Discount Medical Plan Organization (DMPO)
Member Rights and Obligations
Access One Consumer Health, Inc. a Discount Medical Plan Organization
The terms and conditions of the ADMINISTRATOR (Access One Consumer Health, Inc.) Discount Medical Program Organization (DMPO) is outlined below.
The DMPO will provide the member with a list of participating providers at its web site
www.accessonedmpo.com or the member may call 800-896-1962 to find a provider. Members will be able to apply program discounts to all providers of each participating network. Provider services may include a combination of any of the following: medical doctors, doctors of osteopathy, dentists, chiropractors, diagnostic labs, out-patient facilities pharmacies, and ophthalmologist, optician, and optometrist services. The Member will be billed by the provider at the discounted rate at the time service is rendered. The Member is obligated to pay the provider for services rendered.
In no instance will the DMPO make payments directly to health care providers on behalf of the Member.
If the Member or the provider has a complaint regarding the DMPO then he or she may go to www.accessonedmpo.com or call 800-896-1962 or write to Access One Consumer Health, Inc., 84 Villa Rd. Greenville, SC 29615 This complaint will be addressed and the member will receive a response within 15 days of receipt of the complaint by the DMPO.
The Member may terminate participation in the first 30 days of the program and receive a full refund on any fees or dues paid less a processing / Enrollment fee. After the first thirty (30) days, the member may cancel participation at any time. The Administrator must receive notification at least five (5) business days in advance of the next billing cycle for the member not to be charged for that billing cycle. If the notice of cancellation is not received prior to that billing cycle, then cancellation of payment will occur at the next billing cycle.
HEALTHCARE SAVINGS PROGRAMS ARE NOT INSURANCE
I acknowledge and understand that I am voluntarily purchasing bundled services and that this agreement is non-transferable.
I acknowledge and understand that this agreement does not provide comprehensive health insurance coverage nor is it a contract of insurance.
I acknowledge and understand that I am responsible for any charges incurred for health care services performed including but not limited to emergency room, hospital and specialty services.
I acknowledge and understand that MyFit Marketing must maintain a record of my information and must protect the privacy of my information as per the terms of the Notice of Privacy Practices. I understand and acknowledge that this policy is available for my review at any time at WWW.MyfitPrivacy.com or upon request.
I acknowledge and understand that no child over 26 can be on my plan and that he/she must enroll in their own plan or loose benefits.
I acknowledge and agree to pre-pay my monthly plan and associated fees on or before its due date for the upcoming month. If I am unable to pay my fee(s) on time, I understand that I will be charged a $5 late fee initially and $5 per month thereafter and agree to owe the total late fee balance along with all past due monthly care fees and acknowledge that my service agreement may be terminated.
I acknowledge and understand that I may terminate this Agreement at any time and for any or for no reason by providing written notice to MyFit Marketing. Monthly fees will continue to accrue until written termination notice is received. Any pre-paid monthly fees will be returned when Myfit Marketing has received the written termination and will be refunded within forty-five (45) days. Refunds are only given if cancellation request was received before the 1st of the requested canceled month.
In addition, I acknowledge and understand that MyFit Marketing may terminate this Agreement by providing me written notice and any pre-paid monthly fees will be refunded to me within ten (10) business days.
I acknowledge and understand that Myfit Marketing may add or discontinue services or may increase my fee schedule at any time (but no more than once per year), and that I will be given, in writing, at least 60 days’ notice of such fee schedule changes.
I acknowledge and understand that MyFit Marketing is not insurance and does not provide payment and or reimbursement to me or on behalf of me to any charges occurred while on this plan. This plans sole purpose is to provide me access to affordable healthcare that has wellness benefits, and other discounted medical benefits and self-pay tools.
Statement of Understanding
MyFit Marketing provides lifestyle-related benefits and services to its members. Participation in Plan is required in order to be eligible to utilize plan benefits. By Applying for a MyFit Marketing plan, you are requesting enrollment in a bundled plan. You also understand that your failure to remit payment for plan will result in loss of eligibility to participate in all sponsored programs and benefits.
Rights and Responsibilities
In the event of plan termination, I understand that I must complete a written Service Cancellation Form. Any differences in payment between my billing date and the date of cancellation will be refunded to me via the payment method I have chosen for my monthly fee.
I understand that if my account is overdue, I am responsible for resolving the outstanding balance prior to my service cancellation.
I understand that I have the right to considerate, respectful, and nondiscriminatory communication from MyFit Marketing. I also understand that I am responsible for communicating clearly and respectfully with MyFit Marketing staff members. Should I become dissatisfied with MyFit Marketing’s services, I agree to notify MyFit Marketing immediately, so my concerns may be addressed in a timely manner.
I am responsible for making prepaid monthly payments on time. On time means on or before the 15th of the month prior to coverage.
I am responsible for my own healthcare decisions and expenses.
I authorize Health Plan, a third-party biller, to auto deduct monthly for my plan services until MyFit Marketing has received written notification of cancelation. I also understand that I am fully responsible for any charges from my bank for these transactions.
|Standard||1-5 business days||$7.95|
|Two Day||2 business days||$15|
|Next Day||1 business day||$30|
|* Free on orders of $50 or more|