What is the Gulf Coast Discount Medical Plan (GCDMP)?

The GCDMP is a network of health care providers that will discount their normal charges when GCDMP members pay at the time of service.

Are these discounts real?

Yes.  In most cases GCDMP members will be asked to pay no more than the amounts paid by Medicare and major insurance companies.  In some cases GCDMP members pay less.  For example, our X-ray, MRI and CT providers expect to be paid only 80% of the applicable Medicare fee.

Is there a way to know in advance how much I will be expected to pay?

Yes.  First check the Provider directory on this website. Payment arrangements offered by each participating provider are listed in the column labeled You Pay.

• If the provider charges a flat rate that is the amount you will pay if you pay at the time of service.

• If the provider expects you to pay 60% of charges for example, call the provider’s office and request an estimate of the usual charges for the service you need. Then multiply the provider's estimate by 60%. For example, if you are interested in a new patient visit and the doctor's typical charge is $100, you will likely pay $100 X 60% = $60.

• If the provider expects to be paid 100% of the applicable Medicare allowance call the provider’s office and request the Medicare allowances for the services you need. As an alternative you may request the CPT codes for the services you need. Then find the applicable Medicare allowances on the internet. Instructions and a link are provided below.
  
  However, if you only need to visit a doctor and don’t need lab tests, injections, sutures or other services from the doctor, the following information may suffice. To begin, there are 5 office visit levels ranging from a brief Level 1 visit to a complex Level 5 visit. Level 3 visits are most common. 2009 Medicare office visit allowances for each level follow.
  
  

  Patient Type	Level 1	Level 2	Level 3	Level 4	Level 5
  New	$   36.38	$   62.96	$   91.86	$ 141.55	$ 178.83
  Established	$   18.27	$   36.72	$   60.45	$   91.24	$ 123.84

  
  
  
  
  Here is an example using the above information. Assume you are a patient of a doctor listed on the Providers page. The You Pay column on the Providers page indicates the doctor expects plan members to pay Medicare’s allowance. You visit this doctor periodically for a blood pressure check. Therefore you are an established patient. This doctor routinely bills a Level 2 visit and charges you $50. You pay only $36.72 because you are a member of the Gulf Coast Discount Medical Plan.

          http://medicare.fcso.com/Fee_lookup/162375.asp


When I schedule my appointment can I request a less expensive Level 1 visit?

No, but you can have an impact on the visit level that is assigned. The two primary factors in visit level assignment are: 1) the amount of time your physician, physician assistant or nurse practitioner spends with you and; 2) the complexity of the problem(s) that you present during your visit. You can save valuable time and help your health care provider diagnose and treat you more quickly and efficiently by preparing in advance for your visit. To learn how please click either of the links below.

http://health.yahoo.com/healthcare-doctorvisit/making-the-most-of-your-appointment/healthwise--hw226888.html

http://women.webmd.com/tc/making-the-most-of-your-appointment-overview


What are CPT codes?

CPT is short for current procedure terminology.  CPT codes are used to describe medical, surgical, and diagnostic services in a uniform manner.

Where do members go for lab tests?

GCDMP members need not go to an independent lab for tests.  Instead, ask your doctor to draw your blood, bill you for the test and apply the applicable GCDMP discount.

Do you have a hospital in your network?

• Gulf Coast Discount Medical Plan members are entitled to discounts when participating health care provider’s bills are paid at the time of service.
• Gulf Coast Discount Medical Plan is not a health insurance plan and will not make any payment on a member’s behalf.