Insurance FAQs

• What if I lost insurance due to COVID-19 or another reason?

  • You may qualify for a Special Enrollment Period to get covered through the Marketplace, Medicaid, or CHIP. If you do, you can enroll outside the yearly Open Enrollment Period. We can help you stay with your ARC doctor.
  • As a courtesy, ARC offers a 25% cash discount on most services to uninsured patients who pay in full at the time of service or by the Due Date on the first billing statement received. Please call 512-407-8686 for further details. For an estimate of charges, it is best to call your clinic in advance. Some services, such as lab tests, may be billed by the laboratory conducting testing.

• What is the difference between in-network and out-of-network?

  There are two levels of coverage in most health plans: in-network and out-of-network. Out-of-pocket costs in both levels of coverage may include: office visit co-payments, deductibles and coinsurance.

  • In-network: This level of benefits applies when you use a physician, specialist, or other provider who is a network member. By utilizing in-network providers, you will pay lower co-payments, deductibles, and coinsurance than you will using out-of-network providers.
  • Out-of-network: This level of benefits applies when you call or see a physician, specialist, or other provider who is not a network member. You are responsible for any amounts incurred in excess of the "covered charges." "Covered charges" are pre-determined usual, customary and reasonable charges for a particular service. You must call your health plan to learn more about your covered charges.

• What is my co-pay?

  The co-pay amount is usually listed on your insurance card. If it is not there you will need to call your insurance company to find out your co-pay amount.

• What is a PCP?

  PCP stands for Primary Care Physician. This would be the physician that you see on a regular basis.

• What is a guarantor VS subscriber?

  • A guarantor is the adult financially responsible for a patient’s account after insurance payments have been made. The guarantor is usually the patient unless the patient is a minor or otherwise incapacitated adult.
  • A subscriber is the main person enrolled in the insurance plan often times through an employer and may also be referred to as the primary insured.

• Does ARC accept Medicare and Medicare Advantage plans?

  ARC accepts traditional Medicare and several Medicare Advantage Plans. We welcome new and established patients with these plans to ARC and encourage all patients to learn about their Medicare options.

  View your Medicare options at ARC.

• How can I get help choosing the right Medicare plan?

  • Call 512-400-2548 (TTY 711) to schedule an annual benefits review with a licensed insurance agent.
  • Visit our Medicare Insurance Help page.

• How do I update my insurance information?

  ARC offers you a few different ways to update your insurance information.

  • If you have an upcoming appointment, follow the link in your appointment reminder text to complete your registration.
  • Log in to your ARC MyChart account to request updates to existing coverage, remove existing coverage, or add new coverage. See step-by-step instructions.
  • Use our online contact form to update your health plan or personal information.
  • Call Central Registration at 512-407-8686.

• How can I get help choosing the right Healthcare Insurance Marketplace plan?

  Visit ProsperHealthCoverage.org or call 512-381-4520 for help finding affordable health insurance that meets your health care needs and budget. Prosper Health Coverage is a free service available to individuals and families in Texas regardless of income level.