Accolade Health Care Advocate

What You Need to Know

Accolade can help PPO members with everything from finding a doctor or therapist to resolving claims issues.

Connect with Accolade at myaccolade.com.

Your Personal Health Care Advocate

Accolade doesn't change your medical benefits; it makes them work better for you.

What could be more personal than your health and your experience when you need health care? Yet the health care system can be anything but personal. From finding a doctor or therapist to resolving claims issues, we’re oftentimes left on our own to deal with a complex and confusing system.

That’s why UC is partnering with Accolade to provide an exceptional level of support to every UC Care, Health Savings Plan and CORE PPO plan member. Accolade doesn’t change your medical benefits; it makes them work better for you.

Accolade is offered exclusively to UC Care, Health Savings Plan and CORE PPO plan members.

You’ll continue to have access to the Anthem provider network and Anthem will continue to process claims for care. However, Accolade is now your first point of contact for help with health benefits questions, big or small. Your experience with Accolade is completely confidential and takes the hassle out of benefits for you and your covered family members. You can ask your Health Assistant or nurse questions like:

Is this procedure covered by my health insurance? How much will I pay if I get the procedure?
Where can I find an in-network pharmacy near me? What prescriptions are covered? What will I pay? Can I get this drug through mail order? Can you help me find discount coupons?
Can you help me find a doctor based on my needs and preferences?
Where is the nearest urgent care facility?
Can you help me schedule and prepare for my next doctor’s visit?
Can I get a second opinion on a diagnosis, possible surgery or treatment plan?
Can you help me understand the information on my claim or Explanation of Benefits (EOB) from my last doctor visit?

You can reach Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT).

Benefits Guidance From Accolade Health Assistants

Virtual Care From Accolade Care

Expert Medical Opinion From 2nd.MD

Outreach From Accolade

Frequently Asked Questions

Accolade Services

When Should You Contact Accolade

Accolade Health Assistants

Finding Providers, Pharmacies and Getting Care

Can I get a primary care on my own? Do I need Accolade to find one?

You can look for a provider on your own, but with Accolade, we can do the work for you. We can even help schedule the appointment if you prefer.

How do I get a referral to see specialist?

The UC PPO plans don’t require a referral to see a specialist. But if you need help finding a specialist in the Anthem network, you can find one by using the Accolade mobile app (download for free from the App Store or Google Play), by visiting the Accolade member portal or by calling Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) to speak with a health assistant.

Do the health assistants have access to providers outside the united states?

No. This is not a global offering, so our providers are only located in the United States.

If a prior authorization and pre-certification is needed, does the doctor contact Accolade or Anthem?

Accolade is now owning prior authorizations and pre-certification. They have a dedicated utilization management department that reviews the medical necessity of any procedures that require prior authorization.

To talk to Accolade about prior authorizations and pre-certification, call the number on the back of your insurance card.

If I can’t reach our doctor in a timely manner for a Paxlovid prescription after testing positive for COVID-19, is there a nurse triage option?

Our nurses can't prescribe medications, but our doctors at Accolade Care, your virtual care service, can examine your and write a prescription for Paxlovid for you.

Most pharmacies and doctors listed are in California, I work remotely in Maryland. How can Accolade assist me?

Accolade providers are available in every state, so you can receive treatment wherever you are. Our primary care doctors are able to address and treat a variety of conditions, and after the appointment, they can send prescriptions to your preferred pharmacy. They can also write any orders, including lab work, if you need any diagnostic testing. They can also write orders for physical therapy or occupational therapy.

If I sustain a minor injury, should I contact Accolade first rather than going directly to urgent care or the emergency room?

Yes, via Accolade Care, you can speak with a board-certified primary care doctor or mental health therapist from your phone, tablet or computer — day or night. Accolade Care providers can help you receive care for urgent medical issues (excluding true emergencies), ongoing and chronic conditions, mental health, preventive care, prescriptions and more. Accolade Care doctors can also be assigned as your primary care physician, so you see the same doctor for each virtual visit, making it easier to manage ongoing conditions and creating a trusting relationship with a doctor and care team who are easy to reach. Learn more at Accolade Care.

How do Accolade health assistants search for in-network providers?

Accolade has a provider search tool within their system. Health assistants can help members find providers through that tool or members can search through member.accolade.com or uchealthplans.com.

How can Accolade help if in-network providers are not able to treat a specific mental health issue, and the provider has told them they cannot treat their condition?

An Accolade health assistant can help you find an in-network provider who can treat a specific condition. If your health assistant cannot find a provider with an opening within 10 days and 30 miles or less in distance who can meet your needs, an out-of-network provider can be considered under the gap exception.

Virtual Care (Physical and Behavioral Health)

Is there a charge for the virtual care through Accolade Care?

Each family member gets 12 no-cost primary care and mental health therapy (age 18 and older) visits each calendar year (between January 1 and December 31). This includes annual wellness checks and preventive care. After 12 visits, the cost is $115 per visit. You can submit this charge to Anthem for reimbursement. (Your reimbursement is based on your plan’s coverage.)

Can I use Accolade Care for an annual physical checkup?

Yes, Accolade providers can also be your resource for annual wellness checks and preventive care.

After my 12 free visits, are virtual care visits billed directly to Anthem?

No. You’ll have to submit a claim with Anthem for reimbursement, either through the Anthem portal at anthem.com/ca or through the Sydney mobile app. You’ll receive a receipt for each visit to include with your claim. Your reimbursement is based on the coverage by your plan.

If you don't use all 12 free visits during the calendar year, does the balance carry over to the next year?

No.

How do I connect with Accolade Care?

You have several options:

Connect through the Accolade member portal or mobile app or portal (download for free from the App Store or Google Play). Select the Accolade Care tile and it will take you to the Accolade Care website. On your first visit, you’ll be asked to register set up a user ID and password for Accolade Care.
Call Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) and select prompt one to be connected to an Accolade health coach.
Call your health assistant and ask to be connected to Accolade Care.

Can I access virtual primary care and mental health providers through Accolade?

You have full access to virtual therapy visits through Accolade Care.

Can the telehealth providers prescribe medications?

Accolade’s mental health therapists are licensed counselors, not psychiatrists, so they can’t write prescriptions. However, if your therapist thinks that a medication regimen is needed, they can collaborate with your primary care doctor through Accolade Care to share the suggestion.

Is there a charge for any Accolade services?

The only thing that would require any out-of-pocket payment from you as the plan member is Accolade Care after you've exhausted your 12 free visits.

How long is the wait time for getting a virtual care appointment?

Oftentimes, there is same or next day availability to speak to our primary care doctors.

Appointment with mental health providers may take longer due to the increased need for mental health but we will strive to get you connected to a therapist as soon as possible.

Is Accolade Care considered in-network?

Your 12 free visits do not go through your Anthem insurance coverage. Once you've exhausted your 12 free visits, Accolade works with Anthem to ensure that all those providers are in-network. And for the UC Care plan members, the Accolade Care doctors will be billed at a tier one level.

Are counseling services provided by licensed therapists or psychologists?

Accolade Care has licensed therapists on its panel, employed by Accolade Care. Currently, there are no psychiatrists on t panel.

Can I talk to an Accolade Care provider outside of California?

Yes. Accolade Care providers are located in all 50 states.

Do you have any bilingual therapists?

Yes. Contact your Health Assistant for help locating one.

About Accolade Care Providers

Expert Medical Opinion Service: 2nd.MD

Contacting Accolade

Questions About Coverage

Your Privacy

Help With Claims and Coverage

See What Other UC PPO Members Are Saying

First of all, I wanted to say what a really lovely person my Health Assistant is. She was so patient and kind and very knowledgeable. She helped me with a couple of things I needed [and] was very thorough in getting me the information I needed. Secondly, I wanted to say how happy I am that UC is working with Accolade and the whole concept of having my own personal advocate and my personal shepherd as I work through the insurance system. This is so wonderful and a fantastic innovation and it makes me feel so much more confident in navigating the insurance system. Thank you so much for all you and your staff do. Blessings on you, your staff and your families.”
This was an incredibly great customer service experience of any type, but certainly for insurance. The person I dealt with was very pleasant, very professional, and very helpful. She answered all my questions properly. She took care of everything I needed to and went above and beyond all in one call. It could not have gone better. Thank you.”

* Accolade and its affiliates (“Accolade”) are not an emergency medical service. Accolade provides a personalized health care information service to support you to better understand and utilize your benefits, receive information from expert medical resources, and facilitate your access to medical care from various health care professionals, including virtual medical care services. Virtual medical care services offered by Accolade are provided through independent professional medical practices, including under the Accolade Care brand, to which Accolade provides various platform and related services.