For assistance, please contact:
Norma Jean Rector
6135 Park South Dr Ste 510
Charlotte, NC 28210
704-945-7173     704-531-9139
normajean@blueprintbenefits.com
FirstChoicePatriot SeriesHospital Indemnity Insurance Policy
Guaranteed Issue*
The FirstChoice in Supplemental Health Insurance Benefits

* To receive Guaranteed Issue underwriting consideration, the primary insured must be gainfully employed, and working an average of 30 or more hours per week.

Considerations for FirstChoice as Supplemental Coverage

Our Complete and Standard package designs each feature a variety of both inpatient as well as outpatient benefits, including surgery. FirstChoice benefits can be paid to any hospital or doctor and when MultiPlan providers are used additional savings through negotiated discounts may be available.

FirstChoice Plan Designs

Complete Plan - is particularly well suited to those aged 50-plus who have pre-existing medical conditions (remember, there is a 12-month wait on pre-existing conditions).

Standard Plan - design is suitable for those with limited budget who desire an affordable plan to which they can add additional customized coverage for necessary Critical Illness, Cancer and Accidents. (Available separately) It provides a backbone for a quality portfolio of these additional supplemental policies.

Basic Plan - a versatile Patriot Series option, this plan can serve as a solid supplement to qualified major medical policy, or supply benefits with which to add a package of supplemental benefit options.

Supplement Plan - a cost effective way to provide a variety of benefits used to "fill the gaps" in qualified major med plans. While the Supplement Plan is sufficient to supply the benefits necessary to reduce or even eliminate the out-of-pocket costs associated with an average period of hospital confinement when used with major medical, it should be supported by additional CI, Accident and Cancer policies whenever possible for the highest levels of protection.

Benefit
Complete
Standard
Basic
Supplement
Maximum Benefit/Year*
Daily Room Benefit
$500
$400
$100
$50
$182,500
Riders
Indemnity (CUL-HRLS)
Paid to an insured upon first hospital confinement each year.
$1,000
$1,000
$500
$100
$1,000
First Hospital Confinement (CUL-HRFHC(2)) Based on duration of first hospital confinement.
$10,000
over 6 days
$10,000
over 6 days
$5,000
over 6 days
$5,000
over 6 days
$10,000
Intensive Care Unit (CUL-HRICU and CHRICU14-LA) Limited to 20 days per confinement
$2,500 per day
$2,000 per day
$1,000 per day
$500 per day
$60,000
Private Duty Nurse (CUL-HRPN) Limited to 30 days per confinement.
$250 per day
$250 per day
$250 per day
$250 per day
$7,500 per confinement
Surgery (CHPHISS14 and CHPHISS14-LA ) Per day when confined and a covered surgical event takes place. Maximum of 5 days per confinement
$3,000per day
$2,000per day
$1,000per day
$1,000per day
$15,000per confinement
Anesthesia Benefit Daily benefit amount paid for each day that a surgical benefit is paid for inpatient surgery
$600per day
$400per day
$200per day
$200per day
$3,000per confinement
Emergency Accident** (CUL-HREA) Limited to 4 different covered injuries per calendar year per insured.
$250per accident
$250per accident
$250per accident
$250per accident
$1,000
Specified Injury Rider
(CUL-HRSI) Not in GA & NC
See rider for specific amounts.
$25 - $2,000 Depending on injury
$25 - $2,000 Depending on injury
$25 - $2,000 Depending on injury
$25 - $2,000 Depending on injury
To a maximum of $2,000
per injury
Outpatient Sickness**
(CHPHIOS14 and CHPHIOS14-LA)
$100
per sickness
Limit 4 different sickness per year **
$75
per sickness
Limit 4 different sickness per year **
$50
per sickness
Limit 4 different sickness per year **
$25
per sickness
Limit 4 different sickness per year **
$400

* For the Complete Plan, per calendar year per insured person, unless otherwise specified.

** Insured categories are the insured person, the insured person’s spouse, and/or all of the insured person’s dependent children. Maximum total of 4 different sicknesses per year for all dependent children, not per child.