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Polk HealthCare Plan


The Polk HealthCare Plan offers Polk residents without insurance access to healthcare. The plan is not insurance and members do not pay annual deductibles, monthly fees, enrollment fees or submit claim forms. Members only pay small co-pays for doctor visits or filled prescriptions. If you’re searching the internet for cheap healthcare this is a great place to start.

The Polk HealthCare Plan partners with licensed medical providers in the community to connect Polk residents with the care they need.

Covered Benefits Overview

Primary Care

A primary care provider (PCP) is a healthcare professional who practices general medicine. A PCP can be a doctor, an advance practice registered nurse or a physician assistant. Prior to enrollment completion, members choose or are assigned a primary care provider based on their preferences and needs.

Your primary care provider’s office will be the place where you receive most of your medical care. Your PCP will be your go-to provider for:

  • Annual physical exams and preventive screenings
  • Sick visits or checkups as needed
  • Prescriptions
  • Immunizations (shots)
  • Referral to a specialist

Specialty Care

If you have a specific health issue, condition, injury or disease you may need to see a specialist. If necessary, your primary care provider will refer you to one for care.

You must receive specialty care from a provider contracted with the Polk HealthCare Plan. If you receive care from a specialty care physician without a referral or authorization and/or who is out of the PHP provider network, you will be responsible for all costs associated with that care.

Specialty Care visits are limited. Please verify with customer services or refer to the copay chart for limits.

Behavioral Health Care

If you have a mental health concern or substance use issue, behavioral health care providers can assist you. You do not need a referral from your PCP to see a mental health or substance abuse provider. The benefit covers a variety of services, evaluations, assessments, therapies (individual, family, group, etc.), counseling, psychiatric support and medication management.

Urgent Care

If you are experiencing a non-life-threatening emergency, e.g., broken bone, hives, etc., or you cannot get an appointment with your PCP and need to see a medical professional, you should go to a participating urgent care center.

Emergency Care

The Polk HealthCare Plan defines emergency care as treatment for potential life-threatening or limb-threatening complications, which means that you believe that you could die or lose a limb, e.g., arm, hand, leg, etc. and that the treatment you need cannot be given in your PCP’s office or an urgent care setting.

Privacy Policy, Uses and Disclosures and Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of a list of your medical services

  • We do not produce medical records and/or collect diagnoses. You can ask to see or get an electronic or paper copy of a list of your medical services that were funded by the indigent health care sales surtax. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your list of medical services

  • You can ask us to correct the list of medical services that you think is incorrect or incomplete.
  • We may deny your request, but we will tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way such as home or office phone, or to send mail to a different address.
  • We will say yes to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment or our operations.
  • We are not required to agree to your request, and we may say no if it would affect your care, or a law requires us to share that information.

Get a list of those with whom we have shared information

  • You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, healthcare operations and certain other disclosures such as any you asked us to make. We will provide one accounting a year free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will verify the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can file a complaint if you feel we have violated your rights by contacting us using the information in our handbook.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends or others involved in your care
  • Share information in a disaster relief situation

If you are not able to tell us your preference, i.e., if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information

Our Uses and Disclosures

How do we typically use or share your health information?

  • Treat you
    • Your health information may be accessed within the shared data information system by other professionals using the system who are treating you.

Example: A doctor treating you for an injury accesses the shared data information system to learn more about health services you received by other contracted providers who use the system.

  • Run our organization
    • We can use and share your health information to run our practice, improve your care and contact you when necessary.

Example: Contracted providers using the shared data information system may use health information about you to manage your treatment and services.

  • Reimburse for your services
    • We can use and share your health information to reimburse contracted providers for services rendered to you by the provider.

Example: We use health information your providers send us so we may properly reimburse the providers for their services.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health. We have to meet many conditions in the law before we can share your information for these purposes. For more information go to

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease  by helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner or funeral director when an individual dies.

Address workers’ compensation, law enforcement and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security and presidential protective services