Supplemental Medical Plan

Hospital & Doctor Insurance/ Health ProtectorGuard

 

Fixed Indemnity Insurance for age below 65
by

Unitedhealthcare

It pays for hospital confinements, surgical services, outpatient services, and more….
Six plans to choose from.

Supplemental Medical Plans

These plans are indemnities designed as financial protections to pay you fixed coverage benefits upon defined occurrences to reduce your out-of-pocket costs of deductible, coinsurance, and other expenses related to your hospitalization, surgery, health emergencies and help you pay for other incidental expenses. You can buy these plans standalone (a-la-carte) or preferably with your main medical health insurance plan (either Short Term Medical, TriTerm Medical or a Major Medical plan).

Here is an example showing effect of adding a supplemental medical plan to the basic ACA or Short Term Medical plan that pays $1,000 per day of hospitalization. 

Key Features of Hospital & Doctor/Health ProtectorGuard

 
For details of plans and their features, see brochure here: View the plans here. A download copy is also available here.

There are six levels of plans in increasing order of coverage of benefits and premiums:

  • Choice Value: $1,000 per day for hospitalization, plus other benefits listed below.
  • Choice Plus: $2,000 per day for hospitalization, plus other benefits listed below.
  • Select Value: $3,000 per day for hospitalization, plus other benefits listed below.
  • Primary Preferred: $4,000 per day for hospitalization, plus other benefits listed below.
  • Select Preferred: $5,000 per day for hospitalization, plus other benefits listed below.
  • Premium Plus: $5,000 per day for hospitalization, plus other benefits listed below.

 

List of Benefits under each level of six plan

 
Hospital Services

  • Inpatient Hospital Confinement
  • Inpatient Hospital Intensive Care Unit (ICU) or Critical Care Unit (CCU)
  • Inpatient Physician Visits (maximum during Inpatient Hospital Confinement)
  • Emergency Room (maximum per calendar year)
  • Ambulance- Ground or Water (maximum per calendar year)
  • Ambulance-Air (maximum per calendar year)

Surgical Services

  • Outpatient Facility Fee (maximum per calendar year)
  • Surgeon: 4-Tier Surgical Schedule (unlimited days per calendar year)
  • Assistant Surgeon – Surgical Schedule (Tier 1 and 2 only) per day.
  • Anesthesiologist (per day)

Doctor Visits

  • Office Visits/Urgent Care Visits for injury or illness: Benefits per visit (maximum per calendar year)
  • Second Surgical Opinion (maximum per calendar year)

Wellness/Preventive

  • Wellness/Preventive Care Visit (maximum per calendar year after initial 6-month waiting period)

Pharmacy Services

  • Maximum Rx Fills Per calendar year (Brand and Generic): Its combination of Discount Card or fixed payment on monthly refills.

Outpatient Services

  • Outpatient Lab/X-ray, Non-preventive/Non-routine: Benefit per test (maximum per calendar year)
  • Outpatient Diagnostic Imaging Services (Benefit per test (maximum per calendar year)
  • Oral Chemotherapy: Benefit per month (maximum per calendar year)
  • Outpatient Chemotherapy and Radiation – Non-Oral: Benefit per day (maximum per calendar year)

 

Highlights of Policy Details

 

  • Eligibility and Renewability: At the time of application, applicant and spouse must be between 18 – 64 years of age. (Drop off on 65th birthday). Children between 0 – 25 years of age are eligible (drop off on 26th birthday).
  • Notice of Claim: Must be filed within 30 days of the commencement of hospitalization.
  • Filing of Claim: Must be done within 90 days or as soon as reasonably possible.
  • Preexisting Conditions: For first 12months of the policy, hospitalization benefit is not covered.
  • Underwriting. These plan are subject to health underwriting. Must give accurate information in the application.
Enter basic information and select tab Hospital & Doctor to find six available choices of indemnities. Click on button Details to see summary of benefits. Select one and Apply.

I’m a policyholder. I need help!

  • Check your email coming from the servicer, www.myUhone.com, and follow instructions.
  • Visit https://www.uhone.com/customers/member-portals , register your account under Member Portal, and get to know all its features.
  • Customer Service: 1-800-657-8205
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