Common use of Insurance Opt-Out Clause in Contracts

Insurance Opt-Out. The fees that the Member pays for services provided by Wellscape Direct MD are not intended to be advance payments for any form of benefit or otherwise constitute any form of insurance. The Member acknowledges that Wellscape Direct MD has explained that its doctor(s) and any staff members have opted out of participating in and are not contracted with any type of insurance, such as a third party payer, health plan, or government program, including the Medicare Program. Members who are Medicare beneficiaries will complete Schedule C, attached. The Member understands that Wellscape Direct MD will not xxxx or otherwise seek payment in any form from any insurer or third party payer to which the Member may be entitled to benefits or coverage for the Services. Although Wellscape Direct MD and its doctor(s) have chosen to opt out of participating with any insurer, the Member is not prohibited from seeking payment for the services from such payers (with the exception of Medicare); however, the Member will be solely responsible for seeking reimbursement from such payers directly. Any Member who is not currently enrolled in Medicare, but who later becomes enrolled in Medicare during his/her tenure as a patient of Wellscape Direct MD, must immediately notify the staff of Wellscape Direct MD in order to complete the required contract (attached as Schedule C).