FAQs

No, but we highly encourage it. With the Firefly app, you’ll be able to chat with Firefly member guides, use your digital member ID card, and view claims anytime. (You can also access Firefly’s member support by phone, and you'll get a member ID card in the mail.)

If you want to use Firefly virtual primary care, you’ll need the app to schedule visits, chat with your team, and view care plans. (Video visits are available on the web for hands-free convenience).

To get our mobile app, go to the App Store (iOS) or Google Play (Android) on your mobile phone and search "Firefly Health." Keep in mind: The Firefly app only works on a phone, not a tablet.

Yep. Choose us as your primary care provider (PCP), and you won't pay anything for care you get from us. Need more than primary care? Reach out. We'll guide you to excellent providers who qualify for a Care Pass for free or lower-cost care.

No, they don’t. Also, when you make payments toward your in-network deductible, they do count toward your out-of-network deductible. But payments toward your out-of-network deductible don’t count toward your in-network deductible.

No. If your plan covers more than one person, each member has an individual deductible. And those deductibles all count toward the family deductible. So together, you can meet the family deductible without any members meeting their individual deductibles. And once you do that, your coverage kicks in for all family members.

Let’s look at a family with three members: Luisa, Stewart, and Jackson. Their individual deductible is $3,000 and the family deductible is $6,000. Let’s say that:

• For Luisa’s care, they pay $2,500
• For Stewart’s care, they pay $2,000
• For Jackson’s care, they pay $1,500

None of them have met their individual deductibles, but together, they’ve reached the $6,000 family deductible. So now, when they need any care that has a deductible, they’ve already reached it. (This is just an example. Check your plan documents for your actual costs.)

No. It works just like the family deductible, where everyone’s individual out-of-pocket maximum counts toward the family out-of-pocket maximum. So, the most your family will pay for care in a plan year is the family out-of-pocket maximum.

You never pay anything for preventive care (like an annual PCP visit and recommended screenings) or any care you get directly from Firefly (like chats or video visits with your Firefly care team).

If you need a sick or specialist visit, reach out to us first — we’ll guide you to an in-network provider that qualifies for Care Pass and in most cases we’ll waive your copay. If you don’t contact us first, you’ll have a copay for these types of visits.

For surgeries and hospitalizations, you’ll have a deductible and coinsurance. But reach out to us — we can help make these types of services more affordable too.

For cost details, check out your plan documents in the app or send us a chat.

Yes. Send us a chat in the app with the details (like the specialty and the provider’s name and location) and we’ll help you figure it out.

Of course! Send us a chat and we’ll help you sort it out.

Copays are flat fees you pay for some services, like $100 for an urgent care visit. (That’s just an example. Check your plan documents for your actual costs.)

It’s an amount you have to pay out of your own pocket before your coverage kicks in. The deductible applies to only certain services. So, suppose you have a $2,000 deductible and you need an MRI that costs $800. If you haven’t paid anything toward your deductible yet, you pay the full $800. And for any other services where the deductible applies, you keep paying out of pocket until you reach that $2,000 mark. (This is just an example. Check your plan documents for your actual costs.)

Note that your plan has separate deductibles for in-network and out-of-network care. If you have dependents on your plan, you also have individual and family deductibles.

It’s the most you’ll pay for covered healthcare services in a plan year. Note that your plan has separate out-of-pocket maximums for in-network and out-of-network care. If you have dependents on your plan, you also have individual and family out-of-pocket maximums.

Coinsurance means you pay a percentage of the cost of a service. Here’s an example. If you don’t have a Care Pass for an MRI, you have a deductible and coinsurance. Let’s say you’ve already reached your deductible and you have 20% coinsurance. For an MRI that costs $800, you pay 20% of $800 (that’s $160). Your plan pays the rest.

Copays, coinsurance, and deductibles all count toward your out-of-pocket maximum. That includes copays and coinsurance you pay for prescriptions. When you pay for in-network care, it does count toward the out-of-pocket maximum for out-of-network care. But when you pay for out-of-network care, it doesn’t count toward your out-of-pocket maximum for in-network care.

Not quite. Most routine care qualifies for Care Pass, but not everything.

If the service you need qualifies (and it often does), you can’t see just any provider. Only high-quality providers qualify for Care Pass, so you have to go to someone we recommend. Also, you can’t get a Care Pass for out-of-network providers.

Send us a chat in the app and tell us what kind of care you need. Be as specific as you can. Are you going for a routine visit? Getting a procedure done? Let us know and we’ll take it from there.

Once we add the Care Pass to the Firefly Health app for you, book a visit with one of the providers listed on it. The Care Pass is good only for the providers and addresses shown. So be sure to book with the right provider at the right location. Once you schedule your visit, add the appointment date to the Care Pass.

When you go to your appointment, show your Care Pass at the front desk so they can apply it to your visit. We're also happy to email your provider ahead of time with the amount you're responsible for (if any) — just let us know. If you have any issues at the time of your visit, you can call us at (888) 897-1887 for help.

It’s your ticket to more affordable — and even free — care. When you need a specialist, procedure, or any other care, send us a chat in the app. We’ll find you an excellent provider and check if the service you need qualifies for Care Pass. If it does, just see a provider we recommend and in most cases you won’t pay anything.

The Firefly care team only practices virtually. But when you need in-person primary or specialty care, we’ll connect you to the right provider for your needs.

Not if they’re younger than 18 years old. Firefly's primary care offering is only available for adults 18+. Dependents younger than 18 on the Firefly plan can choose any pediatrician or family doctor in the First Health network as their PCP.

No, but you'll get the most bang for your buck if you do. We offer high-quality, convenient primary care at no cost to you. If you choose not to go with a Firefly PCP, be sure to pick one that's in-network.

It’s easy to schedule appointments through the Firefly Health app. Not sure if your health need or question warrants an appointment? You can always chat your care team in the app first.

We follow evidence-based guidelines on which vitals need to be checked and how often based on your age, sex, and any chronic conditions you might have.

If you need your vitals checked, you can use any devices you already have at home, like a thermometer or blood pressure cuff. (Don’t worry, your provider will coach you through how to get the most accurate readings). Or we can send you to a Firefly Nearby provider to get these done.

If you have a chronic disease that requires more frequent monitoring, like diabetes or hypertension, we’ll send any devices you need right to your home.

It’s not about one versus the other. Sometimes, you absolutely need hands-on care. But very often, you don’t.

Going virtual means you avoid a lot of hassle, like waiting weeks for an appointment, juggling time off from work, or a million other things that get in the way of seeing your doctor. Firefly builds upon decades of research on virtual care, and takes the best ideas from the in-person way of doing things, to give you healthcare that fits your life.

If you have a life-threatening emergency, always call 911 right away.

But if you’re not feeling well and want to get checked out — or you’re not sure it’s an emergency — message us in the app. Whatever it is, we want you to contact us first so your Firefly care team can guide you through it. On weekdays between 7AM and 7PM, we’ll respond within 30 minutes. If it's after hours, page us in the app and we’ll call you within an hour.

Firefly can handle anything that falls under primary care (and even some things that don’t).

You can count on your Firefly care team to virtually manage:

• Preventive care like guidance on screenings and labs
• Chronic conditions like diabetes and high blood pressure
• ‍Acute concerns like back pain, stomach bugs, headaches, and sinus infections
• ‍Health coaching to help you reach long-term health goals like losing weight, quitting smoking, or sleeping better
• Women’s health like birth control counseling and menstrual concerns
• Mental health support from one of our licensed behavioral health specialists
• Referrals to excellent specialists in your area
• Prescribing and refilling medications

If you need hands-on primary care, like an abdomen exam or a swab, your care team will send you to a Firefly Nearby provider at no cost to you. We also make it easy to collect vitals, like blood pressure.

Wondering if or how we can handle your issue? Send us a message in the app.

If you need hands-on primary care, your Firefly care team will guide you to a Firefly Nearby provider conveniently located near you.

• Firefly Nearby providers are our in-person partners who handle things like:
• Hands-on exams (like abdomen exams)
• Routine lab work, point-of-care tests, and other swabs and testing
• EKGs (echocardiogram)
• X-rays
• Minor procedures like splints or suture removals

Depending on your need, your Firefly Nearby provider could be a local or regional urgent care clinic, retail store clinic (like CVS Minute Clinic), or even a clinician who comes to your home. Whatever provider you see, they’ll be prepared to give you excellent care at no cost to you.

We believe that many heads are better than one — so instead of one provider, we give you a physician, nurse practitioner, and health guide who all work together to help you feel your very best. When you sign up, you can learn a bit about each care team and pick the right one for you.

Unlike a lot of traditional primary care providers these days, your Firefly care team has time for you. They’re here to get to know you, answer your questions, manage your health issues, help you hit your health goals, guide you when something urgent comes up, and support you with whatever else you need.

Because mental health is essential to overall health and well-being, every Firefly member has the option to work with a licensed behavioral health specialist for short-term, solution-based therapy. The behavioral health specialist will start by understanding your unique needs, then work with your care team to create a complete treatment plan that could include lifestyle changes, medications, specialists for long-term therapy, or other treatments.

The health guide on your Firefly care team is there to support you in reaching your individual health and wellness goals. (Real talk: They’re the health coach you always wanted but never thought you could afford.) They’re trained to give nutrition, physical activity, and other wellness guidance. Getting healthy can feel overwhelming at first; that all changes with a health guide in your corner to help you establish behaviors that stick and keep you motivated along the way.

In most cases, the nurse practitioner is the point person on your Firefly care team. Have a medical question? Need routine care? Due for a refill? Your NP’s on it.

NPs are nurses trained at the graduate level. Primary care NPs are licensed and board-certified medical professionals trained to provide primary care, and most states allow them to practice primary care independently. They can perform many of the same services as doctors: diagnose and treat acute conditions, manage chronic diseases, counsel about disease prevention, and prescribe medications. Several peer-reviewed research papers show that NPs provide primary care that is indistinguishable from physician care.

The physician on your Firefly care team collaborates with and supports the NP when more complex issues come up. You’ll usually meet with your NP but can request a visit with your physician, too.

Virtual-first means your Firefly care team is set up to support your health needs through video visits and chat. You’ll get personalized primary care — like checkups, chronic disease management, medical advice, wellness coaching, and help with urgent issues — wherever you are, all from the Firefly app on your phone.

We also get that sometimes you need in-person care — that’s why we’re virtual-first, not virtual-only. In those cases, we’ll connect you with one of our Firefly Nearby partners and work closely with them to manage your care.

Most of the time, but not always. Because we want to help you as quickly and conveniently as possible, you may occasionally talk to a Firefly provider outside your care team — say, if you need after-hours care or support handling a straightforward problem, like a sinus infection or urinary tract infection.

For some types of care, you need to get approval ahead of time — called prior authorization — to make sure your plan will pay for the service. A good rule of thumb is that if it happens outside a doctor’s office, like a surgery or MRI, you might need prior authorization. An in-network provider will usually take care of it for you behind the scenes. If you see an out-of-network provider or you have any questions about prior authorization, reach out to us — we're happy to help.

No, your plan doesn't require referrals. But to avoid extra costs, make sure to go to a specialist who’s in-network. Send us a chat in the app and we’ll help you find covered specialists who also qualify for a Care Pass.Yes, it does. Send us a chat in the app for more details.

Yes, it does. Send us a chat in the app for more details.

Yes, your plan covers all preventive services required by the Affordable Care Act. Check the complete list of covered preventive services.

Send us a chat. We’ll find you a highly rated doctor and check if you can get a Care Pass for your visit. If you already have a doctor in mind and just want to check if they’re in-network, send us a chat and we’ll look them up.

Send us a chat in the app with as much detail as you can. It’s helpful for us to know:

• What you need (Is it a doctor visit? Imaging? Surgery?)
• Who the provider is
• Where you’re going (A doctor’s office? A hospital?)

First, if you’re having a life-threatening emergency, call 911 right away. Your plan covers emergency room services at both in-network and out-of-network hospitals. Check your plan documents for more details.

But if you’re not feeling well and want to get checked out — or you’re not sure it’s an emergency — contact your primary care provider (PCP). It might save you a trip to the emergency room and spare you the extra costs. And remember, if Firefly is your PCP, you can use the app to page us after hours to get the guidance you need.

It’s similar to getting other types of care. Your best bet is to go to an in-network urgent care center. You’ll pay much less compared to going out-of-network. During regular business hours, you can contact us for a Care Pass to get a $0 copay at urgent care centers we recommend.

If Firefly is your primary care provider (PCP), be sure to get in touch with us first. You can always page us in the app after hours. We’ll help you figure out what you need, guide you to the right provider, and give you a Care Pass. Check your plan documents for more details.

We suggest showing the virtual ID card in your Firefly Health app at check-in. (You can find it in the Health Plan section of the app.) If you have any issues, send us a chat and we’ll help you sort it out.

First, send us a chat so we can make sure your doctor is in-network. If they are, tell your doctor that Firefly is part of the First Health network — if they take First Health, they take Firefly. If you still have issues, let us know and we'll get in touch with your doctor.

Send us a chat. We'll then give you a Coordination of Benefits form, which you can fill out in the app. This form lets us know which health plan is your primary insurance and which is your secondary insurance so we can make sure your Firefly plan kicks in to cover care when it should.

Your Firefly plan offers broad, deep coverage for your medical needs, including:

• Preventive care
• Primary and specialty care
• Mental health care
• Prescription drugs
• Labs and imaging
• Maternity and newborn care
• Hospitalizations and surgeries
• ER visits
• Substance use disorder treatment
• Habilitative and rehabilitative services (services that to help you keep or restore existing skills and functions for daily living)

First Health is the network of providers, specialists, hospitals, and facilities covered by the Firefly plan. The logo on the card helps staff at doctor’s offices know that we use First Health.