Minimum Essential Coverage (MEC)
A Minimum Essential Coverage (MEC) plan is an employer funded benefit plan that covers in-network preventative services only, as outlined by the Affordable Care Act. These services are determined by the U.S. Preventive Services Task Force.
How Do I Use My Benefits?
After becoming covered under your MEC plan, but before receiving healthcare services, you will need to find a provider who is in network. ASi works with 2 different networks, depending on where you reside. To find an in-network provider, please visit your network’s website as determined by your residence location.
What’s the Difference Between an In-Network and Out-Of-Network Provider?
By choosing to see an in-network provider, that provider agrees to accept the payment ASi issues as payment in full for eligible services per their provider contract with that network.
By choosing to see an out-of-network provider, that provider does not have to accept the payment ASi issues as payment in full for eligible services. The provider may then bill you for the difference that ASi did not cover.
On your first visit to your provider for preventative services make sure to show them your ASi benefits card. This card gives the provider’s billing department all the information they need to handle your claim. After your visit, your provider will bill ASi directly. ASi will process your claim and issue an explanation of benefits (EOB) by mail to you and your provider.
What Does My MEC Plan Cover?
Preventive services include health care screenings, annual check-ups, and other specific services that are indicated to prevent illnesses, disease, and other health problems. All services must be ordered by your licensed physician or health care professional.
For a complete list of eligible services, please view our Eligible MEC Fact Sheet.
What Type of Documentation Do I Need to Submit?
If your provider accepts your ASi benefits card, you should not have to submit any type of documentation. Your provider should bill ASi directly.
If you must pay for expenses upfront or out-of-pocket, please submit an itemized statement to ASi for review.
To ensure proper claim processing and payment, proof of services provided must be submitted. If ASi requires more information, one of our account representatives will reach out to you for additional information. Your documentation must provide the following information:
- Patient Name and Date of Birth
- Provider Name and Address
- Date of Service
- Type of service/item
- Cost of service or your patient responsibility of the service/item
You can submit documentation to ASi by mail, email, or fax:
Mail: P.O. Box 5809, Fresno, CA 93755
RE: MEC Claims
Our account representatives will contact you if further information is needed.