Page ContentFrequently Asked Questions Member Information How long may my children be enrolled in the plan? Generally, your dependent children are eligible to be on the plan until their 26th birthday. I have a college student attending school outside of Houston. Will my child be covered under KelseyCare powered by Cigna? Yes, college students can be covered under the plan. College students only have emergency room coverage out of area. They must see Kelsey-Seybold doctors for all nonemergency and routine care. What if I'm not currently using a Kelsey-Seybold physician and am undergoing radiation oncology treatment or am pregnant? You may be eligible to continue to receive medical coverage through Transition of Care or Continuity of Care with either your current non-Kelsey-Seybold provider or with a KelseyCare Affiliate Specialist. You will need to complete a Transition of Care Form within 60 days of the date of our effective plan coverage. Download the Transition of Care Form What is Continuity of Care? Patients currently undergoing active treatment for a particular medical condition (for example, in their 24th week of pregnancy, undergoing chemotherapy, or in the immediate post-operative period) may be approved for Continuity of Care coverage. This means the patient will receive his or her ongoing care for a particular medical condition at the in-network level of coverage. With your current provider, you will need to complete a Transition of Care Form within 60 days of the date of our effective plan coverage. Download the "Transition of Care" form. What is MyKelseyOnline? When you enroll in MyKelseyOnline.com, you can email your doctor’s office and get replies to your healthcare questions. You’ll directly schedule appointments with your primary care physician and an ever-expanding list of specialty-care physicians and providers, including endocrinologists, rheumatologists, obstetricians and gynecologists, dietitians, and diabetes educators. What is the KelseyCare powered by Cigna service area? Our service area includes Brazoria, Fort Bend, Galveston, Harris, Liberty, Montgomery, Waller and other surrounding counties. View our Service Area Map. Will my Social Security number appear on my membership identification card? No. Each member will be issued a unique identification number. Plan Benefits What if I have an emergency? We recommend that you call the KelseyCare After-Hours Nurse at 713-442-0000. Our After-Hours Nurses can access your secure electronic medical record and page your physician if necessary. You can call our KelseyCare After-Hours Nurse Hotline at any time after normal business hours to ask questions or discuss concerns regarding symptoms or illnesses you or a family member may be experiencing. Does Kelsey-Seybold have Saturday appointments? Saturday sick-care appointments between 9 a.m. and 2 p.m. are available for children and adults at four locations: our Tanglewood Clinic near Memorial and the Galleria; Spring Medical and Diagnostic Center; Clear Lake Clinic in Webster; and Fort Bend Medical and Diagnostic Center in Sugar Land. Does KelseyCare powered by Cigna have after-hours services? It's important to get the care you need when you need it. Kelsey-Seybold offers resources to help guide you to the right care for you and your family. Our KelseyCare after-hours services include: The reassurance of our After-Hours Nurse Hotline at 713-442-0000. Call our After-Hours Nurses after regular office hours, on weekends, and on holidays. A KelseyCare After-Hours Nurse will answer your questions, page your physician if necessary, and schedule needed appointments. If a situation seems life threatening, take immediate action and call 911. Saturday Sick-Care Appointments for children and adults are available from 9 a.m. to 2 p.m. at Kelsey-Seybold’s Clear Lake Clinic in Webster; Tanglewood Clinic near the Galleria, Spring Medical and Diagnostic Center in the FM 1960 area, and Fort Bend Medical and Diagnostic Center in Sugar Land. Call our 24-hour Contact Center at 713-442-0000 after 5 p.m. on Friday or Saturday morning to schedule a Saturday appointment. Emergency Room (ER) Services are described in your plan document. These include medical, psychiatric, surgical, hospital, and related healthcare services and testing, such as ambulance service, which are required to treat a sudden, unexpected onset of a bodily injury or serious sickness. Examples of emergency situations include uncontrolled bleeding, seizures or loss of consciousness, shortness of breath, chest pains or severe squeezing sensations in the chest, suspected overdose of medication, poisoning, and sudden paralysis or slurred speech. If I need to go to an urgent care center, will the visit be covered? Yes, several urgent care locations in the Greater Houston area are available to you through Cigna Healthcare. Is emergency room (ER) care included in my KelseyCare powered by Cigna plan? Yes, emergency room services are covered. If you have a medical emergency, you should go to the nearest medical facility offering emergency care. (You should notify your Kelsey-Seybold physician as soon as possible.) What happens when I need to go to the hospital? KelseyCare powered by Cigna partners with premier hospitals in the Texas Medical Center and surrounding communities. A partial list of our hospital network includes: CHI St. Luke's Health System, including Baylor St. Luke's Medical Center in the Texas Medical Center, St. Luke’s Sugar Land Hospital, St. Luke’s The Woodlands Hospital, and St. Luke’s Patients Medical CenterTexas Children's HospitalHCA Houston Healthcare Clear LakeHCA Houston Healthcare The Woman's Hospital of Texas What is KelseyCare Member Services? To make your healthcare experience with KelseyCare as hassle-free as possible, we offer a complimentary concierge service that is available exclusively to KelseyCare members. Call the KelseyCare Member Services at 713-442-0006 or toll-free at 866-609-1630, 8 a.m. – 5 p.m., Monday through Friday. Here are just some of the services provided by your KelseyCare Member Services:Personalized assistance in scheduling appointments and selecting physicians.Assistance in finding nearby clinic locations.Expert guidance regarding specific services available at each clinic location.Resolution of complex billing and eligibility issues.Expert help resolving your questions and concerns regarding the KelseyCare plan. Call 713-442-0006 or email email@example.com for more information. What kind of medical specialists does Kelsey-Seybold Clinic offer? Kelsey-Seybold Clinic provides comprehensive primary care and specialty care. You have access to more than 450 physicians with expertise in more than 55 medical specialties. You may see any Kelsey-Seybold physician or specialist at any Kelsey-Seybold location — no referral required. Kelsey-Seybold offers board-certified specialists trained in Family Medicine and Internal Medicine and medical specialties, including Cardiology, Obstetrics and Gynecology (OB/GYN), Ear Nose and Throat (ENT), Endocrinology, Gastroenterology, Urology, Orthopedics, Sports Medicine, Dermatology, Rheumatology, Allergy and Immunology, Pediatrics, General Surgery, Reconstructive Breast Surgery, and many others. What’s included in the KelseyCare powered by Cigna plan? Complete Access to Care, 24/7 — Choose the Kelsey-Seybold physician you want to see at any of our 24 multispecialty care centers and make an appointment with no referral required. Contact our 24/7 Contact Center for appointment scheduling. Speak to an expert Kelsey-Seybold nurse whenever you have a concern after hours — just call 713-442-0000. Make appointments for sick care at four locations on Saturdays: Our Tanglewood Clinic near the Galleria, Fort Bend Medical and Diagnostic Center, Clear Lake Clinic in Webster, and Spring Medical and Diagnostic Center. Access to 7,200+ Medical Specialists and Premier Hospitals — These include CHI St. Luke's Health — Texas Medical Center, Sugar Land, and The Woodlands; The Texas Heart Institute; The Woman’s Hospital of Texas; Texas Children’s Hospital; Methodist – Sugar Land, and Willowbrook; and HCA Houston Healthcare Clear Lake. One-Stop Care — KelseyCare’s state-of-the-art care centers are located throughout the Greater Houston area and bring together for you primary care, many specialists, lab and X-ray, and on-site pharmacies. We offer advanced imaging (MRI, CT, PET, digital mammography, bone densitometry), and outpatient surgery on a scheduled basis. Secure Online Access to Your Physician — Join MyKelseyOnline to securely view your lab results and email your physician’s office with questions and follow-ups. Our Reputation for Excellence — Kelsey-Seybold Clinic is consistently recognized for excellence, with the most physicians in Houston recognized by the National Committee for Quality Assurance (NCQA) for excellence in diabetes care and heart and stroke care. Kelsey-Seybold has also been recognized by the NCQA as the nation’s first accredited Accountable Care Organization. Coordinated Care — Ever wish your physicians talked to each other? Kelsey-Seybold physicians are experts on coordination and collaboration. We know that coordinated care is the key to superior care. Your secure medical information is always available to your Kelsey-Seybold physicians through our state-of-the-art electronic medical record (EMR). KelseyCare Members Services — This exclusive service for KelseyCare powered by Cigna members provides personalized assistance in scheduling appointments and selecting physicians. Call the KelseyCare Member Services at 713-442-0006 or toll-free at 866-609-1630, 8 a.m. to 5 p.m., Monday through Friday. Where can I get a prescription filled? You can get prescriptions filled on-site at many of our locations. Learn more about our 17 Kelsey Pharmacy locations and then pick up your prescription right where you see your doctor. Scheduling Your Appointment How can I make an appointment? Call our 24/7 Contact Center at 713-442-0000 at any time. You can also request and schedule appointments online through MyKelseyOnline.com, your secure online connection to your Kelsey-Seybold physicians.To schedule a pediatric appointment, call 713-442-KIDS (5437) or schedule online with AppointmentsNOW.For personalized assistance in finding doctors and scheduling appointments, call your KelseyCare Members Services at 713-442-0006 or toll-free at 866-609-1630, 8 a.m. to 5 p.m., Monday through Friday. How do I go about choosing a primary care physician? Your primary care physician is your personal physician and the gatekeeper who will help you achieve good health. You’re not required to designate a Kelsey-Seybold physician as your personal physician to participate in the KelseyCare powered by Cigna plan. However, we encourage you to choose a primary care physician before you get sick or need to make an appointment for your annual physical. We invite you to review our primary care physician bios. You can search by Family Medicine, Internal Medicine, or Pediatrics to find a primary care physician who is right for you and your covered family members. Many of our video bios explain the physician’s philosophy of care. Is there a Kelsey-Seybold Clinic location near me? Kelsey-Seybold Clinic offers 24 locations throughout the Greater Houston area. For personalized assistance in finding a location close to you, call the KelseyCare Member Services at 713-442-0006. For detailed information and driving instructions to a Kelsey-Seybold location, click here What do I need to bring to my first appointment? For your first visit, we suggest bringing: A list of your current medications. Bring your prescription bottles or a written list. If you bring in a list of your medications, be sure to include the name of the medication, dosage, and the pharmacy where last filled.Previous medical records. There are two ways to have your records transferred to Kelsey-Seybold.First, a Kelsey-Seybold physician can request your medical records from your previous physician(s). Download the Kelsey-Seybold’s Authorization for Release of Healthcare Information form. Please complete this form, sign it, and bring to your first appointment. (Note: There is no charge for physician-requested records.)Second, you have the right to request a copy of your medical records from your previous physician(s). Bring the records to your first Kelsey-Seybold appointment. (Note: You may be asked to pay for copies of your records.) For pediatric patients, parents should bring a copy of their child’s shot records to the first appointment. What happens if I'm not sure which Kelsey-Seybold primary care physician to choose? You'll select Kelsey-Seybold Clinic as your overall provider of care. That's what will appear on your ID card. There are many services available to help you choose a primary care physician: For personal assistance in selecting a physician, call your KelseyCare Members Services at 713-442-0006 or toll-free at 866-609-1630 between 8 a.m. and 5 p.m., Monday through Friday.Email firstname.lastname@example.org. View biographies and search for physicians by specialty.Call the Kelsey-Seybold Contact Center which is available 24/7 at 713-442-0000.Our goal is to help you make your own choice of a primary care physician. We do not assign a physician to you. Why KelseyCare powered by Cigna Does the KelseyCare powered by Cigna plan offer all the specialists I need? KelseyCare physicians include all Kelsey-Seybold physicians, as well as more than 7,200 KelseyCare affiliate specialists. As part of your care coordination, your Kelsey-Seybold physician will guide your treatment and may refer you to a KelseyCare affiliate specialist. KelseyCare affiliate specialists, like Kelsey-Seybold physicians and specialists, are among Houston’s top doctors and include physicians from the Texas Heart Institute, Baylor College of Medicine, UTHealth, and leading private practices. If I enroll in KelseyCare powered by Cigna, can I withdraw from the plan before the next annual enrollment period? If you were to withdraw, you would not be covered until the next open enrollment. Your enrollment election is a one-time annual election and may not be changed during the plan year. The only exception to this restriction occurs if you experience a qualifying event. Qualifying events include, but are not limited to, marriage, birth of a child, or change in employment status. Do I need a referral to see a specialist with the KelseyCare powered by Cigna plan? You do not need a referral to see a Kelsey-Seybold specialist, including more than 450 doctors in more than 55 medical specialties. However, you do need a referral from your Kelsey-Seybold physician to see a KelseyCare affiliate specialist. I already see a Kelsey-Seybold doctor. Why should I choose KelseyCare powered by Cigna? KelseyCare powered by Cigna has many advantages, including affordable co-pays and predictable coinsurance. Plus, you get personalized assistance through the KelseyCare Members Services program. Why should I choose the KelseyCare powered by Cigna insurance plan and Kelsey-Seybold Clinic for my medical care? With KelseyCare, you’ll get quality care from leading physicians and premier hospitals. You’ll also have predictable copays and a concierge level of service available exclusively for KelseyCare members.When you select KelseyCare, you are exclusively selecting Kelsey-Seybold physicians and KelseyCare affiliate specialists to coordinate and deliver your care and treatment. Kelsey-Seybold physicians are your doctors for Life — with local, regional, and national recognition for medical excellence.KelseyCare powered by Cigna offers comprehensive benefits, including physician care, hospitalization, outpatient surgery and treatment, diagnostic service, and preventive care, including exams to diagnose and treat diseases and conditions of the eye.The bottom line — Kelsey-Seybold Clinic and KelseyCare are the partners you want for convenient and comprehensive quality care.