Limited Indemnity Insurance Benefits – Medical

Limited Indemnity Physician/Hospital Benefits

Coverage for Hospital Care, Surgery, Doctor Office Visits, Physical Therapy and Hospice Care for sickness and injuries, as well as Wellness Care.

LIMITED INDEMNITY INSURANCE BENEFITS - MEDICAL

Physician/Hospital Benefits
Daily Hospital Confinement Benefit: $1,000
This benefit is payable for up to 31 days when a Covered Person is admitted to a hospital (semi-private room) due to a covered Injury or Sickness.

Intensive Care Unit Benefit: $2,000
This benefit is payable for 2-31 days, when as the result of a Covered Injury or Sickness, a Covered Person is confined to a Hospital ICU or CCU unit. This benefit is in lieu of the Daily Hospital Confinement Benefit.

Surgery (Inpatient/Outpatient)
Covered Expenses due to an Injury or Sickness are payable at 100% of the Medicare Allowance, per covered surgery.

Anesthesia
When a surgical procedure is preformed, which is the result of a covered Injury or Sickness, a benefit for Anesthesia is payable at 25% of the Surgery Benefit.

Doctor Office Visit:
When a Doctor Visit is Medically Necessary due to an Injury or Sickness coverage is provided up to $30 per visit, 5 visits Maximum per Individual, 10 visits Maximum per Family, per Policy Year. In lieu of the $30 daily indemnity maximum, visits to your USA+'s Provider Network would only require a $20 co-pay per visit. This benefit is not subject to a waiting period for pre-existing conditions.

Wellness Visit:
This benefit is payable for a routine doctor visit for other than treatment of an Injury or Sickness, up to $30 for a visit, 1 visit Maximum per Policy Year. In lieu of the $30 daily indemnity Maximum, a visit to USA+’s Provider Network would only require a $20 co-pay. Wellness includes health appraisals, including doctor examinations and related tests, routine annual physical examinations conducted by or under the direction of a doctor, without regard to medical necessity, in order to detect disease, disability, or other physical or mental conditions. This benefit is not subject to a waiting period for pre-existing conditions.

PROVIDER LOCATOR (Click Here)

Emergency Room: up to $100
When Medically Necessary treatment by a Doctor in a Hospital Emergency Room for a Medical Emergency due to an Injury or Sickness, is required, coverage is provided for treatment up to $100 per Policy Year, 1 visit Maximum per covered person.

Physical Therapy Visits: $25 per visit
When as the result of a Covered Injury or Sickness, a Doctor certifies that a Covered Person requires Physical Therapy. Maximum of 10 visits per person per Policy Year.

Ambulance Benefit: $300 Per Trip
When as the result of a Covered Injury or Sickness, a Covered Person requires the services of a licensed professional ambulance company for transportation to or from a Hospital. For Medical Emergencies only. Maximum of one trip per Policy Year.

Hospice Benefit: $100 per day
This benefit is payable, when a Doctor certifies that as the result of a Covered Injury or Sickness, the Covered Persons life expectancy is not more than 6 months. Maximum of 20 days per Policy Year.

CLICK HERE FOR EXCLUSIONS

These benefits are underwritten by United States Fire Insurance Company and are subject to the terms, definitions, conditions, exclusions and limitations of the group policy. Coverage is not provided for loss due to pre-existing condition for 12 months from the Covered Person’s effective membership date. Coverage is not provided for members age 65 or over.

Certain terms and conditions apply.

THIS IS NOT BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE AND IS NOT DESIGNED AS A SUBSTITUTE FOR BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE.

*Through your USA+ membership, you can select from over 237,000 Beech Street Physicians and over 430,000 Beech Street Specialists.

PROVIDER LOCATOR (Click Here)

NOT AVAILABLE IN CT, KS, MT, NH, NJ, NY, SD and VT

Excess Medical Accident Expense Benefits

Excess Accident Medical/Dental Expense Benefit

Coverage for accidental injuries that require medically necessary care.

Accidental Death & Dismemberment Benefit

24 Hours a Day, 365 Days a Year, Worlwide Accident Protection; Paid in Addition to Other Insurance; Covers Accidents in the Course of Business or Pleasure, on or off the job.

Insured Benefits – Medical

Surgical Trip - Your International Healthcare Network

USA+ members can now access a special network “Surgical Trip” and receive significant savings on major surgeries at select Accredited Hospitals.

How you benefit
The Surgical Trip network provides you with world class hospitals, clinics and expert surgeons who offer affordable “fixed” prices, typically 40% to 90% less than in the US. Now, you can have peace of mind knowing that you can receive top quality care for major surgeries at affordable prices.

What does Surgical Trip offer?
• Internationally Accredited Hospitals • Bilingual Professional Counselors • Coordination of All Services among Employee, Provider, Physician & Insurer • Board Certified Surgeons • HIPAA Privacy Protection • Full Concierge & Facilitation of Services

The Surgical Trip covers a wide variety of surgical procedures, including:
• Orthopedic • Bariatric Surgery • General Surgeries • Heart • Gynecology• Spine • Urology

Medical providers procedures are available in these locations:
• Costa Rica • Korea • Taiwan • Germany • Mexico • Turkey • Jordan • Singapore • United States

What is the quality of care available overseas?
The Quality of Care available overseas is extremely high. All the hospitals in Surgical Trip’s network are Joint Commission International (the international arm of the organization that accredits US hospitals) accredited or are U.S. or European trained. Here you will have access to personalized attention and services that you will seldom find at most U.S. hospitals.

What is the medical equipment/technology like overseas? Is it comparable to the US?
The medical equipment and technology at Surgical Trip’s hospitals are often better and more advanced than the average American hospital. Overseas hospitals, and in many cases governments, have worked hard to provide foreign patients with world-class facilities, top medical staff and cutting-edge technology.

How to use your benefit
1. Contact your Surgical Trip Support Team:
• Call us toll free at 1-800-513-8996 and speak to our Surgical Trip Support team or click here.to view benefits
(You can also send an email to info@surgicaltrip.com)p>

2. A Surgical Trip Support Representative will respond with;
   • A step by step guide to the Surgical Trip process
   • A typical price range for your requested procedure
   (along with a comparison of the price you might pay in the U.S.)
   • Important facts about your requested medical procedure
   • Information and credentials of our recommended overseas hospitals and physicians
   • Typical length of stay for your procedure
   • A medical questionnaire for you to fill out and return
   • Destination information

Prescription Drug Benefits

Companion Life Rx Benefit

Coverage for prescription drugs purchased on a retail or mail order basis.

Non-Insured Benefits – Protection

Benefits Protector

Our Benefits Protector Program helps cushion the impact of economic downturns.

Non-Insured Benefits – Medical

Karis Group

Patient Advocacy service provides a comprehensive solution that goes well beyond the benefits that a stock PPO discount can provide.

The Karis flagship Patient Advocacy service could be the most cost effective and valuable health benefit we provide to take care of your self-pay balances. Karis mediators work directly with patients and providers to resolve bills, allowing patients to focus on their health while Karis focuses on the most cost effective solutions.

WATCH THE INTRODUCTORY VIDEO TO LEARN MORE

Facts and figures say a lot about what Karis does. Stories about the people that Karis helps everyday say even more. Below you will find personal stories describing what Karis does for patients, and how their knowledgeable and attentive staff has impacted their lives.

John owned his company and medical insurance was unfortunately low on the priority list. When a symptom-free aneurysm burst and caused a stroke, John had to be airlifted to his local care hospital where it was decided that he needed more extensive care at a regional center. Four weeks later the total bills – including the flight, two hospitals and rehab – exceeded $46,000. John did not qualify for Medicaid and lacked the funds to pay bills of this size. After much negotiation, we reached a settlement with all of the parties involved, averting financial ruin for John. Savings: Over $42,000.

Brandon cut and dislocated his finger playing hockey. He drove himself to the emergency room where he waited for two hours before a doctor saw him. The doctor put his finger back in place and stitched up the cut. The whole procedure took less than thirty minutes. Two weeks later Brandon received a bill for $5,500. We contacted the doctor who agreed to reduce the bill to $2,500 and accept monthly payments to pay off the balance. Savings: $3,000.

Hannah broke her hip following a nasty fall a year ago. The hip had to be replaced, resulting in medical bills of $44,000. We managed to obtain a 50% discount off the hospital bill. The doctor’s bill of $6,500 was reduced by 25%. Hannah now needs to have her other hip replaced. Both the hospital and the doctor have agreed to give her the same discounts as before. Savings: $47,250 plus ongoing savings.

To maintain patient privacy, names and other sensitive information has been changed or removed.

DirectLabs

An annual Comprehensive Wellness Exam (CWP™), at no charge!

CallMD

Save time and money spent in a physician's office by engaging in a telephone consultation with a nurse and a physician at no charge.

Optum® NurseLine

Speak with a caring staff of registered nurses toll-free, 24 hours a day, 7 days a week at no charge.

Best Doctors®

A high level second opinion to confirm diagnosis and treatment from one of 50,000 of the leading medical specialists in over 400 subspecialties of medicine at no charge.

MyHealthCompass™

Internet tool provides quality ratings for hospitals and pricing for medical procedures.

My eWellness

Health resources to help you achieve your personal goals.

Protection Benefits

Helicopter Rescue Benefit

Emergency medical transportation by helicopter

In the event that an eligible member suffers from a “Covered Injury” that requires emergency medical transportation by helicopter in accordance with EMS protocols, the program will reimburse the participant up to a maximium of $4,000.00 per occurrence per individual or $16,000.00 per family. Reimbursement includes expenses incurred for the cost of “Medically Necessary” helicopter transportation from the scene of an accident to the nearest medical facility capable of treating the injuries or from one medical facility to another. Claims for “Medically Necessary” transports from one medical facility to another medical facility are subject to review by the claims administrator.

Provisions...
• One benefit will be paid per occurence.
• Benefits in excess of all valid collectable insurance.
• Coverage is worldwide.
• Transportation by helicopter only.
NOT AVAILABLE IN: CA, CT, MN, MT, NH, WA, AND VT. Residents of CA, MN, NH and WA should contact USA+ for information.

We will not pay benefits for any loss or Injury that is caused by, or results from:
1. intentionally self-inflicted Injury.
2. suicide or attempted suicide.
3. war or any act of war, whether declared or not.
4. service in the military, naval or air service of any country.
5. mental and nervous disorders.
6. the Covered Person being legally intoxicated as determined according to the laws of the jurisdiction in which the Injury occurred.
7. drug addiction or the use of any drug or narcotic except as prescribed by a Doctor.
8. commission of, or attempt to commit, a felony, an assault or other illegal activity.
9. participation as a professional in athletics.
10. pregnancy and childbirth (except for complications of pregnancy due to a covered accident).

This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to, the payment of claims.

Underwritten by an A (Excellent) rated carrier by AM Best

CareFlite Air Ambulance

Provides worldwide, 24 -hour hospital bed-to-hospital bed fixed wing air ambulance service at no charge.

Dental Benefits

Ameritas Group Dental Benefits*

Dental coverage for basic and preventive services, based on a schedule of benefits, plus a Rewards Program that increases the annual coverage maximum each year.

Vision Benefits

Ameritas Group Vision Service Plan*

Free eye exam once per year per family member from participating providers.

The USA+ membership is not an insurance contract. The membership includes insured & non-insured benefits. This is an Association Membership offered and administered by United Service Association For Health Care, P.O. Box 200905, Arlington, TX 76006-0905, 800-USA-1187.

Approval of your membership application provides guaranteed acceptance on all benefits included in the membership package except as specifically provided in the terms of the individual benefits.

Secure Advantage