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FAQ

FREQUENTLY ASKED QUESTIONS

I have a benefits question, how do I get it answered?

Contact ATRIO Customer Service at 877-672-8620 or visit your local ATRIO office for assistance. You can also send an email to ATRIO Customer service by using the Contact Us form.

Is my doctor in network?

You can view the ATRIO Provider Directory here. You can utilize our printable directories or our online search tool. If you need assistance in locating a provider, please contact ATRIO Customer Service.

Do I need a referral to see a specialist?

ATRIO does not require members to obtain a referral from their PCP to see a specialist, however some specialists may require a PCP referral before accepting a new patient into their practice. If you are a member of our Special Needs Plan, a prior authorization will be required to see out of network providers.

Is my medication covered?

You can view ATRIO drug formularies here. You can search the formulary to see if your medication is covered. For more information regarding your medication and your cost please contact our ATRIO Customer Service Team at 877-672-8620.

What is the coverage gap for my Part D prescription drugs?

When the total paid by you and the plan reaches $3,820, you move to the Coverage Gap stage. Once you are in the Coverage Gap stage you pay generally no more than 25% of the cost of covered brand name drugs and 37% of the cost of covered generic drugs until you reach the maximum out of pocket cost of $5,100. The discount you receive for brand name medications while you are in the coverage gap is counted toward satisfying your maximum out-of-pocket cost. For more information regarding your prescription drug plan please contact ATRIO Customer Service at 877-672-8620.

Is the shingles vaccine covered?

Yes, the shingles vaccine is a covered benefit for members with Part D prescription drug coverage. The new vaccine is covered even if you have already had the old vaccine. You can read more about vaccines here.

What do I do if I get a bill from my provider that appears incorrect?

Begin by contacting ATRIO Customer Service or stopping by your local ATRIO office. We can work with you to determine if your bill is inaccurate.

What should I do if a doctor is asking me to pay in full for the care I’m receiving at the time of my visit?

If you are seeking care at an approved Medicare provider, you should not be asked to pay for any services at the time of your visit as long as you are receiving “covered services”. If you are uncertain whether or not the services you are seeking are covered, or the provider of your choice does not participate with Medicare, please contact our Customer Service staff prior to your visit.

How do I authorize someone to speak on my behalf?

ATRIO has an Authorized Representative Form available. You can request one by contacting ATRIO Customer Service, by visiting your local ATRIO office, or by printing one from our Member Forms section of our website. Another option is to obtain a certified Power of Attorney which can be provided to you by your legal counsel.

I paid an entire year for my gym membership, can I send the entire receipt in for reimbursement?

Yes, for members who are enrolled in a plan that includes a Fitness Benefit. ATRIO will process up to the current month (with a maximum of 12 months), and reimburse any future months as they arrive. The gym reimbursement form is here.

Why do I get so much mail from ATRIO?

All Medicare contracted health plans are required by the Centers for Medicare Services to use the U.S. Postal Service for certain mailings. You can contact ATRIO Customer Service, or send us an email via our website, to ask to be removed from non-required communications.