Get to the Right Care
Tools to Estimate Your Care Costs and Locate Network Providers
Horizon and UHC offer a variety of resources to help you make health care choices, including cost comparison tools (to help you compare costs for different procedures with different providers), provider directories (to help you find in-network providers) and treatment facility locators (where you can receive care from expert health care professionals). To access these tools, go to your medical plan administrator’s website:
Horizon
Horizon: For medical and mental health/substance use services
horizonblue.com/Pfizer/ (To access the Treatment Cost Estimator, or click on Find a Doctor)
UHC
UHC: For medical services
whyuhc.com/pfizer (Select Benefits and Find a Doctor or Facility to access cost estimates. The UHC tool is available to both members and non-members; members may log in to access more specific cost estimates such as how your deductible is impacted.)
Optum: For mental health/substance use services (for UHC members only)
liveandworkwell.com (Log in or use access code 61550 to enter the site anonymously.)
Remember, if you are having a high-cost procedure or treatment, ask your provider to request a pre-determination of benefits to ensure it is covered and meets your plan administrator’s medical necessity requirements.
Where You Go Matters
Chosen for their expertise, high-quality care, and experience diagnosing and treating various health issues, a Blue Distinction Center (BDC) (as referred to by Horizon) or a Center of Excellence (COE) (as referred to by UHC) increases the likelihood that the most appropriate and effective treatment will be given. If you are considering a specialized procedure or you have a complex health issue, a BDC/COE may be the best place to receive treatment.
Health Insurance Claims Support
You can receive assistance escalating a concern you have with your Pfizer health care coverage. Participant Advocacy Services can guide you through issues you experience with your Pfizer health coverage, prior authorizations, claims submissions and appealing denied claims.
Call 1-866-476-8723 and follow the Colleague Services prompts for Benefits at Fidelity to reach the Pfizer Benefits Center. Once connected, request a Participant Advocate to get connected with a Fidelity benefits representative. Ask the representative to open a case with the Participant Advocacy Team. You will be asked to provide a brief overview of your concern and a Participant Advocate case manager will call you back within three business days.
No Cost Expert Medical Opinion Services
Get help navigating a serious or complex health issue such as cancer, a major surgery, or a complex behavioral health or substance use issue. Expert Medical Opinion Service through Health Navigator, powered by PinnacleCare will coordinate with you to confirm your diagnosis and treatment plan to get you to the best provider and most effective treatment quickly. It is not intended for medical emergencies.
Here’s how the service works.
- Connect — Reach out by phone, or web
- Review and Coordinate — Health Navigator, powered by PinnacleCare will collect, organize, and review your medical records, and identify medical experts to confirm your diagnosis and next steps.
- Communicate — Your Health Navigator, powered by PinnacleCare Health Advisor will help you understand your diagnosis, choice of providers, and/or treatment options.
- Schedule and Follow Up — Your Health Advisor will also facilitate appointments and medical record transfers and will follow up with you throughout the process to answer questions and make sure you’re on the right path.
This service is available if you are enrolled in Pfizer medical coverage. You can access services for yourself, your covered dependents, your parents, your parents-in-law (or parents of your domestic partner), and your adult children over age 26 who are not enrolled in Pfizer medical coverage. Visit Support for Caregivers and Parents for additional resources to help you care for your loved ones.
sunlife.com/pfizer
1-877-280-7466
Podcasts
A Conversation with Health Navigator, powered by PinnacleCare
Check out this podcast to learn more about Health Navigator, powered by PinnacleCare.
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