Frequently Asked Questions
2023 Health Renewal
1. How will my premium be calculated this year?
This year’s premium calculations remain the same as in previous years. Your total premium will be inclusive of the Standard Premium Rate (SPR) and your Supplementary Premium, as follows:
Standard Premium Rate (SPR)
The SPR remains at $400.31 per month, per insured adult. This includes the Mutual Reinsurance Fund and Standard Health Benefit Premiums, an amount set and charged by the Government that Argus pays on your behalf.
The premiums for supplemental medical, dental, and vision care benefits are administered by Argus and are based on:
- Your plan’s claims experience over a three-year period.
- General medical inflation.
- Group demographics.
- Trends in service utilisation.
- Claims experience for our entire book of business.
- Your benefits plan.
2. What are the 2023 benefit enhancements to my health plan?
Every year we review benefits to ensure that they meet the unique healthcare needs of our members. This year’s new benefits are as follows:
Preventative and Diagnostic
- Allergy Testing – increased from $600 Lifetime to $900 every five years
Home and Office:
- Specialist Consultation at Island Health Services and Family Practice Group covers 100% of billed charges
- Physical Medicine and Supplementary Therapies: now inclusive of Complimentary & Alternative Therapies (e.g., massage, chiropractic, osteopathy, acupuncture, and naturopathy) - increased the maximum from $75 to $85 per per visit and a combine maximum of $3,600 per policy year
- Individual Visit – increased the maximum from $75 to $85
- Group Session – increased the maximum from $35 to $40
- Chiropody/Podiatry – increased the maximum from $75 to $85 per visit
- Neuropsychological Testing – one test every two policy years with a maximum benefit $5,000.
- Specialty Network – Non-Solid Organ Transplants: to provide world class care while reducing costs for Bone Marrow, Stem Cell and CAR-T therapies
- Increased our Accommodation Benefit on all plans for care in the Argus Preferred Provider & Specialty Networks
- Student Mental Health Hotline available to students studying overseas.
1Depending on your healthcare plan
3. Who should I contact if I require medical treatment overseas?
Argus, in partnership with One Team Health, Inc. (‘OTH’), provides seamless overseas healthcare management, while helping to reduce and control costs. The OTH staff of doctors, nurses, and case managers work together to provide access to appropriate and high-quality care, allowing you to focus on your health, not logistics. Please call 298-0429 to speak to an OTH representative.
4. What tools are available to help me better manage my healthcare?
Our Thrive. Case Management Programme is voluntary, confidential, and free of charge to members with complex health conditions. A Nurse Case Manager provides one-on-one support and guidance to help you navigate your health plan benefit and local healthcare resources to help you get the care you need. Thrive. Case Management can benefit members who:
- are being discharged from an inpatient stay or have received care overseas.
- have at least one of the care needs below:
- one or more chronic health conditions including, but not limited to, heart disease, diabetes, hypertension, inflammatory bowel disease, degenerative musculoskeletal disorders, renal disease, etc.
- undergone an organ/tissue transplant
- complex medication regimes (high cost or specialty drugs)
- durable medical equipment needs
- a high-risk pregnancy
Contact us at email@example.com to learn more and enroll.
Our Wellness Rewards Programme, powered by Tictrac, can be customised to help you build healthy habits. Tictrac measures your activity against a weekly target of 150 active minutes. Meet this goal and we'll reward you $5 each week – that's up to $260 a year! All rewards will be paid on a quarterly basis through our electronic funds transfer service.
To learn more, contact Shakira Warner, VP, Population Health Management, at firstname.lastname@example.org.
5. What are the benefits of using our online portal Argus Vantage?
With Argus Vantage, you can obtain a total view of your Argus Health account using a single username and password. Using your desktop, tablet or smartphone, Vantage provides easy access to the tools and resources needed to help you better manage your plan.
- Access benefits information 24/7
- Submit claims online
- View and print ID cards from home
- Access digital wellness tools and challenges with Get Up & Thrive.
6. How do I sign up to receive my Argus reimbursement payments via electronic funds transfer (EFT)?
EFT is a secure and efficient wat to receive your reimbursement payments. The process is quick and easy. Click here to sign up.
Note that all members are now required to sign up for EFT to receive their health claims reimbursements. If you have questions, please contact the Argus Customer Service Centre, by phone at 298-0888 or email at email@example.com.