-Rates 50% Less than ACA, Obamacare Plans, or the MarketPlace.
-Enroll ANYTIME, these Private Policies are not subject to Open Enrollment
Your first step is to view an online health insurance quote.
Golden Rule Insurance Company is owned by UnitedHealthcare, one of the largest health insurers in the U.S. According to Annual Form 10-K 12/31/18, UnitedHealthcare provides over 27 million Americans access to health care. Additionally, the UnitedHealthcare Choice and Choice Plus networks provide access to over 1.3 million network providers. Golden Rule Insurance Company has provided individual and family health insurance for over 60 years. Today Golden Rule markets the individual under 65 products for UnitedHealthcare or UnitedHealthOne.
Golden Rule Insurance Company offers private health insurance options. The portfolio includes:
Obtain your quote on Golden Rule Insurance Products
Dental insurance is something that can help reduce overall dental expenses. Dental procedures can be quite costly. Therefore, dental insurance through Central United Life Insurance Company can help pay for general dental visits as well as necessary dental procedures. Central United Life Insurance company (CUL) is part of the Manhattan Life Group which has been doing business since 1850.
This is a private policy for individual or families.
KEY POINT: Central United Life Insurance allows YOU to choose your own dentist. There are no dental networks that assign a particular dentist to the policy holder. In addition, the dental insurance plans offer special family rates which are great savings when it comes to children.
As an added bonus, ALL the policies include Vision and Hearing coverage as well.
Each year CUL offers policy holders a benefit amount of $1,000 or $1,500. The person gets to choose their own plan benefit amount. The available limits can be used for dental, vision, or hearing benefits. This coverage is very nice because some clients who prefer expensive eye-wear and vision services are covered up to the policy limit through this plan. Some clients buy this policy only to use on dental, while other buy it only for vision, and some buy it mostly for hearing coverage. However, the choice is yours. You can use your policy benefits however you best feel fit.
There is absolutely no waiting period for preventative dental services. Therefore, services that are completely covered include the following:
Members are happy to know that their is no waiting periods on basic dental services. This is excellent news for people who may need some basic work completed sooner than later. Basic dental services include:
Example, you have tooth pain and you need 2 fillings replace right away. The dentist charges you $400 for the filling. The CUL plan will cover 60%. So right away your plan pays $240 toward your fillings.
To check rates and learn more, get an online quote and compare plan options.
Major dental services can get very expensive. For this reason it is common for many policies to have a waiting period of up to 12 months for major dental procedures. Major dental procedures that require a waiting period according to the policy include:
Example, Year three your dentist charges a costly $1200 for a crown. Your dental insurance would cover 80%. That means $960 would be paid by the insurance company.
Hot Tip, If you are in need of dental implants visit. GPM Dental Insurance.
Vision services are available after you have owned your policy for six months. For example, there is a six month waiting period for an eye exam, glasses, or contact lenses. You can choose your very own Optometrist. There is no network of eye specialists that you are required to choose from.
This plan allow full policy limit on vision services. Members who utilize expensive doctors or members who prefer expensive frames or lenses truly love this plan. It is one of the few plans that allows up to $1,500 in vision coverage.
Once benefits take effect the company will pay the following according to plan guidelines:
For example a $500 frame would be covered at 80% after the second year. So the policy would cover $400 of the $500 charge.
Learn more, through the Central United Life Dental, Vision, and Hearing Brochure
Hearing coverage is another added benefit to this plan. While many people do not have any concerns with hearing, this benefit can be very valuable to other members. A 12 month waiting period is required for anyone in need of new hearing aids or in need of repairs.
Keep in mind a 12 month waiting period does apply to anyone who may need hearing aid repairs or adjustments.
The issuer of this dental, vision, hearing policy makes sure all benefits and claims are paid quickly. In addition, other plan benefits include:
All coverage, as well as claims information can be easily managed online. Also, new and replacement cards can be printed directly from the company web site. If any changes or adjustments are made to existing coverage benefits, the changes will be updated within 24 hours. Information such as this can also be accessed on line.
Affordable & Valuable Coverage:
It is extremely important to have dental, hearing and eye coverage especially if an emergency situation arises. It is important to keep in mind that Medicare Plans do not cover dental, vision or hearing expenses. Therefore, it is critical that you have affordable coverage to help pay for expenses related to dental, vision as well as hearing expenses.
All charges for monthly premiums are broken down according to age. All rates are based on the $1,000-$1,500 policy maximum. Coverage can be obtained for as little as $25 per month. If for some reason you are not satisfied with your new coverage, the company will cancel the coverage and refund your money within first 30 days.
Coverage of this nature is critically important for the health and well being of you and your family. Therefore, if you are in need of dental, hearing and vision coverage this is an opportunity to take advantage of this very valuable and very necessary coverage. Your health and the health of your loved ones is a valuable asset.
Cigna provides millions of American’s with healthcare products. These products include not only individual and family Health Insurance, but also expand to Medicare Supplement, Dental Insurance, and International Medical Coverage.
Cigna currently offers private under 65 health insurance options in many states. Some common plan benefits are:
Cigna offers dental insurance in most states. Common Plan Benefits are:
Cigna Medicare Supplement is one of the best selling Medicare Supplement products in a multitude of states. Some Plan Options Include
National General Accident and Health is a branch of the National General Holdings Corporation. It focuses on providing short term and supplemental health coverage. All National General health insurance products are underwritten by four other companies focused on insurance. All four of those companies are permitted to provide health insurance in all of the states and the District of Colombia. The underwritten companies are each responsible for the product the company is associated with.
National General currently utilizes Aetna Open Choice PPO Network for Individual and Family Health Insurance.
National General Accident and Health has five products available to customers. The first is Short Term Medical, which is an insurance policy that can be purchased for a full year in most states. The next product is Supplemental Insurance, which is for unpredictable medical expenses. National General Accident and Health also provides Dental Insurance. Fixed-Medical Benefit is a product that offers set benefits on medical expenses. Finally, National General Accident and Health offers Medicare Supplement Insurance.
Short Term Medical insurance is designed to be an affordable insurance policy. The plan will provide financial protection for medical bills and other expenses related to health care. The plan will cover doctor visits, hospital stays, lab, x-rays, medical equipment, surgeries, etc. The Short Term Medical plan also covers emergency room visits and ambulance rides. Urgent care benefits are included in the plan and most plans cover Urgent Care with a $50 Copay.
The Short Term Medical Plan includes a wide variety of deductible and coinsurance choices to help settle upon a plan that best fits a budget. Coverage can be provided as soon as the next day, so there is not a long period between application and effective date. The plan will also allow a physician to be chosen through the national Aetna Open Choice PPO Network.
It is important to remember that this plan is designed to be short term, but healthy consumers often buy this coverage and their primary health insurance. There is also no guarantee that everyone will be eligible for this plan, as there is underwriting and pre-existing is not covered on temporary health insurance plans.
The Supplemental Insurance Plan is designed for unforeseen medical issues. For example, a sudden onset and diagnosis of a critical condition would be included with supplemental insurance. There are no network limitations on doctors, so people are free to choose any physician they like and cash benefits are paid to the insured. There are many different options to choose from, so a plan can be created for any budget.
Accident plans are available to cover accidental medical expenses, such as a broken bone. The Accident plans provides coverage for unexpected expenses related to accidental injuries, such as broken bones, cuts, sprains, etc. Some plans also offer coverage for accidental death and dismemberment. The Accident Fixed-Benefit plan is effective immediately and provides a cash payment to the insured person to help make up for unexpected medical expenses.
Hospitalization Sickness coverage is another possible supplemental plan. This plan helps cover hospitalization and related costs. It helps people keep financial stability whether because of deductibles or because of primary insurance having high deductibles. This coverage will pay cash directly to the insured to help with costs, allowing a person to use the money in a way that benefits them the most.
There are also Critical Illness plans. These plans are designed to help pay for treatments related to acute illnesses, or simply a cash benefit to the insured to help make ends meet while they are ill. The Cancer and Heart/Stroke plan gives a cash benefit to a person when first diagnosed with cancer, heart attack, or stroke, and it can be used in any way deemed necessary by the ill person. The Critical Illness – Term Life plan functions identically to the Cancer and Heart/Stroke plan, but it extends coverage a whole family rather than an individual.
The final supplemental plan offered is the Multi-Coverage Out-of-Pocket plan. Included here is the TrioMed plan, which provides supplemental insurance for the previous three types of coverage. It provides coverage for accidents, hospitalization, and critical illness. A plan enhancer can also be purchased. The enhancer provides a larger benefit.
As these plans are supplemental, it is important to remember that they do have limited benefits. The Supplemental Insurance plans are not meant to replace primary health insurance. The availability of coverage does change state to state, so it is important to remember that as well. These products are priced very well and are very popular with consumers.
Get Quote – View Plans – See Rates Now
National General Accident and Health offers two different dental insurance plans. Both plans provide access to the Careington Maximum Care Dental Network. Understanding these plans is important because dental health affects the health of the rest of the body. Dental insurance can help to keep dental health ventures affordable.
The Dental PPO plan offers an average of 40% reduced rates on dental. It includes three benefit levels, so it is easier to find a plan that fits one’s budget. This plan also has no waiting period for preventive care, so the needed coverage can be received almost immediately. The plan also provides discounts for all major and basic dental services.
The Dental Indemnity plan works differently than the Dental PPO plan. The Dental Indemnity plan will pay a cash benefit for dental checkups and treatments. Since this helps to catch small dental issues before they become large expenses, this plan mostly focuses on preventive care. There is the option to add a discount of around 42% to the plan, and there are no waiting periods. The Dental Indemnity plan does have a higher out-of-pocket expense for customers.
The goal of this plan is to rethink health insurance. Most health insurance plans are expensive, and copays and deductibles tend to get in the way of any benefits being usable. Rather than being waited down with deductibles and copays, customers are paid a set dollar amount on covered health care services. This helps the insured come up with money to pay their deductibles and copays. This plan plan also has a network of providers to choose from to access lower rates.
The plan comes with some other perks. When in-network providers are visited, there are discounts available for covered health care services. Health care is more easily attainable because there are no waiting periods and the benefits are easy to use. The plan will also give access to telemedicine and discounts on prescriptions.
The Fixed-Benefit Medical insurance plan is easy to use. All customers must do is present the insurance card at check-in. From there, the in-network health care provider will inform the insurance company what services were given to the patient, without the need of claim forms. The customer pays the remaining medical expenses once network discounts and benefits have been deducted.
The Medicare Supplement plan is designed to provide supplements for costs that may not be covered by Medicare Parts A and B. The plan provides a way to pay for unexpected health care costs without having to dig too deeply into savings. With this plan, set percentages are paid on covered on Medicare services. The deductibles and copays vary from plan to plan.
The plan provides some advantages. There are no network restrictions other than the doctors accepting Medicare, and no referrals needed for visits to specialists. For those living with a spouse, then the customer is eligible for a 7% discount on the premium for the household. There is a 30-day trial period, so if a customer dislikes the plan and returns it within that time period, the customer will be reimbursed any paid premiums.
The plan renews automatically and the premium increases or decreases along with Medicare deductibles and coinsurance. There is no waiting period, so a person is eligible to receive benefits the moment the plan goes into effect. Finally, there is no paperwork associated with filing a claim, the insurance card just must be shown to the health care provider and Medicare benefits are paid directly to the provider.
National General Accident and Health has a variety of insurance products. This allows people to choose what is best for their health care needs. The company also provides many different payment options for its products, so a plan can be selected to fit many budgets. National General Accident and Health offers affordable insurance in the short-term, the long-term, and for teeth. Plans to supplement outside insurance are also available at affordable prices.
Medicare Part A and Medicare Part B are required if you want to apply for a Medicare Supplement policy. When you have both Medicare Parts A and B it is commonly known as Original or Traditional Medicare. For Americans over the age of 65, Medicare Part A and Part B form the core of their healthcare. Medicare is one of the best healthcare systems in the world.
Medicare Part A is the first part of Medicare. It is free and is mostly in-patient Hospital Coverage. Medicare Part B is the second part; it helps cover outpatient treatments. The services fall into two categories, (1) Medically necessary services, such as treatments required to diagnose and treat accepted medical conditions. (2) Preventative services to help prevent illnesses, like flu shots, or to detect conditions at an early stage like prostate cancer screenings or mammograms.
However, Medicare Part B is not designed for long term care, dental issues, routine foot care, hearing devices, or eye exams to name a few.
Although Medicare is administered by the government, it comes at a small price. Most Americans pay a monthly cost of $135.50. However, some people who are Medicaid eligible may get it for free. And some higher income individuals will pay higher rates for their Part B. Once you enroll in Medicare, a review of your last two years tax returns will be used to determine the cost of your Part B.
The standard Part B premium amount in 2019 is $135.50 and most people will pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
Medicare Part B has a deductible and co-insurance. Each person must meet the $185 per year deductible. This is a calendar year deductible. After deductible Medicare Covers 80% in most cases, leaving the patient with 20% of the cost.
The government and healthcare community want to make sure certain medical items are covered. Preventive care helps both medical insurance and the government save money. Medicare Part B recipients can receive the following each year for free:
Enrollment in Part B is easy. Often times it will automatically process or you could visit Medicare.gov to enroll online. It is very common today that a person’s Part A and Part B both automatically begin on the 1st day of one’s 65th birth month. So if a person turns 65 on June 7th, their Part A and Part B would begin June 1st. If you have questions about Part B enrollment and want to learn more about Medicare it is best to let us provide you with a Medicare Overview.
Anthem Blue Cross Blue Shield has many health insurance options for 2019.
It is important to know that plans vary from state to state. Some plans are offered directly through Anthem Blue Cross Blue Shield, while other plans have to be purchased through the Health Insurance Marketplace or the a state exchange. The good news is we can help you obtain quotes and see plan benefits on the policies offered in your area.
This website focuses on private policies for individuals and families who purchase their own health insurance. Plan options vary by state. To get an online quote, start here.
Also be sure to learn about Anthem Dental and Vision Insurance.
Ameritas offers affordable dental and vision insurance plans for individuals and families. Ameritas plans have several options available so the insured can tailor them for a perfect fit. There are two different dental plans under the Advantage Plus umbrella. The PrimeStar vision plans offer different levels of coverage under either VSP or EyeMed, the two top providers of vision plans in the US. Listed below will be details of the coverage Ameritas offers. Plan benefits can vary slightly from state to state.
The Advantage Plus II plan allows you to utilize an Ameritas Dental Network dentist for additional savings. This plan provides graduated coverage, so the percentage paid by the insurer increases each year. You are able to select this plan either with or without orthodontic coverage for those up to age 19. In general, the Ameritas Dental Network also provides the following benefits:
The Advantage II Plus Network plan specifically offers the following benefits:
Preventative services include two exams, cleanings and x-rays per year and fluoride and sealant treatment for patients under 16 years old. The annual calendar year deductible for all services is only $50, and orthodontic coverage has a lifetime maximum of $1,000.
Basic services include fillings and simple extractions and major services include many different services as listed below:
The Advantage II Plus plan offers the same level of coverage listed above and also allows patients to choose ANY DENTIST, however, additional savings apply when using an in-network provider.
Not all dentists are listed in a PPO network, so if your dentist does not accept insurance, it does NOT mean you can’t use insurance. The Ameritas Advantage II PLUS plan offers enhanced benefits, so you can still submit dental claims to Ameritas. Many dentists who do not accept PPO dental insurance will even help you turn in a claim to Ameritas. After all the the dentist does want your business!
Vision plans are also available. PrimeStar Select Vision offers benefits through any EyeMed Access provider. The plan has no waiting periods and offers a vision exam once per year. Co-pays apply for in-network coverage and out of network providers are given allowance amounts. Lens enhancements are also available in-network with an additional co-pay ranging from $15 to $65 and enhancements outside the standard scope are offered at a discounted rate. The plan also provides additional discounts after the plan amounts have been exhausted, and the balance of any uncovered charges such as designer frames. Discounts are also available for Lasik procedure(s). The standard benefits are as follows:
PrimeStar Choice Vision is designed for use in the VSP Vision Care Provider network. In-network services require a copay and out of network coverage is also provided with an allowance. Most lens enhancements are not given an allowance, with the exception of standard progressive lenses. The plan also provides additional discounts for items that exceed the coverage amounts and an additional $25 discount on selected frames. Discounts are also available for elective procedure(s) such as Lasik vision correction. The benefits are as follows:
Lens enhancements can be purchased with additional co-pays ranging from $16 to $50, and other enhancements outside the typical coverage level are available at a discount.
Please note that coverage(s) and amount(s) may vary based on location and the exact level of coverage(s) selected. Ameritas will gladly provide a quote from an expert based on location and the level of coverage(s) required. Having great insurance doesn’t have to be a complicated task, Ameritas experts are able to be reached by telephone, live chat or e-mail. Check on Ameritas Dental and Vision Quotes!
If you are shopping for Private Health Insurance be sure to check our Aetna PPO plans being offered by National General Insurance Company. These affordable plans are an excellent option for individuals and families who buy their own health insurance. The Aetna Open Choice PPO Network is one of the largest doctor networks in the country.
Your first step is to view rates is to obtain an online quote.
The Aetna Open Choice PPO Network plans by National General Insurance Company are most popular for these shoppers.
URGENT CARE is a popular benefit on these plans. An urgent care facility is a medical facility providing immediate, non-routine urgent care for an injury or sickness treated on a walk-in basis. This policy provides you with unlimited visit for a $50 copay. Your medical deductible is waived and remaining expenses are applied to co-insurance. This is a popular benefit and thousands of Urgent Care facilities participate with Aetna Open Choice PPO.
Since these policies are private policies. They do require a basic health questionnaire. The questions mostly focus around pre-existing conditions including but not limited to cancer, heart attack, stroke, diabetes, COPD, drug or alcohol abuse, etc. Furthermore people who are currently in the middle of care would most likely to best to buy an ACA/Obamacare plans. The reason is because private policies, such as these, do not cover pre-existing conditions. Pre-existing conditions are referred to as conditions for which medical advice, diagnosis, care, or treatment (including services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received within the 12 months immediately preceding the effective date, unless a lesser period is required by state regulation.
This coverage is not required to comply with federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.
Also, this coverage is not “minimum essential coverage”. If you don’t have minimum essential coverage for any month in 2018, you may have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month. For 2019 the tax penalty goes away. Mandated ACA compliant coverage is not required starting January 1st 2019.
Fill out the information below to learn more about plans rates and to see if this is a good options for your 2019 health insurance policy.
The IHC Group has some of the most affordable health insurance in Maryland. When circumstances leave you temporarily uninsured, the Connect Value short-term medical insurance plan helps protect you during coverage gaps. Value Connect is an affordable way for Maryland residents to avoid going without health insurance.
Read below for more information about this exciting product.
Office Visit Copay – $50
The copay applies to the first covered office visit during the policy period. After the copay, the balance of the doctor office visit charge is covered at 100 percent. Additional covered expenses incurred during the office visit, including expenses for laboratory and diagnostic tests will be subject to plan deductible and coinsurance.
Looking for more coverage, learn about Learn about Other Plans in Maryland.
Maximum benefit $1,000,000
View an online health insurance quote.
All benefits, except office visits applied to the copay, are subject to the selected plan deductible and coinsurance. Covered expenses are limited by the usual and reasonable charge as well as any benefit-specific maximum. If a benefit-specific maximum does not apply to the
covered expense, benefits are limited by the coverage period maximum. Benefits may vary by state.
Deductible – $1,000 | $2,500 | $5,000
The selected deductible must be paid by the covered person before coinsurance benefits begin. Family deductible maximum: Three times the individual deductible amount.
Coinsurance percentage and out-of-pocket costs
After the deductible has been met, you pay the selected percentage of covered expenses until the out-of-pocket amount has been reached.
The Connect Value plan covers the remaining percentage of covered expenses up to the maximum benefit. The out-of-pocket amount is specific to expenses applied to coinsurance; it does not include the deductible.
Utilize a network provider and Save
With your Connect Value short-term medical plan, you have the freedom to choose any provider. In certain markets, you also have access to discounted medical services through national preferred provider organizations (PPOs). These network providers have agreed to
negotiated prices for their services and supplies. While you have the flexibility to choose any healthcare provider, the discounts available through network providers for covered services may help to lower your out-of-pocket costs. At the time of service, simply present your identification card, which will include the network information needed for the provider to correctly process covered billed charges.
Why short term medical insurance?
When you are temporarily between major medical policies or waiting for coverage to begin, short-term plans provide benefits to help pay for unexpected healthcare. Covered expenses may include emergency room treatment, hospital stays, surgery, intensive care and more.
Underwritten by Independence American Insurance Company, (IAIC), a member of The IHC Group. For more information about IAIC and The IHC Group, visit www.ihcgroup.com. This product is not considered to be Minimum Essential Coverage as defined by the Patient Protection and Affordable Care Act (ACA). This product is administered by The Loomis Company.
Connect Value offers short-term medical coverage with an affordable premium
Connect Value’s low premium is achieved through carefully selected benefit limitations. Coverage is available in most states for 30 to 90 days. Short-term medical insurance is not a substitute for a major medical plan that meets the minimum essential coverage levels as defined by the Patient Protection and Affordable Care Act, also known as ACA. It can, however, offer financial protection in the event of an unexpected injury or illness while you are waiting for coverage to begin under an ACA compliant plan.
Waiting for an ACA plan
Many plans on the Health Insurance Exchange offer only one effective date, the first of the month. Depending on when you submit your application, you may have to wait up to 45 days for your coverage to begin.
Often, an employer-sponsored plan includes a waiting period before health insurance benefits begin.
Missed Open Enrollment
If you have missed the opportunity to secure coverage during the open enrollment period, you may be ineligible to buy a major medical policy until the next open enrollment period, unless you have a qualifying event.
Can I Apply?
Connect Value is available to the primary applicant from age 18 to 64, his or her spouse age 18 to 64 and dependent children under the age of 26. A child-only plan is available for children age 2 up to age 18.
Covered Services Include Treatment for services and supplies for:
• Inpatient hospital room, board and general nursing care up to the amount billed for a semi-private room or 90 percent of the private room billed amount, not to exceed $10,000 per day
• Inpatient intensive care or specialized care unit up to three times the amount billed for a semi-private room or three times 90 percent the private room billed amount, not to exceed $12,500 per day
• Inpatient doctor visits not to exceed $500 per confinement
• Inpatient prescription drugs administered while hospital confined
• Emergency room up to $500 per day
• Office visits not paid through a copay will be subject to deductible and coinsurance, not to exceed a maximum benefit of $1,000 per covered person
• Outpatient hospital surgery or ambulatory surgical center charges not to exceed $1,000 per day
• Surgeon services in the hospital or ambulatory surgical center not to exceed $2,500 per surgery
• Anesthesiologist services not to exceed the maximum benefit of 20 percent of the surgeon’s benefit
• Assistant surgeon services not to exceed 20 percent of the primary surgeon’s covered charges
• Surgeon’s assistant services not to exceed 15 percent of the primary surgeon’s covered charges
• Ground ambulance services not to exceed $250 per occurrence
• Air ambulance services not to exceed $250 per occurrence
• Organ, tissue, or bone marrow transplants not to exceed $150,000 per coverage period
• Acquired Immune Deficiency Syndrome (AIDS) not to exceed $10,000 per coverage period
• Outpatient hospital surgery or ambulatory surgical center not to exceed the maximum benefit of $1,000 per day
Pre-certification is required prior to each inpatient confinement for injury or illness, including chemotherapy or radiation treatment at least seven days prior to receiving treatment. Emergency admissions must be pre-certified within 48 hours following the admission, or
as soon as reasonably possible. Failure to complete pre-certification will result in a benefit reduction of 50 percent which would have otherwise been paid. Pre-certification is not a guarantee of benefits and may vary by state.
Pre-existing Condition Limitation
Connect Value will not provide benefits for any loss caused by or resulting from a pre-existing condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years* immediately preceding the covered person’s effective date of coverage; or symptoms within the five years immediately prior to the coverage that would cause a reasonable person to seek diagnosis, care or treatment.
*In the following states, the pre-existing condition time period is 6 months: GA, ID, KY, MA, MI, NH, NJ, NM, NY, ND, WA, WY.
Coverage ends on the earliest of the date: the premium is not paid when due; you enter full-time active duty in the armed forces; or Independence American Insurance Company determines intentional fraud or material misrepresentation has been made in filing a claim for benefits. A dependent’s coverage ends on the earliest of the date: your coverage terminates; the dependent becomes eligible for Medicare; or the dependent ceases to be eligible.
If your need for temporary health insurance continues, most states allow you to apply for another short-term medical plan. Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not a
continuation of the previous period; it is a new plan with a new deductible, coinsurance and pre-existing condition limitation.
The Policy does not provide any benefits for the following expenses:
• Treatment of pre-existing conditions, as defined in the pre-existing conditions limitation provision, shown in the Policy
• Incurred prior to the effective date of a covered person’s coverage or incurred after the expiration date, regardless of
when the condition originated, except in accordance with the extension of benefits provision
• Treatment, services & supplies for:
• complications resulting from treatment, drugs, supplies, devices, procedures or conditions which are not covered
under the Policy;
• experimental or investigational services or treatment or unproven services or treatment;
• Amounts in excess of the usual, reasonable and customary charges made for covered services or supplies or you or your
covered dependent are not required to pay, or which would not have been billed, if no insurance existed;
• Paid under another insurance plan, including Medicare, government institutions, workers’ compensation or automobile insurance
• Expenses incurred by a covered person while on active duty in the armed forces. Upon written notice to us of entry into such active duty, the unused premium will be returned to you on a pro-rated basis
• Treatment, services and supplies resulting from:
• war (declared or undeclared);
• the commission of engaging in an illegal occupation;
• normal pregnancy or childbirth, except for complications of pregnancy;
• a newborn child not yet discharged from the hospital, unless the charges are medically necessary to treat premature birth, congenital injury or sickness, or sickness or injury sustained during or after birth;
• voluntary termination of normal pregnancy, normal childbirth or elective cesarean section;
• any drug, including birth control pills, implants, injections, supply, treatment device or procedure that prevents conception or childbirth, including sterilization or reversal of sterilization; sex transformation (unless required by law), penile implants, sex dysfunction or inadequacies and/or diagnosis and treatment of infertility, including but not limited to any attempt to induce fertilization by any method, invitro fertilization, artificial insemination or similar procedures, whether the covered person is a donor, recipient or surrogate.
• Physical exams or prophylactic treatment, including surgery or diagnostic testing, except as specifically covered
• Mental illness or substance use, including alcoholism or drug addiction or loss due to intoxication of any kind unless
mandated by law
• Tobacco use cessation
• Suicide or attempted suicide or intentionally self-inflicted Injury, while sane or insane
• Dental treatment or care or orthodontia or other treatment involving the teeth or supporting structures, except as specifically covered and the treatment by any method for jaw joint problems including temporomandibular joint dysfunction (TMJ), TMJ pain syndromes, craniomandibular disorders, myofascial pain dysfunction or other conditions of the joint linking the jaw bone and skull and the complex of muscles, nerves and other tissues related to the joint
• Eye care, hearing, including hearing aids and testing
• Cosmetic or reconstructive procedures that are not medically necessary, breast reduction or augmentation or complications arising from these procedures
• Outpatient prescriptions, drugs to treat hair loss
• Feet unless due to accidental bodily injury or disease
• Weight loss programs or diets, obesity treatment or weight reduction including all forms of intestinal and gastric bypass
surgery, including the reversal of such surgery
• Transportation expenses, except as specifically covered
• Rest or recuperation cures or care in an extended care facility, convalescent nursing home, a facility providing rehabilitative treatment, skilled nursing facility, or home for the aged, whether or not part of a hospital
• Providing a covered person with (1) training in the requirements of daily living; (2) instruction in scholastic skills such as reading and writing; (3) preparation for an occupation; (4) treatment of learning disabilities, developmental delays or dyslexia; or (5) development beyond a point where function has been demonstrably restored
• Personal comfort or convenience, including homemaker services or supportive services focusing on activities of daily life that do not require the skills of qualified technical or professional personnel, including bathing, dressing, feeding, routine skin care, bladder care and administration of oral medications or eye drops;
• Supplies provided by a member of your immediate family
• Sleeping disorders
• Expenses incurred in the treatment of injury or sickness resulting from participation in skydiving, scuba diving, hang or ultralight gliding, riding an all-terrain vehicle such as a dirt bike, snowmobile or go-cart, racing with a motorcycle, boat or any form of aircraft, any participation in sports for pay or profit, or participation in rodeo contests
• Bone stimulator, common household items
• Participating in interscholastic, intercollegiate or organized competitive sports
• Medical care, treatment, service or supplies received outside of the United States, Canada or its possessions
• Spinal manipulation or adjustment
• Private duty nursing services
• The repair or maintenance of a wheelchair, hospital-type bed or similar durable medical equipment
• Marital counseling or social counseling
• Expenses for replacement of artificial limbs or eyes, removal of breast implants
• Treatment, services or supplies not defined or specifically covered under the Policy
About The IHC Group
Independence Holding Company (NYSE: IHC), formed in 1980, is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries (Independence Holding Company and its subsidiaries collectively referred to as “The IHC Group”). The IHC Group consists of three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, call centers, advisors, private label arrangements, independent agents, and through the following brands: www.HealtheDeals.com; Health eDeals Advisors; Aspira A Mas; www.PetPartners.com; and www.PetPlace.com.
If you live in Pennsylvania you will be happy to know that New Health Insurance Plans are available for 2019. Many large name carriers are offering Private Health Insurance Policies. Prices on these policies are 40% less than the Obamacare plans, and the plans are PPO coverage so you can choose your doctor and hospital.
Here are some key points: