How Does the Plan Pay
ChoiceAmerica is a fixed dollar based limited coverage plan.The plan pays a pre-defined fixed dollar amount for every service or treatment. These specific amounts are mentioned in the plan brochure and the Description of Coverage.The policy maximum is just the outer maximum
How Does the Deductible Work
The ChoiceAmerica plan pays a limited amount for every service and treatment. The deductible for limited coverage plans is applied to the amount the doctor's charge. For example, for a $50,000 policy maximum, the plan pays $3,300 for covered surgeries for people 79 years of age and under. Now the surgery can cost $15,000 or $40,000, but the insurance would pay a maximum up to $3,300. If you choose a $100 deductible, the deductible would apply to the total bill owed to the medical provider. The insurance would only pay $3,300 (fixed benefit amount). Any amount over the fixed benefit will be the responsibility of the insured person.
What is the Deductible? How many times does it apply?
The deductible is the first amount of the covered bill that is the insured person's responsibility before the insurance starts paying. The insured person has to first satisfy the deductible before the insurance starts paying. The Deductible for the ChoiceAmerica plan is one time in a continuous 12 months period. If you renew the policy beyond 12 months, a new deductible would apply.
Coverage within PPO Network in USA
ChoiceAmerica participates in the First Health PPO network. However, an insured person can visit any doctor or hospital of their choice. By visiting an in-network provider, rates for medical treatments and services may be lower.
Where Does the Plan Cover
USA
The ChoiceAmerica plan covers in the U.S., Mexico and Canada for Non U.S. citizens and Residents.
First: You satisfy accumulated medical expenses until your deductible is met.
Then: Insurance pays fixed amount per eligible medical service as outlined in the benefit table below, up to the policy maximum.
All expenses beyond the policy maximum are the responsibility of the insured.
Read the ChoiceAmerica Brochure for complete details.
