The Patriot V QPOS Plan offered by the Fund provides you with in-network (referred) services coordinated by your participating Primary Care Physician (PCP). The Plan offers participants the options of going directly to out-of-network (self-referred) providers or facilities without a referral.
When you self-refer, you will be subject to the applicable self-referred deductible and coinsurance benefits levels and maximums.
The Patriot V Plan covers routine Wellness and Preventive Care provided by your PCP.
You may also obtain pediatric dental services and gynecological exams from participating providers without a referral from your PCP. If you choose to access care without a referral, you must obtain authorization prior to receiving self-referred care for certain services. Failure to precertify may result in a reduction of benefits