| How Plan Works |
After the deductible, program pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Maximum. Coinsurance will be waived for claims incurred within the PPO if expenses are submitted to Underwriters for review and payment directly to the provider.
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Plan pays 90% for first $5000 of expenses, 100% thereafter.
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Plan pays fixed, pre-defined rate for each medical service.
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| Pre-Existing Coverage |
If you are under age 70, you are covered for an Acute Onset of a Pre-existing Condition. Coverage is available up to $15,000 Maximum for Eligible Medical Expenses and up to $25,000 for Emergency Medical Evacuation.
[An Acute Onset of a Pre-existing Condition is a sudden and unexpected outbreak or recurrence of a Pre-existing Condition which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.]
Note: Age Over 70yrs - NO Pre-Existing Coverage
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Maximum benefit of $3,000 coverage for Myocardial Infarction (heart attack) or stroke.
[Up to $200 per day for each night spent in the hospital after being admitted for either a heart attack or stroke.] |
Age under 70yrs : $5,000 coverage for Myocardial Infarction (heart attack) or Stroke
For Ages 70 & Over: $3,000 coverage for Myocardial Infarction (heart attack) or Stroke |
