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The health care landscape has been anything but stable over the past five years.
Our Classic and Elite plans offer Stability, which is one thing that individuals
and families need when it comes to health care. It’s affordable, accessible and
flexible.
- Affordability
- Choose from two plan options; find the one that fits your budget.
- Accessibility
- Only a few medical questions on the application.
- Flexibility
- Keep your own doctors; choose from individual or family coverage, and access network
discounts.
Affordable Choice
Unlike traditional health insurance plans, our plan pays a specified cash amount
when you receive a particular service, regardless of what your provider charges
you. Cash is paid to you or your provider if you assign the benefits.
- Inpatient Benefits
- Hospital Admission Benefit
- Surgical Benefits
- Doctor's Office visit
- Outpatient Medical Benefits
- Emergency or Urgent Care
- $2,000,000 Over Your Lifetime
- Discount Pharmacy Card
- Teladoc & Karis 360
Daily Room Benefit1
$50/day
Surgical Schedule2
$50,000
Intensive Care Unit3
$2,000/day
Private Duty Nursing4
$200/day
1 To a maximum of
365 days per period of confinement.
2 Surgical percentage in schedule with unlimited occurrences, inpatient
or outpatient.3
To a maximum 20 days per calendar year.4
To a maximum of 30 days per period of confinement.
Affordable Choice Enhanced Benefit (Optional)
The Affordable Choice Enhanced Benefit is a predetermined package of additional benefits made available to accompany a submitted Affordable Choice application for underwriting consideration, or to augment an in force Affordable Choice policy.
What is the plan design?
Quite simply, it's optional supplemental coverage to the Affordable Choice plan design (Classic or Elite) and includes:
· $50 Daily Room Benefit (0/0 180)
· ICU $2,000 Per Day ( To a maximum of 20 days per confinement period)
· Daily Surgical Benefit $2,000 (To a maximum of 5 days per confinement period)
· Anesthesia $400 Per Day (To a maximum of 5 days per confinement period)
· Private Duty Nursing $200 Per Day (To a maximum of 30 days per period of confinement)
Can just the Affordable Choice Enhanced Benefit be purchased?
No. It is not available as a stand alone coverage or with any other company products.
Underwriting will be identical to the Affordable Choice base policy. Once submitted for underwriting consideration, the Enhanced Benefit will be pended awaiting an underwriting decision on the base Affordable Choice Plan.
The Enhanced Benefit is a marketing name only. The actual form number is HPHI from our filed product under that form number. The base plan Affordable Choice will issue under policy form CHCS11.
The only way to enroll the Enhanced Benefit portion is via our online electronic platforms (Manhattan Direct or ACE). A paper application for Enhanced Benefit is not available.
Elite
Hospital Confinement
|
- $3,000 per Inpatient Day.*
- $200,000 calendar year limit.
|
Hospital Admission Benefits
|
- $2,000 for the first Inpatient Day per calendar year.
|
Emergency Room or Urgent Care
|
- $250 per day
- Limit of 1 daily benefit per calendar year
|
Surgery Benefit
|
- Daily surgical benefits for both inpatient and outpatient surgery. Maximum benefit
of $50,000 per calendar year.**
|
Assistant Surgeon
|
- Pays a daily amount per surgery.**
|
Anesthesiologist
|
- Pays a daily amount per surgery.**
|
Doctor’s Office Visit
|
- $75 per day.
- Four days per calendar year.
|
Outpatient Medical Benefits
|
Preventative Services
- $300 colonoscopy
- $100 per Pap
- $100 per PSA
Laboratory Services
- $100 per day for surgical pathology
- $50 per day for other laboratory tests
Radiology services
- $500 per day for MRI scan
- $250 per day per PET scan
- $150 per day for Mammogram
- $2,000 per calendar year limit for all outpatient events
|
Prescription Drugs Benefit
(not available in AZ and OH)
|
- $25
- $750 Calendar Year Maximum
|
Ground and Air Ambulance
|
- $1,000 per day for air transportation
- $100 per day for ground transportation.
- Limit of 2 daily benefits per calendar year for all ambulance transportation.
|
Lifetime Maximum
|
|
Classic
Hospital Confinement
|
- $2,000 per Inpatient Day.*
- $100,000 calendar year limit.
|
Hospital Admission Benefits
|
- $1,000 for the first Inpatient Day per calendar year.
|
Emergency Room or Urgent Care
|
- $150 per day
- Limit of 1 daily benefit per calendar year
|
Surgery Benefit
|
- Daily surgical benefits for both inpatient and outpatient surgery. Maximum benefit
of $50,000 per calendar year.**
|
Assistant Surgeon
|
- Pays a daily amount per surgery.**
|
Anesthesiologist
|
- Pays a daily amount per surgery.**
|
Doctor’s Office Visit
|
- $50 per day.
- Three days per calendar year.
|
Outpatient Medical Benefits
|
Laboratory Services
- $100 per day for surgical pathology
- $25 per day for other laboratory tests
Radiology services
- $250 per day for MRI scan
- $250 per day per PET scan
- $100 per day for Mammogram
- $2,000 per calendar year limit for all outpatient events
|
Prescription Drugs Benefit
(not available in AZ and OH)
|
- $25
- $750 Calendar Year Maximum
|
Ground and Air Ambulance
|
- $1,000 per day for air transportation
- $100 per day for ground transportation.
- Limit of 2 daily benefits per calendar year for all ambulance transportation.
|
Lifetime Maximum
|
|
Teladoc
Physicians are available anytime, anywhere for personalized, secure,
Web or phone-base consultation that includes diagnosis And treatment of medical issues.
Members can use 24/7 Physician Consultations:
• For common, acute conditions that can be treated
Without a face-to-face visit. From anywhere - at home, at work or on the road. After hours - during the evening, on weekends or Holidays.
• When they cannot reach their primary care Physician.
Product Highlights:
• Offers a fast, affordable alternative for minor
Medical problems and health issues. All physicians are licensed, board certified and based in the U.S.
• Visit Fee is $0.00
For more information go to
Online: www.teladoc.com
Mobile App (App Store and Google Play):
www.teladoc.com/mobile
or call
1-800-Teladoc (832-2362)
Karis 360
Helps policyholders save on out-of-pocket Expenses, in finding doctors, assists in searching and comparing facilities, providers, and prescription costs, as well as many other services. Karis360 offers 3 services
To policyholders.
Karis Healthcare Navigator
• Provides each member a personal, expert advisor to address healthcare-related questions and concerns. • Services include, but are not limited to: physician and healthcare facility searches, prescription cost search, health cost estimates, alternative medicine, laboratory and imaging services, elder care solutions, appointment scheduling.
Karis Surgery Saver
• Helps members when a non-emergency surgical procedure is being considered. Specialized Advisors provide cost, quality and availability comparison of up to 5 facilities in the area.
Karis Bill Negotiator
• Works directly with healthcare providers to help reduce out-of-pocket expenses.• Negotiates directly with providers and collection agencies to try and reduce medical bill balances. Works with providers to develop payment plans.
For more information go to
www.thekarisgroup.com
855-399-4457
Karis360 is not insurance and does not provide funds to pay
for bills. This is a best-efforts service and results cannot be
Guaranteed.