Patient Resources

Please call your pharmacy first to request a refill of your medication. It is important that you do not let your medication run out before contacting the pharmacy. Due to the high volume of refill requests, please allow AT LEAST 3 business days from the day of request for the clinical staff to refill your medications if a provider approval is required.

Refill requests can also be submitted through your Patient Portal.

Well Visit: Focused on your overall wellness

A physical visit is an annual preventative appointment with the goal to prevent illnesses and identify health concerns early before any symptoms arise. Physical exams are also known as, well child check or exam, wellness exam, Medicare wellness exam, or Medicare wellness exam. During your visit, we will review your overall well-being and depending on your age, the services may include:

• Complete physical exam
• Immunization review and update
• Age related heart screenings (blood pressure check, blood glucose, cholesterol lab)
• Cancer risk screenings (pelvic exams, pap smear, colorectal screenings)
• Sexually transmitted disease testing
• Alcohol, depression, nutrition, and tobacco counseling
• Prescription refills

Please be advised that non-related preventative concerns discussed during the physical visit, could possibly result in additional costs.

Sick Visit: Getting you well

An office visit aims to discuss new or existing health problems, concerns, worries, or current symptoms. Your medical provider may order laboratory tests, prescribe medication, refer you to a specialist, and give you advice and education.

We look forward to caring for all your needs.

HMO

A Health Maintenance Organization (HMO) plan is one of the cheapest types of health insurance. It has low premiums and deductibles, and fixed copays for doctor visits. HMOs require you to choose doctors within their network. When you sign up for the plan, you’ll select a primary care physician (PCP), whom you’ll see for regular checkups. Your PCP will need to give you a referral before you can see a specialist, like a dermatologist (skin doctor). Because all your health services are funneled through your PCP, it’s important to find one you trust. HMOs are a good choice if you’re on a tight budget and don’t have many medical issues.

POS

As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. But for slightly higher premiums than an HMO, this plan covers out-of-network doctors, though you’ll pay more than for in-network doctors. This is an important difference if you are managing a condition and one or more of your doctors are not in network.

PPO

A Preferred Provider Organization (PPO) has pricier premiums than an HMO or POS. But this plan allows you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network doctors are low. If you know you’ll need more health care in the coming year and you can afford higher premiums, a PPO is a good choice.

Deductible

A deductible is a set amount you pay each year for your healthcare before your plan starts to share the costs of covered services. For example, if you have a $3,000 deductible, you have to pay $3,000 before your insurance kicks in fully.

If you have any dependents on your policy, you'll have an individual deductible and a different amount for the family.

Co-Pay

Copays are set amounts you pay to your medical provider when you receive services. Copays vary depending on the type of care you receive. Different copays usually apply to office visits, specialist visits, urgent care, emergency room visits, and prescriptions.

Your copay applies even if you haven't met your deductible yet. For example, if you have a $50 specialist copay, that's what you'll pay to see a specialist—whether or not you've met your deductible.

Most plans cover preventive services at 100%, meaning, you won't owe anything

Co-Insurance

Coinsurance is the percentage of covered medical expenses you pay after you've met your deductible. Your health insurance plan pays the rest. For example, if you have an "80/20" plan, it means your plan covers 80% and you pay 20%—up until you reach your maximum out-of-pocket limit.

Still, coinsurance only applies to covered services. If you have expenses for services that the plan doesn't cover, you'll be responsible for the entire bill. If you're not sure what your plan covers, review your benefits booklet or call your plan provider.

Out of Pocket Maximum

Once you reach your out-of-pocket maximum, your health insurance plan covers 100% of all covered services for the rest of the year. Any money you spend on deductibles, copays, and coinsurance counts toward your out-of-pocket maximum. However, premiums don't count, and neither does anything you spend on services that your plan doesn't cover.

Like deductibles, you might have two out-of-pocket limits—an individual one and a family one.

In-Network vs. Out-of-Network

Some plans have two sets of deductibles, copays, coinsurance, and out-of-pocket maximums: one for in-network providers and one for out-of-network providers.

In-network providers are doctors or medical facilities that your plan has negotiated special rates with. Out-of-network providers are everything else—and they are generally much more expensive.

Keep in mind that in-network doesn't necessarily mean close to where you live. You could have a Louisiana plan and see an in-network provider at our Clinics in Houston.

Whenever possible, be sure you're using in-network providers for all of your healthcare needs. If you have certain doctors and facilities that you'd like to use, be sure they're part of your plan's network. If not, it might make financial sense to switch plans during the next open enrollment period.

We welcome Medicaid patients to make us their health home and we accept most Medicaid and Medicaid HMO plans along with both CHIP and CHIP Perinatal.

An Eligibility Specialist can help you sign up for Medicaid at our locations. Simply visit or call SBCHC to set up a time for you to meet with our Eligibility Specialist. At that meeting, you will need to provide our specialist:

• Valid photo ID
• Proof of income
• Birth Certificate
• Social Security Number
• If you are pregnant, bring proof of pregnancy (if you believe you may be pregnant, you can schedule a pregnancy test at any of our locations). Form H3037 is considered a valid proof of pregnancy.

You will need to complete an application for discounted services and provide the following documents.

• Completed application that includes the names of all household members
• Proof of Identity
• Proof of Residency
• Proof of Household Composition
• Any Healthcare Coverage
• Valid Phone Number
• Proof of Household Income

We provide a Sliding Fee Discount to patients needing assistance with the cost of their visit. Eligibility is based on family income and household size. To receive these discounts, an application must be submitted. There are three ways to fill out the application.

• An application can be sent to your phone once an appointment is scheduled (this is the fastest way to complete it)
• An application can be download here.
• Applications can be picked up at any of our locations

Discounts help cover the costs of the visit with the provider but do not cover the cost of labs, vaccines and additional procedures that may be needed. Patients may apply at any clinic location or by working with one of our Eligibility Specialists. Call to schedule an appointment.

We do our best to accommodate patients on the schedule. If you are running late to your appointment please call us as soon as you can.

1. We will try to work you into a different available open slot.
2. If there are no open slots at the time, you can wait until one becomes available. We cannot guarantee that a slot will become available.
3. If there are no slots available and you choose not to wait, we can reschedule you for another date.