Guaranteed Issue Health Insurance Plan (no medical questions)

 

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Basic Health Insurance is an insurance program that offers members guaranteed issue insurance benefits to help with the everyday cost of medical treatment.

Benefits include:

• Single or Family Coverage Plans
• Doctors Office Visits
• Hospitalization Benefits
• Emergency Room Benefits
• Surgical Benefits

Affordable - Comprehensive health insurance is expensive. Basic Health Insurance offers a less expensive solution for everyone.

Accessible - Basic Health Insurance is a guaranteed issue plan for eligible members. There are no medical questions or physical examinations to qualify.

Choose Any Doctor or Hospital- Choose the Doctor, Hospital or clinic of your choice. You are free to go to any medical provider.

 

•                  No Medical Questions to answer or Physical Examinations to pass - Guaranteed Issue for Eligible Members
•                  Freedom to Choose any Health Service Provider or Hospital
•                  No Deductibles to meet- First Dollar Coverage
•                  Fixed Benefit $ Amounts - Pays Benefits Directly to the Insured
•                  Pays in Addition to Other Private health Insurance
•                100% Voluntary Plan - No Minimum Participation Requirements

 

Value Plan

      Procedure                             Insurance Pays

        Doctor Office Visits                          $30

        Diagnostic Testing                           $30

        Child Wellness Visits                         $30

        Hospitalization                                 $100 a day

        Intensive Care Unit                          $200 a day

        Surgery (Inpatient/Outpatient)           $500 / $200

        Emergency Room                             $100

 

              Enhanced Plan

    Procedure                              Insurance Pays

         Doctor Office Visits                           $65

         Diagnostic Testing                            $65

         Child Wellness Visits                          $65

         Hospitalization                                 $300 a day

         Intensive Care Unit                           $600 a day

         Surgery (Inpatient/Outpatient)           $2000 / $800

         Emergency Room                              $300

 

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Doctors Office Visits

 $30 or $65 per visits to a doctor's office for treatment of injury or sickness. 5 visits allowed per covered person per calendar year; 1 of which may be used for wellness care.

Diagnostic Testing

$30 or $65 per visits to a doctors office or outpatient facility for medically necessary diagnostic testing and x-rays of an injury or sickness. 3 visits allowed per covered person per calendar year; 1 of which may be used for wellness care.

Child Wellness Visits

 $30 or $65 per visits to a doctors office for well childcare at 11 specified age intervals from birth through age 5. Well child-care includes physical exam, laboratory tests, immunizations, and vision and hearing screening.

 

Hospitalization

 From $100 or $300 per day for overnight stays in a hospital for up to 100 days per confinement for injury or sickness. The benefit amount for hospitalization for confinement in an Intensive Care Unit/Coronary Care Unit is doubled for a maximum of 30 days per confinement. Benefits for Mental Illness / Alcohol or Drug Abuse confinements are payable at 50% for a maximum of 30 days per confinement. Benefits for Convalescent Facility confinements are payable at 50% for a maximum of 60 days per confinement; confinement must begin within 3 days of an inpatient hospitalization of at least 3 consecutive days.

Surgery

 From $500 or $2,000 for 1 inpatient surgery and $200 or $800 for 1 outpatient surgery (performed in a hospital or outpatient surgery center) per covered person per calendar year.

Emergency Room

 $100 or $300 for 2 visits each to the emergency room for injury and for sickness per covered person per calendar year.

Survivor Benefit

 Dependent coverage will continue premium free for up to 18 months after the end of the
month in which the insured member's death occurs.

 

Eligibility

 All members of the Association of United Internet Consumers are eligible for guaranteed issue provided they:

• People under age 65;
• People actively at work, performing all the normal duties of their job or, if not employed, performing the normal activities of a person of like age and gender;
• People residing in the United States;
• People not in full-time service of the Armed Forces.  

 

Rate Increases / Policy Cancellation

 No individuals can be singled out for cancellation or rate increase under the policy. The Policyholder (association) has the right to cancel the policy on any premium due date by providing 31 days written notice. The insurance company has the right to cancel the policy by providing at least 31 days notice to the Policyholder.

Effective Date of Coverage

 Coverage becomes effective on the first day of the month coinciding with or immediately following the date a completed enrollment form is received, provided that full premium for the coverage has been received.

Payment of Claims

  All claims are paid directly to the insured member. A welcome kit will be issued which includes claim forms and instructions for filing claims.

Pre-Existing Conditions Limitation

 (Is applicable to Hospitalization and Surgery benefits only). A pre-existing condition is defined as any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within 6 months prior to becoming covered under the plan. It includes any condition manifesting itself in symptoms that would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment. Benefits under the Hospitalization or Surgery provisions of the plan are not payable for a pre-existing condition for the first 6 months following an insured's effective date.