine visits to an in-network gynecologist or pediatrician. Specialists may also refer you for testing or to another provider. Please ensure you are referred in-network to reduce your out of pocket liability. We’re here to help if you’re ever unsure of what to do.
If you are experiencing any COVID-19 symptoms or if you know that you may have been exposed to someone who has tested positive for COVID-19, please consult with your selected Direct Primary Care (DPC) doctor by phone or text, or visit a CareNow urgent care location. Many test locations require a physician referral or prior authorization due to the volume of cases, so we recommend calling ahead for an appointment for the smoothest experience. You can utilize this resource to find a convenient test location.