FAQ

The Centivo PCP Plan is designed to offer high-quality care at prices that don’t break the bank. By focusing on a relationship between you and your primary care doctor – which can help keep you healthier, improve your healthcare experience and reduce emergency room visits – your costs stay lower without sacrificing quality of care.

Your primary care doctor focuses on your overall well-being, and visits are free whether you’re sick, taking care of an ongoing issue, or getting an annual wellness exam. They get to know you and your healthcare needs, help you navigate the healthcare system, and guide you to trusted, in-network specialists and services when needed.

This plan offers you lower costs when you need care so you can get the care you need without thinking twice about what it will cost you. When you work with your primary care doctor, you’ll get:

• No deductible
• FREE primary care visits, including visits with pediatricians, for sick and routine care
• Pre-set copays for all other care, so you’ll always know what you’ll owe before going to the doctor
• Urgent care and emergency care covered as in-network no matter where you are
• A convenient virtual primary care option as an alternative to in-person primary care

The Centivo Network was built with providers who offer quality care at a low cost. The network includes trusted local health systems, virtual doctors and national providers so you have access to all the specialists and services you need. If you ever have trouble finding a provider, contact Centivo Member Care for help.

You can view the online directory or contact Centivo Member Care if you need help finding a provider.

Once you enroll in the plan, you’ll be able to view the Centivo Network through the Centivo app.

Yes! The Ralph Lauren Onsite Care Clinic is also available to you through this plan. While you won’t be able to select the clinic as your Primary Care Team, they can help coordinate any care you need so you stay in-network. The Ralph Lauren Onsite Care Clinic is open to all employees, dependent children ages 2-25 and spouses or certified domestic partners. Visit ralphlaurenncwellness.com to view available services and to book an appointment.

• Centivo IS a different kind of health plan. It’s built differently than plans you may have had in the past; ones where costs go up every year.
• Your employer chose to offer Centivo to make quality care more affordable for employees like you.
• It may sound too good to be true, but there’s no catch. Here’s how we do it:
  • First, we contract directly with local, virtual and national providers who are committed to quality care at lower costs, and that savings is passed on to you.
  • Second, our members choose a primary care doctor who gets to know them and their health needs and guides their care. Having that solid primary care relationship has been shown to keep people healthier overall. And if you do need other care – specialist visits, procedures, hospital care – your primary care doctor helps connects you with the right care for your needs.
• Bottom line, you can see your doctor whenever you need care without worrying, since you’ll know how much it will cost with preset copays. So there’s no need to ever wait out feeling sick until you end up at an urgent care or ER, where your care will cost a lot more.

Your plan uses the Centivo Network, which is available in several cities across the U.S. If you have a dependent away at college or living outside of the Centivo Network area for part of the year, they may still be able to benefit from this plan. Search the online directory to see if there are providers available near where they live and keep in mind these additional options:

• They can choose Centivo Care as their primary care doctor if they are 18 or older and live in a state where it’s available. View the map here.
• They can choose a primary care doctor close to their permanent address that offers virtual visits by phone, mobile device or computer.
• They also have access to MDLIVE for telemedicine, no matter where they are.
• They can always go to urgent care or the ER and it will be covered as in-network, no matter where they are.
• Most colleges offer on-site medical care. Your enrolled dependent can also consider using their school’s student health services for care.

Activation is the process of choosing a primary care doctor for you and any family members covered under your plan. You’ll receive information with your ID card on how to activate at the start of the plan year – it’s a simple process you can do in the Centivo app or by calling Centivo Member Care once your plan year begins. You can choose the same or different doctor for everyone on your plan. Once activated with a primary care physician, you can also see a physician assistant or nurse practitioner in their office. And, if you activated last year, you don’t need to activate again.

Absolutely! It’s important to find the doctor that’s the right fit for you. Change your designated primary care doctor at any time in the Centivo app or by calling Centivo Member Care.

Centivo Care is a convenient primary care practice that takes the place of an in-person primary care doctor. You can visit with your Centivo Care doctor online using a secure app, as well as schedule appointments, ask questions, refill your prescriptions and more. Centivo Care is available for members 18 and older in many states. Click here to learn more.

If you’re currently pregnant (and will be in your second or third trimester once the plan year begins) or actively being treated for a medical condition by a provider who isn’t in the Centivo Network, you may be eligible to continue care with your current provider at the in-network rate until your current treatment is completed. However, you must submit your request and determination must be made prior to receiving additional care. For more information on how to submit this request, please contact Centivo Member Care.

You can’t add tax-free dollars into a health savings account (HSA) if you enroll in this plan. However, you can use any money you’ve already put into your HSA to pay for qualified medical expenses.

As Centivo continues to grow and expand, this sometimes happens. Simply ask your doctor’s office to call Centivo at the number on your member ID card, or you can call Centivo directly to confirm whether your provider is in the network.

Centivo Member Care is available Monday through Friday from 8 am to 8 pm ET at 833-433-1379. Support is available in English and Spanish, as well as 150 other languages.

For any other questions, please reach out to Centivo Member Care.