Elan Benefit Services Employee Urgent Care at Z-2-H™

SMARTCARE Coverage for Compassionate Primary Care Across Texas

When you or a family member needs medical attention, knowing where to receive care can make the experience less stressful. Z-2-H™ Family Med & Urgent Care Clinic provides compassionate primary and urgent care at participating Texas clinic locations.

Elan Benefit Services employees enrolled in the SMARTCARE 200804 Rx 15-25 Plan may have access to participating providers through the EHN Preferred Network. Members should verify their eligibility, benefits, and provider participation before receiving care.

What Does the Elan SMARTCARE Plan Include?

The Elan SMARTCARE 200804 Rx 15-25 Plan lists:

• A $25 copay for primary-care visits

• A $65 copay for specialist visits

The available plan information does not identify a specific urgent-care copay. Contact Elan Member Services or Coastal Administrative Services before your appointment to confirm what you may owe.

Your cost may depend on current eligibility, network participation, medical necessity, prior-authorization requirements, and the services provided. An insurance card does not guarantee coverage or payment.

For scheduling assistance, call Z-2-H at (469) 283-0076.

Can Elan Employees Visit Z-2-H?

Eligible Elan Benefit Services employees and covered family members may visit Z-2-H for primary care, urgent care, preventive services, and many everyday health concerns.

Z-2-H can evaluate and treat concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Ear pain or possible ear infections

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild allergic reactions

• Rashes and skin concerns

• Minor injuries

• Routine primary-care concerns

• Chronic-condition follow-ups

• Preventive care and physical examinations

Coverage depends on eligibility, plan benefits, network participation, medical necessity, and the services provided.

Call 911 or go to the nearest emergency room for chest pain, severe breathing difficulty, signs of a stroke, fainting, confusion, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the Elan SMARTCARE Plan?

Coastal Administrative Services, also known as CAS, is the third-party administrator for the Elan SMARTCARE 200804 Rx 15-25 Plan.

CAS and Elan Member Services can assist with:

• Member eligibility

• Benefit verification

• Prior-authorization requirements

• Claim-status questions

• Copays and other member costs

• Provider-network participation

• General plan questions

Members and providers may:

• Call Elan Member Services at (833) 845-8854

• Call CAS at (800) 870-1831

• Visit the CAS Website

There is currently no dedicated Elan Benefit Services insurance page on the Z-2-H website. Members should use the official CAS resources and the information printed on their current insurance cards.

How Do I Verify My Benefits?

Before scheduling an appointment, contact Elan Member Services at (833) 845-8854 or CAS at (800) 870-1831.

Consider asking:

• Does Z-2-H participate with my specific SMARTCARE plan?

• Is the requested medical service covered?

• Will the $25 primary-care copay apply?

• What deductible or coinsurance might apply?

• Is prior authorization required?

• Are laboratory services billed separately?

• Are medications or medical supplies processed separately?

• Are there clinic or network restrictions?

• Will I have a time-of-service responsibility?

Ask the representative for a reference number and keep it with your records. Benefit information provided before the visit is helpful, but final coverage is determined when the plan processes the claim.

Is Prior Authorization Required?

Prior-authorization requirements depend on the medical service being requested.

Contact Elan Member Services at (833) 845-8854 or CAS at (800) 870-1831 before receiving services that may require advance approval. Providers may also use the CAS Website for plan-related assistance.

Receiving prior authorization does not guarantee claim payment. Eligibility, medical necessity, network participation, and other plan provisions may still apply.

What Provider Network Does the Plan Use?

The Elan SMARTCARE plan uses the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have elected to participate.

Not every Baylor Scott & White Quality Alliance provider participates in this particular network. Members should confirm that their preferred Z-2-H clinic and requested service participate with the SMARTCARE plan.

To locate or confirm an in-network provider:

• Visit the EHN Member Portal

• Call Elan Member Services at (833) 845-8854

• Contact BSWQA Care Navigation at 1-844-279-7589

Provide the Elan Benefit Services employer name, member identification number, clinic name, and requested service when confirming participation.

Are Specialist Referrals Required?

The available Elan Benefit Services plan information does not identify a standard specialist-referral requirement.

Referral and prior-authorization requirements may vary according to the requested service. Even when a referral is not required, certain specialist visits, procedures, imaging studies, or treatments may need advance approval. Contact Elan Member Services or CAS before beginning specialist care.

What Should I Bring to My Appointment?

Please bring or prepare:

• Your Elan SMARTCARE insurance card

• A photo identification card

• A current medication list

• Known medication or food allergies

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A description of your symptoms

• The date your symptoms began

• Your preferred pharmacy information

Providing accurate medical and insurance information can help the care team prepare for your appointment and may prevent delays with benefit verification.

Claims Information for Providers

Elan SMARTCARE claims are administered through Coastal Administrative Services.

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network
P.O. Box 507
Arnold, MD 21012

Providers should verify the member’s eligibility, insurance-card information, and current claim-submission instructions before sending a claim.

Compassionate Primary and Urgent Care in Texas

Z-2-H works to make primary and urgent care easier to access and understand. Whether you need help with a sudden illness, a minor injury, preventive care, or an ongoing health concern, our medical team will listen and help you understand the appropriate next step.

You can Book an Appointment to select an eligible clinic location. When you are ready, Book Today or call (469) 283-0076.

Please have your Elan SMARTCARE insurance card available so your eligibility, benefits, and network participation can be reviewed before your visit.