FAQ

Frequently Asked Questions

Wooden scrabble tiles spelling out FAQ. All of our frequently asked questions answered on this page.
Welcome to Nova Healthcare FAQ. If you do not find the question you are looking for, please contact one of our representatives at 1-(888) 266-4462

Do Nova Plans Qualify for a Health Savings Account (HSA)?

Yes,an HSA provides additional tax benefits. Not only does our High Deductible Health Plan qualify, but we encourage our members to enroll in an HSA. More information on HSA and the benefits here.

Does NOVA Pathfinder Limited Company Plan Cover Pre-Existing Conditions?

Whether it’s the Individual, Family or Group Plans, pre-existing conditions are covered.

Do Nova Plans Cover the Health and Wellness Treatments and Services that I use?

Most likely. We cover most conventional, complementary and alternative care including naturopathic, homeopathic, chiropractic, acupuncture, indigenous, Ayurveda, as well as holistic dental care. List of services can be found here.

Does the Nova Plan Cover Preventative Care? Allergies? Physical Therapy? Durable Medical Equipment? Pregnancy?

Yes, all of these are included in our plan, but please refer to your benefits coverage for our coverage limits and pre-authorizations.

Does the Nova HealthCare Plan Include Prescribed Medications?

Yes,prescribed medications count toward your deductible. Please refer to your benefits coverage for our coverage limits and how to use your prescription benefits.

Does the Nova HealthCare Plan Cover Dental

Yes,as a part of our wellness care, we have added coverage for conventional and holistic dental care with a maximum annual allowance of $1,000 toward your deductible, per individual.

Are Nutritional Supplements Covered on the NOVA Pathfinder HealthCare Plan, and if so, how?

Nutritional Supplements are covered in your NOVA HealthCare Plan as part of the Wellness Treatments & Services option. To claim this benefit, please refer to your benefits coverage for our coverage limits and check the Reimbursement Policy. Taking a high quality, broad spectrum multi-vitamin (preferably made from raw foods you recognize) as well as more specific supplements may be beneficial to your health. Speak with a healthcare specialist to find what is right for you. You will be covered for the use of Nutritional Supplements that are “prescribed/recommended” by a healthcare professional and are high quality, medicinal grade (pharmaceutical manufacturing standards), and medically necessary. As with prescription drugs, NOVA Pathfinder HealthCare may require you to purchase an equally effective supplement that is available at a lower price. NOVA HealthCare may have listings of suitable, high quality nutritional supplements (pharmaceutical manufacturing standards) as well as online vendors who can help you save even more money. In short, our goal is to provide a maintenance program for your health while respecting what is recommended by a healthcare professional in response to your specific health needs.

What Exclusions Are There in Meeting My Deductible Costs?

Exclusions include medically unnecessary and non-covered or ineligible expenses, which can be found in the Quick Facts on NOVA Pathfinder Limited HealthCare Company Plan Coverage Document.

Do Monthly Plan Payments Count Toward My Deductible Costs

Similar to a traditional health insurance plan, monthly payments are the costs associated with your membership or policy and do not count toward your NOVA Pathfinder HealthCare deductible costs.

If Monthly Membership Costs Change, How Far in Advance Will I Be Notified

Members will receive a minimum 90-day notice of any changes to the fee schedule.

Is Policy Renewal Guaranteed? What Event Would Cause NOVA Pathfinder HealthCare to Terminate My Coverage?

A Member will stop receiving coverage if they do not pay their monthly membership fees, do not adhere to the NOVA Pathfinder HealthCare Limited Company Membership Agreement, improperly disclose appropriate medical information, or commit insurance fraud. Members should give NOVA Pathfinder HealthCare a 30-day written notice if they want to cancel their plan.

What Process Should I Go Through During A Medical Emergency?

In a medical emergency, proceed immediately to the nearest medical facility and provide them with your NOVA HealthCare Membership ID. All emergency claims are to be submitted to NOVA Pathfinder Limited HealthCare Company. Medically necessary emergencies/admissions are covered. Please submit a Pre-Authorization for any Optional Procedures to avoid balance billing. Most hospitals and doctors across the U.S. will accept our plans

How Am I Reimbursed When Something Happens?

How NOVA Pathfinder’s High Deductible Health Plan works with receipts from supplements and wellness visits: If you are an active person who uses wellness services and takes supplements to stay healthy, don’t forget to keep your receipts for these services and items. You can send the expenses to NOVA Pathfinder’s Claim Department and they can be applied to your annual deductible.   Before your deductible has been met, money spent on services such as massages and acupuncture and items like essential oils will count toward your deductible. Once your deductible has been met, you will be reimbursed for future wellness visits and supplements up to the maximum benefit allowance. It is important to note that not all supplements and essential oils are equal, nor will all of them be accepted. Check with your Personal Care Advocate to make sure the supplements and oils you wish to buy are approved prior to purchase. Remember that health and wellness service receipts, including visits as well as the purchase of supplements, essential oils, etc. must be submitted within 30 days of service or purchase, and it is the member’s responsibility to validate that NOVA’s Claim Department has received those expense receipts. We will confirm via fax or email upon request. Member must request a confirmation via email by contacting claims@mynovahealthcare.org

If I Need Treatment, Do I Need to Be Pre-Approved? What Happens If I Don’t Get Pre-Approval or If It’s an Emergency Situation?

In an emergency, call 911 or go to the nearest Emergency Room to be treated. For most general treatments, you should contact 24/7 Teladoc first. Teledoc may refer you to a practitioner as appropriate. Pre-authorizations should be filled out for all optional inpatient and outpatient surgical and diagnostic procedures. For any health screenings not included in your plan—other than wellness care as outlined in the Quick Facts on NOVA Healthcare Coverage Plans Document—a pre-authorization is required, except in the case of an emergency. If there are any questions or concerns, feel free to contact the NOVA HealthCare Claims Department by email at: claims@mynovahealthcare.org, or call 1888-266-4462 ext. 1013

Is My Personal Information Safe?

Yes, NOVA Pathfinder Limited Company subscribes to the safe practice of encryption and protection of your personal and medical information beginning with the submittal of your application on our secure website to storing information on our secure servers. We meet all HIPAA rules and regulations.

How Does A Medical Practitioner Join NOVA Pathfinder Limited Company In-Network Provider’s Network?

Because NOVA Pathfinder Limited Company is committed to providing the highest quality of healthcare coverage, all practitioners seeking to become part of the network should email providers@mynovahealthcare.org.

Can Non-Traditional Families Be Covered?

Yes, we recognize blended and “non-traditional” families and cover them in the same way as so-called “traditional” family units.

If An Employee Leaves The Company Or Loses Their Job Can They Remain On The Plan?

Yes, employees can remain on the plan if they leave or lose their job. Staying on as an Individual/Family plan, they can continue to make their own payments and also keep and transfer their HSA.

What Types Of Plans Are Available?

NOVA Pathfinder Limited Company offers Individual, Individual +1 (two-party), Family (3 or more individuals of the same household*) and Group Plans. Our Plans may qualify for an optional Health Savings Account for these categories. Our Group Plans may qualify for an optional Health Savings Account for small employer group/business owners with 50 or fewer employees. *Dependent children are eligible to be part of a Family Plan until age 26 and may continue coverage under our optional Economic Unit model with the same coverage and cost, if living in the same household. Family coverage includes up to four Individuals. The Family rate increases by $280.00 per additional member per month thereafter. Contact us to find out more

Am I Covered When I Travel?

You are covered anywhere in the United States. Because allowed medical costs are based on approved U.S. government standards, we can manage and negotiate expenses in the U.S. NOVA HealthCare’s plan does not cover individuals outside of the States; we highly recommend anyone traveling outside the country to consider Travel Insurance.

Can I Enroll Anytime, Or Only During Open Enrollment?

You can enroll any day of the year. There are no restrictions as to when you can begin receiving coverage from NOVA Pathfinder HealthCare Limited Company.

Can I Start Coverage Anytime In The Month?

You may choose to start your coverage on the 1st or 15th of any month.

Can I Cover My Adult Children on my Plan?

Yes, individuals living in the same household (receiving mail at that address) that contribute to the payment of bills (the economy of the house) can be covered as an Economic Family Unit regardless of their sex, age or relation.

Are Copays, Coinsurance and Deductibles Part of the Plan Coverage?

NOVA’s plan is a high deductible healthcare plan HDHP. Deductibles are $5,000 for an individual and $10,000 for a two-party, or family. When an individual reaches $5,000 ($10,000 family) out of pocket, then they have met their deductible. Please refer to NOVA HealthCare’s plan coverage limits. NOVA Pathfinder HealthCare pays 100 percent of our usual and customary allowed amounts after the member’s deductible has been met.

Will Hospitals/Doctors Accept This Plan? Do I Have Emergency?

Medically necessary emergencies/admissions are covered. Hospitals and doctors will accept our plan all over the country. Present your NOVA Membership ID card when you check in. NOVA HealthCare requires that the providers bill them directly. Bills may be sent to claims@mynovahealthcare.org or faxed to 833-444-Nova (6682).