Benefits designed to match medical procedure costs
Stable Rates – annual increase 3%
Guaranteed renewal to age 65
Lifetime Maximum $5 Million
For Individuals & Groups
Preferred Plan Benefits Overview
Preferred Plan Benefits
Doctor Visit & Pharmacy Benefit
Benefit Pays $120 for 18 doctor visits per insured per calendar year, includes 6 chiropractor visits
Benefit Pays $150 for 2 Specialists visits per calendar year
Benefit Pays per prescription Generic Drugs $20 Brand Name $40
Wellness Preventative Care Benefit
Benefit Pays $250 For Annual Checkup
Benefit Pays $250 for Mammograms per calendar year & $500 for a Colonoscopy
Benefit Pays $160 for X-Rays, Diagnostic and $80 per Laboratory
Benefits start 60 days after policy Effective Date
Surgery Benefit Outpatient or Inpatient
Benefit Pays Outpatient Surgical Facility $3,500 under general anesthesia or $1,500 local anesthesia
Benefit Pays Surgeons and Anesthesiologists 2x CPT code.
Benefit Pays MRI, CAT Scan PET $500 per
Hospital Inpatient Benefit
Benefit Pays Hospital $4,500 per day for Injury and $3,000 for Sickness- General Room
Benefit Pays Hospital ICU $4,500 per day for 20 days per calendar year
Benefit Pays Skilled Nursing Facility $1,500 per day
Accident & Emergency Benefit
Minor Accident Benefit pays up to $4K of Actual Expenses for up to 45 days from the Accident
Major Accident Benefit pays by Schedule up to policy Maximum $500,000
Ambulance air or ground benefit pays up to $11K of Actual Expenses per Accident
Pays $300 for Urgent or Emergency Care 2 times per year Non-Accident
Catastrophic Diagnosis Benefit
Benefit Pays a Lump Sum upon diagnosis up to $40,000 per Adult and $10,000 per Child
Benefit Pays up to an Additional $250,000 in Actual Treatment Expenses Per Year
Benefits for Internal Cancer, Heart Attack, Stroke, Organ Transplant & Renal Failure
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Transparent Reference Based Benefits – Our cost-containment method to assure clients pay clear reasonable prices for healthcare and medical procedures based on CPT code
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Doctor Visit & Pharmacy Benefit
Benefit Pays $120 for 18 visits per Insured per year, includes 6 chiro. visits - No Deductible or Copay
Benefit Pays $150 for 2 Specialists visits per year
Generic Drugs $20 per day Brand Name Drugs $40 per day
Preventative Wellness Care Benefit
Benefit starts 60 days after policy Effective Date
Benefit $250 for Mammograms per year & $500 for a Colonoscopy
Additional $250 Benefit for other Preventative Services
Surgery Benefit
Pays Outpatient surgical facility $3,500 under general anesthesia or $1,500 local anesthesia
Pays Surgeons and Anesthesiologists based on Mcode (1x, 2x or 3x)
Hospital Inpatient Benefit
Hospital per day benefit up to $4,500 for Injury and $3,000 for Sickness
Hospital ICU benefit up to $4,500 per day for 20 days per calendar year
Optional First Hospital Admission $6,350 Lump Sum - per calendar yr, 24 hr stay required
Accident & Emergency Benefit
Minor Accident Benefit Pays $4,000 of Expenses within 45 days of Accident
Major Accident Pays by policy schedule up to the Maximum of $500,000
Ambulance air or ground pays up to $11K of Actual Expenses
Catastrophic Diagnosis Benefit
Pays a Lump Sum upon diagnosis up to $40K per Adult and $10K per child
Pays up to $250K Additional for Actual Treatment Expenses per calendar year
Coverage for Internal Cancer, Heart Attack, Stroke, Organ Transplant, Renal Failure