FREQUENTLY ASKED QUESTIONS
What is CooperativePlus?
CooperativePlus was established in 2005 as Patient/Physician Cooperatives (PPC), an organization of patients, physicians and member representatives, with two clinics in Houston, Texas. Since then, the organization has grown to 125 clinics distributed throughout the Houston area and beyond, including clinics and employer groups in Oregon, Arizona, New Mexico, and Oklahoma.
In 2017, PPC established CooperativePlus as a business name for member services.
How is CooperativePlus different from insurance?
CooperativePlus is a healthcare system focusing on wellness and comprehensive healthcare services for individuals. It provides members easy access to affordable, medically necessary services at affordable rates.
Unlike most insurance companies, CooperativePlus has no exclusions for age (under 65), income, or pre-existing conditions.
By creating this comprehensive system, incorporating medical discount programs, and a variety of Association Group or Employer Sponsored insurance plans, CooperativePlus has simplified access to high-quality healthcare services for individuals.
What services does CooperativePlus offer?
CooperativePlus provides a variety of healthcare services for an affordable monthly fee. There are several plans from which to choose.
Benefits and services in the most popular plan include:
- Prescription Drug Discount: Accepted at more than 60,000 pharmacies, the plan’s drug discount card saves members up to 75% on prescription medicines.
- Lab Tests and Imaging: Through its partnership with Clinical Pathology Labs (CPL), Quest Diagnostics, and numerous imaging centers throughout the United States, the flat rate membership fee covers the cost 100%.
- Patient Advocacy: CooperativePlus gives members priceless peace of mind. A personal Patient Advocate is available to guide members through the healthcare system by mediating and negotiating medical bills and expenses on their behalf. They protect against excessive billing practices and support high quality medical outcomes.
- Teladoc: A national network of US board-certified physicians, Teladoc provides telephone and online consultations to treat non-emergency conditions and write certain short-term prescriptions when appropriate. The service is available 24 hours a day, 365 days a year.
- Dental care, vision, hearing, and durable medical equipment
- 24/7 roadside assistance
- Health club membership (in Greater Houston area)
- Optional benefits: With your membership, you have the option of purchasing indemnity or stop-loss insurance plans. These are community-rated, guaranteed issue coverage.
Why do we focus on primary care?
The focus of CooperativePlus is continuity of care, to maintain and achieve wellness, and to provide access to healthcare services members need.
We encourage our members to develop real relationships with their providers. This allows patients to seek healthcare before sickness or injuries become critical. The primary care provider offers services such as annual exams, general health and wellness, and diagnosis and treatment of acute and chronic medical conditions.
What is patient advocacy and why is it so important?
Patient Advocacy is one of the most important benefits of the CooperativePlus model. The CooperativePlus Patient Advocacy Team performs care coordination to ensure all of the entities that participate in the members’ healthcare programs work together. They protect against excessive billing practices and support high quality medical outcomes.
What types of providers do you have?
CooperativePlus provides members with access to a wide variety of services, from primary care to licensed specialists and wellness affiliates.
What if I don’t want to switch from my current provider?
It’s easy for a physician to join CooperativePlus. Call Member Services at 1-866-549-4199 and let your Advocate know who your doctor is, and we will invite him or her to accept CooperativePlus Plans that you have chosen. Usually, this is no problem because the CooperativePlus plans are better than the ones most physicians accept, both in terms of money and prompt payment.
What if I need a specialist?
CooperativePlus has many specialists for in-network referrals, and we’re constantly expanding. You can see any of the specialists for reasonable prices. If you need to see a specialist outside of our network, our patient advocates will work with members to bring the costs down to fair and reasonable rates such as those paid by Medicare.
What are my membership fees used for?
Monthly payments to primary care providers go directly to their practices each month as you make payments. The portion of membership fees that cover other benefits go to support additional medical care providers such as lab, diagnostic imaging, telemedicine, health club (Greater Houston area), patient advocacy, to maintain our provider network, and to reach out to the community about CooperativePlus.