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HEALTH (HOSPITAL-SURGICAL) DEFINED BENEFIT INDEMNITY PLANS

Benefits Of Health Indemnity Plans

These plans are alternatives for those who are concerned about the cost of ACA plans, want to know how much their healthcare services will cost them before obtaining services, and desire an insured plan in lieu of Medical Cost Sharing.

What are the Benefits of Health (Hospital-Surgical) Defined Benefit Indemnity Plans?

In today's market where health insurance is often unavailable or not affordable, a Health (Hospital-Surgical) Defined Benefit Indemnity plan can help individuals and families budget and pay for health care expenditures. By providing a choice between three levels of hospital, medical and outpatient coverage, individuals and families can choose a plan according to their health care needs. The goal of these plans is to provide you simple, transparent and affordable healthcare in today’s world where rapidly rising premiums and unpredictable provider charges make healthcare confusing and financially difficult to manage.

[Note: these are not major medical plans and are legally referred to as Limited Benefit plans. They do not comply with the Affordable Care Act (for example they do not include all the minimum essential benefits) but are not subject to tax penalties, as those penalties were removed January 1, 2019.]

Depending on the state, two basic plans are offered. Health Saver Plus Gold Edition has just been introduced, is currently available in 21 states including Florida (more states are being added), and plan highlights are outlined below.

Health Saver Plus III is a less comprehensive version that has been approved in some states but is not available in Florida. Both plans are offered in certain states. Contact us at 877-734-3884 for product availability and details.

Eligibility for these plans is based on medical underwriting and not all those who apply will be eligible for coverage. The plans have a 12-month pre-existing condition limitation, and pre-existing conditions are not covered until the policy has been in effect for 12 consecutive months.

Major features of the Health Saver Plus Gold Edition plan include:

  • $5,000.000 Lifetime Maximum per policy
  • Customize a plan to fit your healthcare and budget needs
  • Three Annual Maximum Benefit Calendar Year Amounts to choose from ($250,000, $500,000 or $1,000,000)
  • Annual deductible applies only to inpatient confinement. The deductible does not apply to outpatient benefits, professional fees, etc.
  • Three Benefit Levels (benefits can be purchased in either 1, 2 or 3 units) to fit your needs
  • By selecting one of these optional products offered by New Era (or one or more supplemental products from another carrier) you can manage risk at a price point you can afford (note: availability varies by state):
    • Catastrophic Accident Plan
    • Specified Disease Policy
    • Enhanced Accident Plan with or without Disability Income Rider
    • Crisis Recovery Benefits (Rider or Stand-Alone)
  • You can choose any doctor or hospital without penalty; or you can take advantage of additional savings by using a provider who accepts the PHCS network offered as a value-added benefit
  • Experience additional savings by calling the Healthcare PALs team at 1-888-748-3040. PALS helps guide you on smart healthcare shopping, getting the most out of your benefits, and reducing or eliminating your out-of-pocket medical expenses.

Reward Yourself for Smart Healthcare Management

Health Saver Plus Gold puts the consumer in charge of their healthcare spending dollars and rewards consumers who practice smart healthcare management. No matter what the provider, doctor, or facility charges, your insurance benefits for covered services remain the same. Therefore, a dedicated consumer could receive excess benefit dollars directly in their pocket!

Resources and Value-Added Benefits

Many resources and value-added benefits are available for you to use at no additional charge. TelaDoc™, the Karis Group™, ScriptSave and the PHCS network are all value-added healthcare programs from other providers designed to save you money and enhance your healthcare experience without additional cost to you.

TelaDoc™

TelaDoc™ (www.teladoc.com) is a convenient alternative to urgent care and ER visits. U.S. board-certified physicians are available anytime, anywhere and can resolve many non-emergency medical issues via phone or on-line video and can also prescribe certain medications. Services are not available in Arkansas, and some states allow only phone OR video consultations.

Save By Taking Advantage of the PPO Network Discounts

While you're free to use any Doctor or Hospital you choose without penalty, you have the option of accessing the Multiplan/PHCS Limited Benefit Network (note that PHCS has many different networks and this plan uses the PHCS Limited Benefit network) to take advantage of great savings at no additional cost. You'll have access to Doctors, Hospitals, Labs, Imaging Centers and Home Healthcare Centers at network discount prices.

(Some of New Era’s optional products mentioned in the sixth bullet above use a larger PHCS network. If you purchase one of these optional products that offers the larger network, network discounts that may not have been available for the Health Benefit Defined Benefit Indemnity Plan may be available to cover payment for services that were not discounted under the Defined Benefit plan.)

You can locate providers who are in the Limited Benefits Network by clicking here. Enter as a guest and follow the instructions to find providers. Contact us at 877-734-3884 if you want help in finding accepting providers.

The Karis Group™: Advocating For Patients

Karis™360 (www.thekarisgroup.com) gives you telephone access to a dedicated team of professional advisors to assist with healthcare-related questions and concerns.

Services include:

  • Healthcare Navigator (help in finding doctors and healthcare facilities, obtaining best-available pricing for procedures or help shop for better pricing on prescription drugs, imaging services or lab tests)
  • Karis™ Surgery Saver (the Karis™ team works to save money by shopping the local and regional market for healthcare facility options that combine affordability and quality services for a given non-emergency surgery)
  • Karis™ Bill Negotiator (available to negotiate discounts on medical bills over $2,500 after services are performed)
  • Concierge Phone Service (provides concierge-type patient advocacy service via a toll-free phone number. Upon receiving an inquiry via phone, the Karis™ team defines the issue, establishes mutual expectations, and fulfills the request)

Save on Brand-Name and Generic Prescriptions

The Script Save WellRx card (www.scriptsave.com) is provided at NO cost to help you save money on your prescriptions. The card is accepted at over 62,000 participating pharmacies nationwide. Note: this is a discount card and is not insurance.

PLEASE CALL US AT 877-734-3884 FOR MORE INFORMATION AND TO ENROLL IN A PLAN

Review the 3 types of programs
health excellence plus

SELF-MANAGED PROGRAM OPTIONS
Partially Self-Directed Healthcare
Partially Self-Directed Healthcare
Partially Self-Directed Program Combining Wellness Services, Preventive Care, An Optional Health Savings Account, AND Medical Cost Sharing For Large Expenses
LEARN MORE
PHYSICIAN-DIRECTED PLAN OPTIONS
DPC - Direct Primary Healthcare
DPC - Direct Primary Healthcare
Provider-Directed Program Supplementing Direct Primary Care With Wellness Services AND Medical Cost Sharing Plan For Large Expenses, Screening Colonoscopies And Mammograms, And Childhood Immunizations/Vaccinations
LEARN MORE
Provider-Directed Healthcare
Provider-Directed Healthcare
Provider-Directed Program Combining Wellness Services, Redirect Health for Preventive Care And Most Small Expenses, AND Medical Cost Sharing For Large Medical Expenses

LEARN MORE
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