Polk HealthCare Plan

Indigent Health Care (IHC) manages and administers the Polk HealthCare Plan (PHP) for those who are caught in the gap between not qualifying for Medicaid, and not being able to afford market place insurance.

While the PHP is not insurance, it is a way for qualifying individuals to get healthcare. IHC manages a provider network for the healthcare plan that includes primary care and specialty care physicians, urgent care centers and five area hospitals. Sponsored services include primary and specialty careservices, routine diagnostic testing, lab, radiology, hospital inpatient, outpatient and emergency services, and a Plan formulary.

Because the PHP is not insurance, participants have no annual deductibles and no claim forms. Most services require a low co-payment, which is collected by the provider.

What is the Polk HealthCare Plan?

Primary Care Physicians Directory

Primary Care Directory

Specialty Care Physicians Directory

Specialty Care Directory
NOTE: All specialty services require an authorized referral from the member's primary care provider.

Formulary Drug List

2018 CitizensRx Formulary.docx

Membership Eligibility - show / hide

Disclaimer: Only Polk County residents who are not covered by any other health insurance and are not eligible for any other state or federal programs are eligible for the Polk HealthCare Plan. PHP requires that residents must apply for and fully utilize all other healthcare options for which they may be eligible, including Medicaid and Medicare, prior to the Polk HealthCare Plan providing coverage. The Polk HealthCare Plan is considered the payor of last resort whenever payment is requested.

The Member Services team of Indigent Healthcare assists potential members with Polk HealthCare Plan eligibility (membership eligibility factors). If an individual does not qualify for the healthcare plan, the team assists in finding suitable resources and assists them with applications for other programs.

Individuals, who meet the eligibility requirements, join the Polk HealthCare Plan as members. The Member Services team is available to help members understand and use the Polk HealthCare Plan (PHP) to meet their healthcare needs. The team provides information about the benefits, coverage and the rights and responsibilities of healthcare plan members.

You may request a member handbook or submit questions via email at phpeligibility@polk-county.net.

Member Reminder: If you have any major changes in your life, like a new address, a change in family size, income or a change in job you must notify Member Services

  • Eligibility Factors for the Program - more info
  • Premiums, Deductibles, and Copayments - more info
  • Polk HealthCare Plan Enrollment Card - more info
  • Medical Management - more info
Provider Information - show / hide

Medical services are made available to members through the Polk HealthCare Plan. This countywide program is made possible through public/private partnerships with hospitals, physicians, diagnostic testing facilities and other medical professionals (providers).

Once providers are approved and enrolled in the network, PHP's Provider Services Section will provide introductory training to the providers and their office personnel.

During this training, providers are given a manual, which is reviewed in detail at an on-site orientation. This training familiarizes new providers with the Polk HealthCare Plan policies and procedures.

Each participating provider will have access to a provider services representative who is responsible for ongoing education. As a follow-up to the initial orientation session, the representative will contact each provider and their employees on a periodic basis to ensure that they fully understand the responsibilities outlined in their contract and provider manual.

If you are interested in learning more or becoming a Polk Health Care Plan provider, call (863) 533-1111.

Claims

Providers are responsible for submitting claims to the plan within 180 days from the date of service. The claims section of Indigent HealthCare will not process any claims that are more than 12 months after the date of service..

  • Claims are processed within 45 days from the date received in our office; for claims inquires, allow an additional 15 days
  • All claims inquiries should call 1-888-850-8222
  • Claims and claims appeals should be submitted to Meritain Health Appeals Department, PO Box 41980, Plymouth, MN 55441-0970
  • For emergency room visits, there is a payment cap of $1,500 per county fiscal year
  • Inpatient hospital stays are limited to six days per stay and 30 days per county fiscal year

If you have questions, feel free to ask. It is vital to have a strong working relationship with our providers and their employees. For more information on members' needs, contract requirements, protocols, contract standards and federal or state regulations, please contact us.


Contact:

For information or to schedule an appointment:
(863) 533-1111   OR     Email PHP Eligibility

Polk County Seal

The Polk County Board of County Commissioners is an equal opportunity and affirmative action employer.

Polk County Board of County Commissioners