Deductible

The amount of covered expenses that the insured must pay before a plan or insurance contract starts to pay.

$0.0

Coinsurance

Most policies require the insured to pay some portion of the health care bills. A typical arrangement is that the insurer pays 80 percent and the insured 20 percent, up to $3,000 of covered expenses after the insured has paid the deductible. After the insured hits the maximum out-of-pocket limit, the insurance company pays 100 percent of covered expenses during the remainder of the calendar year, up to any applicable annual benefit or lifetime maximum of the policy.

None

Coinsurance Out-of-Pocket Maximum

The limit on the amount an individual is required to pay for health care services covered by his or her benefits plan after the deductibles and any copays are paid. Refers to care received from the network of participating physicians, hospitals, and health care professionals. Coinsurance Out-of-Pocket amounts are in addition to any Deductible amounts.

0.0

Network

A group of doctors, hospitals and other health care providers and facilities that have, either, (i) contracted with a health insurer or health plan to provide medical services at negotiated or discounted rates, or (ii) for limited benefits supplemental coverage, contracted directly or indirectly with an underwriter to agree to reduced fees for medical services.

MultiPlan

Inpatient Hospital Confinement

$5,000 per day (Unlimited)

Intensive Care Unit

Additional $10,000 per day (maximum 31 days per year)

Inpatient Physician Visits

$100 per visit (2 visits per day)

Emergency Room

$500 per day (2 visits per calendar year)

Wellness/Preventive Care Visit

$250 per visit (1 visit per calendar year after 6-month waiting period)

Outpatient Facility Fee

$1,000 (3 days per calendar year)

Surgeon / Surgical Schedule (Inpatient or Outpatient)

4-Tier Surgical Schedule (benefit per day/based on surgery type): Tier 1 - $10,000 Tier 2 - $5,000 Tier 3 - $1,000 Tier 4 - $500 (unlimited days per calendar year)

Underwriter

Golden Rule Insurance Company

How It Works

Coverage provides indemnity benefits in a stated amount regardless of the actual expenses incurred. No Lifetime Maximum Benefit.

Office Visits/Urgent Care Visits for Injury or Illness

$100 per visit (5 visits per calendar year after 5 day waiting period for illness)

Prescription Drugs: Generic

$20 (maximum 12 per calendar year combined)

Prescription Drugs: Brand

$40 (maximum 12 per calendar year combined)

Outpatient Lab/X-Ray - Non-preventive/Non-routine

$300 per test (1 test per calendar year)

Outpatient Diagnostic Imaging Services

$1,000 per test (1 test per calendar year)