Your Paradigm Health Portal provides you with online access to your personal healthcare information.
Go to PortalYou’ll have access to forms, tools,
and any outside resources that
you might need.
CIGNA Network Select Medical PPO
PHCS Network Select PHCS Network
A lot! You can call our Member 360 Program at 888.422.8181 Monday–Friday, 8am–7pm (ET) as often as needed. Or email us at member360@paradigmhealthplans.org.
Unprecedented dedicated care
Access to a nationwide network of providers and hospitals
High-quality care with pricing transparency that may result in the elimination or reduction of your out-of-pocket expenses
Nationwide emergency coverage
Our Member 360 Program takes the guesswork out of navigating your healthcare. The days of calling a health plan and getting different answers from different people are gone! Each Paradigm Health Plans Member is assigned a personal Member 360 Program Team Member who becomes your benefit advocate throughout your enrollment in Paradigm Health Plans—that means you get consistent answers you can trust! Your Member 360 Program will remove obstacles and barriers to getting the care you need. Empower you through education about your plan and how to access care when you need it.
You can reach out to your Member 360 Program for just about anything related to your healthcare. Your Member 360 Program will:
Paradigm offers access to a national network of thousands of high-quality, physicians, hospitals and out-patient clinics. Your employer selects your provider network prior to plan enrollment. Contact your Member 360 Program when you receive your Member Identification Cards and ask them if your preferred doctors are in the network. If your doctor is not participating, your MAP will reach out to your doctor to either facilitate enrollment in the network or work out next steps so your care isn’t interrupted!
It’s easy! Call the Member 360 Program Team and they will help you find in-network providers or help you extend your care with your existing provider until you can transition to an in-network provider. If you cannot locate your personal provider in your network, please contact the Member 360 Program Team and they will verify the provider’s participation for you!
Members who have the CIGNA network can search for a provider, hospital or facility by name, specialty and location by following the link below.
Find Doctors (select Medical PPO)Members who have the PHCS network can search for a provider, hospital or facility by name, specialty and location following the link below.
Find Doctors (select PHCS Network)What services does Paradigm Health Plans cover?
Our health plans have different levels of coverage selected by your employer that are offered to you. To understand your level of coverage, you can review your Member Identification Card or call your Member 360 Program! Our EPO and PPO plans cover essential services that fall into the following categories:
How will my pharmacy and prescription needs be handled?
Paradigm Health Plans has chosen Serve You as our Pharmacy Benefit Manager. As a plan Member, you can register for the Member Portal through serve-you-rx.com. This free, password-protected portal contains information about your benefits and will help you track and organize prescription details for yourself or your covered family Members. Using Serve You, you can:
Cannot find what you need? Call the Member 360 Program Team at 888.422.8181
Mail-Order Pharmacy enrollment needs to be set up for all your maintenance medications.
What Is 1.800MD?
How do I know if I am covered for a service?
Find out by contacting your Member 360 Program Team Member or emailing member360@paradigmhealthplans.org.
I’ve lost my Member Identification (ID) Card. How can I replace it?
Call the Member 360 Program Team Monday-Friday between 8am-7pm and ask for a new copy of your card.
Urgent Care vs. Emergency Room Coverage
What should I do if I require emergency care after hours or over the weekend?
If you require urgent care in an emergency that could not be authorized prior, please call your Member 360 Program Team Member the following day after receiving the care if services were rendered Monday-Friday. If emergency services were rendered during the weekend, please call your Member 360 Program Team first thing Monday morning.
What if I have a chronic condition that requires coordination with my health plan and providers?
Contact the Member 360 Program Team and ask to speak with a Team Member in Medical Management. Our Disease Management Program is URAC-Accredited through American Health and targets nine prevalent conditions for which evidence-based guidelines are established to impact health. If you have a chronic condition, you can work with a one-to-one nurse coach.
All Disease Management Nurse health coaches are registered nurses and will assist you in developing a care plan to manage even the most complex diseases.