Additional Information about Wellscape Direct MD, in accordance with the Massachusetts Department of Insurance (DOI)
The Wellscape Direct MD contract is not a health benefit plan as otherwise described by law as it only pertains to a limited set of services provided through Wellscape Direct MD’s health care practitioner(s).
The Wellscape Direct MD contract does not satisfy minimum essential coverage standards for health insurance under state law or under the federal Affordable Care Act and there may be tax consequences for Wellscape Direct MD patients who do not have qualified comprehensive health coverage in addition to the Wellscape Direct MD contract.
If the contract terminates for any reason, and the patient has not already purchased health care insurance coverage that will satisfy state and federal minimum coverage standards, the patient will not be able to purchase new individual health insurance until the next Massachusetts health insurance open enrollment period has begun.
Wellscape Direct MD and Wellscape Direct MD’s provider(s) are not affiliated with any health insurance plan, and none of the medical services being provided under Wellscape Direct MD will be covered by the patient’s health insurance.
Wellscape Direct MD only covers those services specifically identified in the Wellscape Direct MD contract when delivered or arranged by Wellscape Direct MD’s health care practitioner(s) according to the terms of the contract. Wellscape Direct MD’s provider(s) may refer a patient to a non-Wellscape Direct MD provider for medical services, prescription drugs or supplies, but in that circumstance a patient will need to contact his or her health insurance provider and follow the health plan’s managed care procedures in order to obtain coverage for the referred services, prescription drugs or supplies under the health plan’s benefits.
Certain services identified in the Wellscape Direct MD contract may already be covered under a patient’s health plan at no additional cost when provided by non-Wellscape Direct MD providers. The patient will need to contact his or her health plan to understand the benefits and limitations of the patient’s health insurance plan and any overlap between the services offered under the Wellscape Direct MD direct contract and the coverage under the patient’s health insurance plan.