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Independent Sales Agent: Custom Health Plans, Inc.
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Essential Health

20001000500300

Highlights of the program features are listed below. Click, the "Details" button for additional information on the benefits, including exclusions and limitations. Pdficon Small Click here to download the pdf brochure.

Limited Indemnity Insurance Benefits – Medical

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.

Daily Hospital Confinement Benefit: $2,000
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 performed, 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.

PROVIDER LOCATOR 

Wellness Exam:
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 person 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 

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.

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.

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

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Excess Medical Accident Expense Benefits

Excess Accident Medical/Dental Expense Benefit

Coverage for accidental injuries that require medically necessary care.

Accident Medical/Dental Expense Benefit: $5,000
When a Covered Person sustains an accidental Injury that requires Medically Necessary care by a Doctor, coverage is provided, less a $200 deductible, up to $5,000, for treatment, services and supplies for such Injury. Maximum of one occurrence per member per Policy Year. Initial treatment for the Injury must be received within 30 days of the Injury.

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.

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.  NOT AVAILABLE IN CT, MT, NJ, NY, SD, and VT.

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

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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

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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.

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DirectLabs

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

A simple inexpensive blood test could save your life. Serious Medical Conditions such as heart disease, prostate cancer, diabetes, thyroid disease, and more, can go undetected for up to two years - without noticeable symptoms.

The earlier a problem is detected, the easier and more likely it is to be treatable. A Comprehensive Wellness Exam (CWP™), which includes a Complete Blood Count, Liver Profile, Kidney Panel, Thyroid Panel, Lipid Profile, Bone and Minerals, Fluids & Electrolytes and Diabetes, costs over $500.  DirectLabs provides direct access to major clinical labs across the USA for these important blood tests one time annually at no charge for each enrolled member and the member’s spouse, if enrolled.

New York residents: a kit will be sent to you with location choices for blood draw, instructions for the phlebotomist on handling the specimen, and an overnight package. Extra fees apply

 

This benefit is NOT available in New Jersey or  Rhode Island.

Comprehensive Wellness Exam (CWP™) with 50+ results includes CBC's, lipids, kidney, liver, glucose, electrolytes, bones, minerals, and more.

This benefit is not available until the 61st day following effective date.


 

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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.

This benefit will save you time and money that might otherwise have been spent in a physician's waiting room or office. With this service, you can use a toll-free number that connects you with a nurse and ultimately with a physician, who will discuss symptoms with you and where allowed by law, may write a prescription for non-narcotic or non controlled medications at any time day or night.

Click here to download the CallMD Medical History Application.

 

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Optum® NurseLine

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

As a USA+ member, receive easy access to a team of registered nurses, 24 hours a day - at no additional cost.

This toll free access provides a valuable resource that can help you make decisions when faced with health related challenges.

How it works:
Call the toll free number at 1-866-850-6215 for immediate access to a registered nurse who can address your concerns. Refer to your member's handbook for additional information in accessing the Audio Library. You may also access additional information through the Health Forums site Audio messages and interactive internet forums give you additional access to a wealth of reliable health and well-being information. www.healthforums.com

Listening to Audio Messages - Optum gives you another convenient way to access health information. Simply call the same toll-free number to listen to the Health Information Library's recorded messages on a wide variety of health and well-being issues. A sample of the more than 1,100 topics is available. Ask a Optum nurse about additional topics.

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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.

You and your doctor have access to the medical guidance of over 50,000 of the leading medical specialists in over 400 subspecialties of medicine. This benefit provides you with the following services:

InterConsultation™ — a high level second opinion, to confirm diagnosis and treatment.

FindBestDoc™ — assistance in locating doctors in your area that have been identified as ‘best’ by their peers to treat specific medical conditions.

FindBestCare® — arranging access to hospitals and treatment.

Best Doctors, Information when it matters most, the Best Doctors Logo, FindBestDoc, Interconsultation, and FindBestCare are trademarks or registered trademarks of Best Doctors, Inc. in the U.S. and other countries, and are used under license.

How it works:
Simply call 1-888-362-8677 and a Best Doctors Personal Advocate will help you receive the information needed to get the right treatment the first time.

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MyHealthCompass™

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

The most comprehensive consumer health information tool available. With MyHealthCompass™, you'll have access to detailed information about healthcare providers, and be better equipped to make healthcare decisions. As a member of MyHealthCompass, you'll benefit from:

  • Quality ratings for hospitals and medical procedures
     
  • Pricing information for medical procedures
     
  • Detailed profiles on doctors and hospitals
     
  • Additional intelligence assures smart choices: disease-specific data; links to leading-edge research, including clinical trials; tips on asking providers the right questions; and glossary of medical terms

Login here to access your benefit

How it works:To obtain information and compare the performance of medical providers, go online and follow the prompts or should you have any questions, feel free to contact USA+ Member Services at 1-800-872-1187.

 

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My eWellness

Internet comprehensive health resource that helps individuals nutrition, weight-loss, exercise and disease prevention goals.

My eWellness.com is a comprehensive health resource that helps individuals achieve their personal goals.

  • Simple to follow workout plans with muscle maps, descriptions and animations to assist you with your exercises
  • Daily health tips on nutrition, weight-loss, exercise and disease prevention
  • Access to over 4,500 current health and wellness related articles and links to hundreds of additional wellness resources
  • Health calculators that enable you to easily track and assess your progress

Click here to get started

 

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Dignity Memorial Funeral Services

A nationwide network of funeral, cremation and cemetery service providers.

Dignity Memorial is a nationwide network of over 1,800 funeral, cremation, and cemetery service providers who deliver exceptional standards of care at affordable prices.

  • 10% savings on funeral or cremation services1
  • Funeral Protection Certificate for children and grandchildren worth up to $2,5002
  • Family Planning Guide
  • Access to an extensive Grief Management Library
  • Funeral and cremation preplanning services
  • Substantial savings on bereavement airfares
  • Extended family coverage
  • A 10% savings on cemetery interment rights, services and merchandise through Dignity Memorial plans1

How it works
To locate the Dignity Memorial provider nearest you, call 1-800-495-1230. Provide your zip code and identify yourself as a USA+ Member. When visiting your local Dignity Memorial provider to arrange services or to preplan your wishes, just present your USA+ membership card to the funeral service professional you are working with.

1Where available by law. 10% savings does not apply to cash advance items or already discounted Dignity Memorial plans. Not available in Louisiana and may not be available in New York.

2Not available to Maryland residents. This offer cannot be used in conjuction with any other affinity group offers, discounts, saving certificates or promotional programs. This offer is subject to change and may not be available at certain locations.

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Non-Insured Benefits – Protection

Benefits Protector

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

How you Benefit
Many individuals lose their job due to a company re-location, company downsizing or as the result of natural disasters. For most individuals, loss of employment also means a monetary loss. 

The Benefits Protector program helps cushion the impact of economic downturns that occur. Should you lose your job through no fault of your own, we will be there for you. Your membership dues will be waived and your membership benefits will continue for three (3) months. (Certain Terms and Conditions Apply. Please refer to your Membership Handbook for complete details.) 

How to Use Your Benefit
1. Notify USA+ within 20 days of the loss of employment. Notice must be submitted to
     USA+ at the following address: 

P O Box 200905
Arlington, Texas 76006-0905

 2. Upon receipt of your written request, USA+ will send you a Benefits Requests
     application to complete and return to USA+. 

3. When the completed form is received, USA+ will contact your former employer and
     validate the reason for separation. 

4. If the employer confirms that the loss of employment was not the result of misconduct
     connected with your work and you did not voluntarily quit, you will receive a letter from
     USA+ confirming the continuation of your USA+ membership. 

5. If the employer is not able to confirm your loss of employment, you will receive a letter
     from USA+ stating that we are unable to continue your USA+ membership.

 

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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.

Texas Plan
  • Secure Advantage
  • Secure Advantage USA+
  • Essential Health
  • Life Protector
  • Silver Life 10
  • Gold Life 10
  • Platinum Life 20
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Enrollment Options

Type: Individual
Monthly Price: $295.00
Setup Fee: $100.00

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Type: Member/Spouse
Monthly Price: $565.00
Setup Fee: $100.00

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Type: Member/Child
Monthly Price: $545.00
Setup Fee: $100.00

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Type: Family
Monthly Price: $750.00
Setup Fee: $100.00

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