How does the Patriot America Plan Work?

Patriot America is a percentage based comprehensive plan. The plan covers for any unexpected sickness or injury that starts after the policy becomes effective.

Which Doctor to Go To

You can go to any doctor or hospital of your choice. However it is better to go to a doctor within the PPO network to get better provider rates, and better percentage of coverage. The Patriot America plan is part of the First Health PPO network. To search for nearby providers in your area visit Patriot America Insurance Providers

How does the Deductible Work

The deductible is the first amount of the covered bill that is the insured persons responsibility, before the insurance starts paying. The deductible for the Patriot America plan is one time in the policy period or once annually, if you have the policy continually, without break for 12 months. If you need to have the policy continuously, for more than 12 months, then after 12 months, a new deductible would apply. If the policy expires, and you need to buy a new policy, then the deductible would reset again. The Patriot America Plan is available for a maximum of 2 years.

Coverage within PPO Network in USA & outside USA

In USA the Patriot America coverage varies slightly,if you visit a provider within or outside the First Health PPO Network.

Within the First Health PPO Network and Internationally Outside USA, : After the deductible is met by the insured person, the plan pays 100% up to the policy maximum.

Outside the PPO network: After the deductible, the plan pays 80% for the first $5,000 and then 100% up to the policy maximum. Any amount above the policy maximum is the insured persons responsibility.

Example
$15,000 Hospital Bill
$500 Deductible
$100,000 Policy Maximum

You Pay $500 Deductible

Insurance Pays $14,500 Up to Policy Maximum

For Coverage outside the PPO Network in USA

In the USA, Outside PPO Network after the deductible is met, the plan pays 80% for the first $5,000 and then 100% up to the policy maximum.

All expenses beyond the policy maximum are the responsibility of the insured.

Example
$15,000 Hospital Bill
$500 Deductible
$100,000 Policy Maximum

You Pay $500 Deductible

You Pay $1000
20% of first $5000 after deductible

Insurance Pays $13,500 Up to Policy Maximum

Read the Patriot America Insurance brochure for complete details.

Disclaimer

Information provided here is high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.