Plan Administrator: International Medical Group | AM Best Rating: A "Excellent" | Underwriter: Sirius Point
Complete details are given in certificate of insurance.
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Age and Policy Maximum |
Age 69: $50,000, $100,000 or $250,000 Ages 70 and older: $50,000 |
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Doctor Visit |
Up to Policy Maximum |
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Urgent Care |
Not subject to Deductible and Coinsurance In-Network Copayment: $25 Out-of-Network Copayment: $50 |
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Hospital Room and Board |
Average semi-private room rate Includes nursing services (It will cover 75% after deductible) |
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Ambulance |
Subject to Deductible and Coinsurance Injury Illness resulting in an Inpatient Hospital admission (It will cover 75% after deductible) |
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Prescription |
It will cover 75% after deductible |
Complete details are given in the certificate of insurance.
Complete details are given in the certificate of insurance.
PPO Providers are contracted separately through United States Preferred Provider Organization.
https://providerlocator.firsthealth.com/LocateProvider/SelectNetworkType
Complete details are given in certificate of insurance
Pre-existing Condition: An Illness, disease, or other condition of the Insured Person that in the twelve (12) month period the insured persons coverage became effective under this insurance a)first manifested itself, worsened, became acute, or exhibited symptoms that would have caused a person to seek diagnosis, care, or Treatment; or b) required taking prescribed drugs or medicines, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or c) was Treated by a Physician or Treatment had been recommended by a Physician.
Deductible: $1,500 per Injury or Illness (plan Deductible waived)
Maximum Limit through age 69: $25,000
Maximum Limit ages 70 and older: $20,000s
The Insured Person shall have three (3) days from the Initial Effective Date of Policy as evidenced and outlined by this Certificate. If not completely satisfied, the Insured Person may request cancellation of this insurance retroactive to the Initial Effective Date of Coverage by sending a written request to the Company by email, mail or fax and received by the Company within the Review Period, thereby qualifying to receive a full refund of Premium paid. Upon effectuation of such cancellation and refund, neither the Company nor the Insured Person shall have any further rights, liabilities or obligations under this insurance. After the Review Period, the Insured person may request cancellation by sending a written request to the Company by email, mail or fax. However, the following conditions apply for Premium refund: (a) If any claims have been filed with the Company, the Premium is fully earned and is non-refundable. (b) If no claims have been filed with the Company: (i) a cancellation fee of fifty dollars ($50.00 USD) will be charged (ii) only Premium covering time periods after cancellation are refundable.
Eligible and covered claims for Eligible Medical Expenses or other benefits under this insurance thereof will be reimbursed by the Company directly to the Insured Person, by check, at their last known residence or mailing address. While this insurance is in effect, in order to effectuate proper administration, the Insured Person shall undertake to promptly notify the Company of any change in such addresses. Eligible and covered claims for Eligible Medical Expenses or other benefits under this insurance that have not been paid by or on behalf of the Insured Person at the time of adjudication will be paid by the Company by check or electronic funds transfer to the Insured Person at their last known residence or mailing address, or, at the sole option and discretion of the Company (but without obligation to do so), and as an accommodation to the Insured Person, directly to the provider(s), as applicable. All claim settlements, payments and reimbursements are subject to the insurance plan shown in the Declaration and all other Terms of this insurance. No healthcare or medical service provider or supplier, or any other third-party, shall have any direct or indirect interest, claim or right of action against the Company under this Certificate, the Declaration or the Master Policy, whether by purported assignment of benefits, subrogation of interests or otherwise, unless first expressly agreed and consented to in writing by the Company, and notwithstanding provision regarding the method of claim payment. No such provider, supplier or other third-party is intended to have or shall have any rights as a third-party beneficiary under this Certificate, the Declaration, or the Master Policy.
Coverage under this Certificate is not renewable or extendable
Complete details are given in certificate of insurance