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Cigna Health Insurance Plan Options

Cigna

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.

Private Health Insurance by Cigna

Cigna currently offers private under 65 health insurance options in many states. Some common plan benefits are:

  • A Variety of Plan Deductibles
  • Co-Pay Benefits
  • 100% Preventive Coverage
  • Prescription Coverage

Dental Insurance by Cigna

Cigna offers dental insurance in most states. Common Plan Benefits are:

  • 100% Preventive Coverage – no deductible
  • Basic Coverage – Fillings / X-rays / Exams
  • Major Coverage – Crowns / Root Canals

Get CIGNA Health Insurance Quotes

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Medicare Supplement by Cigna

Cigna Medicare Supplement is one of the best selling Medicare Supplement products in a multitude of states. Some Plan Options Include

National General Health Insurance Plans


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

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.

Get a Quote On Short Term Health Insurance.

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.

Supplemental Insurance

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.

Get a Quote On Short Term Health Insurance.

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

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Dental Insurance

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.

Fixed-Benefit Medical

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.

Medicare Supplement

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

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 B

Medicare Part BMedicare 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.

What does Medicare Part B Cover?

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.

  • Outpatient Care
  • Home Health Care
  • Preventive Services
  • Durable Medical Equipment (DME)
  • Flu Shots
  • Mental Health
  • Ambulatory service

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.

Who is Eligible for Medicare Part B?

  • Some Disabled individuals
  • People with Renal Disease
  • 65 or older

Take a moment and learn about Medicare Supplement.

What is the Cost of Medicare Part B?

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 Deductible and Co-Insurance

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.

Medicare Part B Preventive Care

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:

  • Cardiovascular disease screenings
  • Diabetes screenings
  • Colo-rectal Cancer Screenings
  • Mammograms
  • HIV Screenings
  • Bone Density
  • Prostate Cancer Screenings
  • Cervical Cancer Screenings
  • Colonoscopies
  • Vaccines
  • Measles
  • Polo
  • Meningitis

Part B Enrollment

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 Health Insurance Plans

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.

Shop for Individual or Family Health Insurance

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.

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Also be sure to learn about Anthem Dental and Vision Insurance.



Ameritas Dental Insurance Plans

Ameritas Dental and Vision InsuranceAmeritas 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.

Save Money with the Ameritas PPO Dental Insurance Plan

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:

  • Discounted fees of up to 30%
  • Immediate in-network discounts
  • One of the largest dental networks nationwide

Get a Quote to see the rates on Ameritas Dental Insurance.

The Advantage II Plus Network plan specifically offers the following benefits:

  • 100% Preventative Care
  • A minimum of 35% and up to 80% of basic services
  • A minimum of 15% and up to 50% on major services
  • A minimum of 15% and up to 50% on Orthodontics (optional)

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.

Get a Quote to see the rates on Ameritas Dental Insurance.

Basic services include fillings and simple extractions and major services include many different services as listed below:

  • Implants
  • Oral Surgery
  • Endodontics
  • Periodontics
  • Crowns
  • Bridges
  • Dentures
  • Panoramic x-rays

Get A Quote On Ameritas Dental

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Choose ANY Dentist with Ameritas Advantage II Plus Plan

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!

VSP Vision Insurance through Ameritas

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:

  • Contact Lenses
  • Frames
  • Single vision, bifocal, and trifocal lenses
  • Lenticular lenses

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:

  • Frames
  • Lenses
  • Contact Lenses
  • Single, Bifocal and Trifocal lenses
  • Lenticular lenses

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!

Mutual of Omaha Dental and Vision Insurance

Mutual of Omaha Dental InsuranceAfter providing Medicare Supplement coverage to over 1 million Americans, Mutual of Omaha will soon be offering dental and vision insurance. Most people are very familiar with Mutual of Omaha from their diverse portfolio of life insurance, long term care, and of course medicare supplement products.

Come October 2017 Mutual will be offering two competitively priced dental options. This will be a nice option for individuals and families along with Medicare recipients. The goal is one stop shopping for medicare supplement, dental, and vision.

Keep reading to learn more about these two exciting products.

Mutual Dental Preferred Insurance Policy

The highest level of coverage offered is the Mutual Dental Preferred Policy. This insurance policy pays as follows:

  • Deductible: $0 per year for preventive services / $50 per year for basic and major services
  • Preventive services: Two Cleanings per year / Bite-wing X-rays – 100% Covered, Insured Pays Nothing
  • Basic Services: Fillings, Extractions, Emergency Treatment, 80% Insured Pays 20%
  • Major Services: After a 12-month waiting period, Crowns, Dentures, Bridges, Root Canals, Periodontics, Full-mouth X-ray, Oral Surgery / 50% Insured pays 50% (Dental Implants, see below)

Calendar Year Benefit: $1,500. This is the maximum amount the policy pays each calendar year for all covered services.

Dental Implants. Lifetime Maximum Benefit for implants is $3,000 This is the maximum amount the policy pays for dental implants.

Read the Dental Insurance Overview.

Mutual Dental Protection Insurance Policy

The lesser level of coverage offered is the Mutual Dental Protection Policy. This insurance policy pays as follows:

  • Deductible: $100 per year for all services
  • Preventive services: Two Cleanings per year / Bite-wing X-rays – 100% Covered, Insured Pays Nothing
  • Basic Services: Fillings, Extractions, Emergency Treatment, 50% Insured Pays 50%
  • Major Services: After a 12-month waiting period, Crowns, Dentures, Bridges, Root Canals, Periodontics, Full-mouth X-ray, Oral Surgery / 50% Insured pays 50% (Dental Implants, see below)

Calendar Year Benefit: $1,000. This is the maximum amount the policy pays each calendar year for all covered services.

Dental Implants. Lifetime Maximum Benefit for implants is $2,000 This is the maximum amount the policy pays for dental implants.

Get a Dental and Vision Insurance Quote.

Mutual Vision Benefit

The Mutual Vision Benefit can be included in either dental policy. It is an additional rider that will have an additional premium.

  • Provides a reimbursement benefit
  • Pays up to $50 every calendar year for one eye exam (no waiting period)
  • Pays up to $150 every two calendar years for eyeglasses or contact lenses (after a six-month waiting period)

Medicare and Dental Insurance Coverage

Mutual Dental insurance policies are designed to help pay for the dental services American’s need and to give members the confidence of knowing what their out-of-pocket costs will be. Medicare doesn’t cover dental services. That means costs for things like routine cleanings, fillings, root canals, bridges and dentures come out of pocket. With Medicare recipients living longer, it is very important to have proper dental hygiene and to keep on top of preventative dental care.

Learn more about Mutual Of Omaha.

Compare similar Dental, Vision, and Hearing plan options with Central United Life or Aetna Dental Vision Hearing.

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Private Aetna PPO by National General Health Insurance Company

If you are shopping for Private Health Insurance be sure to check our Aetna PPO plans being offered by National General Insurance Company. These are affordable Association Plans that are offered in 12 month increments in most states, but not all states. This is a private policy that can be purchased by individuals or families who are under the age of 65.

Key Points:

  • Aetna Open Choice PPO Network – 664,000 participating providers
  • 12 Month Policies available in Most States
  • $1 Million Dollar Limits Available
  • $50 Co-Pays On Urgent Care
  • Choose Your Deductible:  $1,000 | $2,500 | $5,000

Your first step is to view rates is to obtain an online quote.

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The Aetna Open Choice PPO  Network plans by National General Insurance Company are most popular for these shoppers.

  • Healthy shoppers who want basic coverage
  • Consumers who are not eligible for Obamacare/ACA Subsidy
  • Students looks for an affordable option
  • Early Retires who cannot afford ACA coverage
  • 26 year old’s who are dropped from their Parent’s policy

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.

Most Affordable Health Insurance in Maryland

Maryland Connect ValueThe 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.

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Plan Coverage
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?
Affordable Health Isurance for MarylandWhen 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.

Newly hired
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
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 termination
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.

Continuing coverage
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.

Exclusions
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
• Orthotics
• Marital counseling or social counseling
• Acupuncture
• 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.

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Medicare Part A

Medicare Part AMedicare Part A usually begins when turning age 65. Medicare Part A coverage is typically free if you or a spouse paid Medicare taxes during your working career. The majority of Americans are automatically enrolled in Medicare Part A when they are 65 years old. To receive Part A you must be already eligible to receive retirement benefits, either through Social Security or the Railroad Retirement Board. However, you do don’t have to be actively collecting Social Security benefits as many people wait to file. Disabled Americans who are under age 65 and receive Social Security or Railroad Retirement disability benefits are often eligible for Part A after 24 months, and those diagnosed with End-Stage Renal Disease can obtain Medicare Part A.

Key Points of Medicare Part A

  • Americans may receive their Medicare Card three months before their 65th birthday
  • If you receive Social Security checks and turn 65, you are enrolled in Medicare Part A automatically
  • Most Part A beneficiaries will pay zero premium if they contributed 40 or more quarters of work
  • Medicare Part A becomes effective the 1st day of the month of the beneficiaries 65th birthday

What does Medicare Part A Cover?

Medicare Part A is mostly associated with inpatient hospital care. Here is what you pay:

  • $1,364 annual hospital deductible
  • Days 61-90: $341 per a day
  • Days 91 and later (while using 60 lifetime reserve days): $682 per a day

Important: After lifetime reserve days are used Medicare pays nothing, the beneficiary is responsible for all hospital charges.

Keep in mind the above information only lists costs for Medicare Part A. You would also have Medicare Part B costs.

Blood covered under Medicare Part A

Part A annually covers the first three pints of blood at no cost to the beneficiary. The Medicare beneficiary is responsible for paying for all additional pints of blood per calendar year.

What Else does Part A Cover?

Medicare Part A covers expenses that are incurred during a stay in the hospital as well as brief Home Health services for some situations, and sometimes brief Hospice care and Skilled Nursing Facility care, and occasionally Nursing Home care, provided you are not merely in need of assistance with daily living. Mental health care is also a covered service when admitted to a hospital as an in-patient.

Medicare Part A does not cover cosmetic surgery, acupuncture, eye exams for the purpose of prescribing glasses, most dental work, dentures, standard foot care, custodial care or hearing aids and the exams required for fitting them.

Need Help Understanding Medicare Part A?

The easiest way to get help with understanding Medicare Part A is to fill out a request online to speak with us. It only takes ten or fifteen minutes to do a brief overview to Medicare Parts A and B. In the event that more information is needed, we could help direct you to your local Social Security office for an in person appointment.

While Medicare may seem confusing, we strongly urge you to contact us sooner than later. We find many Americans spend a great deal of time looking at the wrong Medicare products or over complicating how Medicare works. Sometimes a nice conversation with a knowledgeable person, can greatly ease the tensions that come with learning something knew and transitioning to Medicare.

What if I want Medicare with No Co-pays or Deductibles?

Medicare with no cost sharing is no problem. About 25% of all Medicare recipients have Part A and Part B. They add a Medicare Supplement to cover their deductibles and co-pays, and Part D, a prescription drug plan. Our office can easily help with this process. As always, our services are no cost to you.