Claims FAQs: Health
- Do I need to notify American Family Insurance for an inpatient admission?
- Prior notification of an inpatient hospital admission is not required, but we ask that you or your provider notify us:
- Within two business days after an emergency admission
- Prior to any planned admission
- Where do I purchase prescribed durable medical equipment (DME)?
- You may purchase DME from the provider of your choice, but you may want to make sure that the provider is in-network to help minimize out of pocket cost. We do offer assistance in purchasing physician prescribed DME to insure a reasonable cost through reputable providers that deliver right to your home. Call 1-800-MYAMFAM (1-800-692-6326) ext 78016 for more information.
- Who can I contact with questions regarding my health insurance coverage and where can I find out what calendar or policy year benefits are available?
- Contact your American Family Insurance agent for information regarding your policy benefits and available coverage. You may also contact our office at 1-800-MYAMFAM (1-800-692-6326) ext. 78016.
- Where do I find an in-network provider?
- Visit the Network Providers page to locate an in-network provider in your area. By utilizing an in-network provider, your out of pocket cost may be waived or lowered from 20% - 10% depending on your policy. Not all services within an in-network facility are provided by an in-network provider. Be sure to question if all the care you are receiving is provided by in-network providers.
- How do I obtain a discount on my prescription drugs?
- A prescription discount program through Medco is provided under many of our health contracts. Medco sends you a prescription drug program packet including a discount card. By utilizing this card at a participating pharmacy, a savings may be obtained even if your policy does not provide a prescription drug benefit or your benefit has been exhausted.
Medco provides a Website to determine your actual savings and to locate a participating pharmacy nearest you. If you do not have a participating pharmacy in your area, you have the option of purchasing your prescriptions by mail through Medco. Visit www.medcohealth.com or call 1-800-473-3455.
The savings depends on the type of medications you and your family are taking and the price your pharmacy is currently charging. In some instances, your pharmacy may be able to offer a better price than what you can receive with the discount card. Work with your pharmacy regarding the option that would be most beneficial to you and any family member insured under your health insurance plan. - How do I file a grievance or an appeal?
- You may file a grievance or appeal by submitting a written request to American Family Mutual Insurance Company, Attn: Health Lines Management Review – Grievance, 6000 American Pkwy, Madison, WI 53783-0001. Please refer to the procedures in your American Family Insurance Policy or call 1-800-MYAMFAM (1-800-692-6326) ext. 78016 for a copy of the procedures.
Have a question that you couldn't find here? Contact your American Family Insurance agent with your additional questions.
For claims related to storms, see Storm Info.
This website is for informational purposes only; it is not part of the insurance contract.