FirstChoice. Doctor Visits Hospital Stays. Maternity Benefits. Supplemental Health Insurance Made Affordable. Surgical Benefits.
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- Virginia Robinson
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1 A Limited Doctor Visits Hospital Stays *Preventive Care Surgical Benefits Maternity Benefits Accident Benefits
2 7 Reasons why is the best choice First Dollar Coverage at an Affordable Cost No deductible, No copays, No coinsurance, No enrollment or application fees No Ineligible Conditions or Occupations As long as the primary applicant works an average of 30 or more hours per week, the policy will be issued, regardless of your occupation or health conditions. There is a one year pre-existing condition limitation that will conclude on your first policy anniversary. Visit any Doctor or Hospital Visit any Doctor, any Hospital. is an any Doctor, any Hospital plan. Our Defined Benefit plan pays the same benefit whether or not you choose to utilize any PPO network. Strong Surgical Schedule uses a rich surgical schedule, not the Medicare surgical reimbursement (RBRVS). Also, whatever amount we pay your surgeon, we ll pay an additional 25% of that amount to the anesthesiologist. PPO Repricing through Beechstreet Network PPO repricing/discounting through the Beechstreet network. If you should choose to use the Beechstreet nationwide network of Doctors/Hospitals, you ll save on your covered medical expenses because these providers will reduce the amount that they charge for their covered medical service(s). The Beechstreet network is provided at no cost to our Platinum and Gold policy holders. Guaranteed Issue Primary applicants ages who work an average of 30 or more hours per week are eligible for the health plans. It is not required that the dependents work, nor that the insured(s) maintain employment after policy issue. Guaranteed Renewable We CAN T cancel policy holders coverage. Once issued, the plan is yours until the first renewal after age 65, unless you cancel us or decide to stop paying your premiums. After age 65, if the primary insured maintains full-time employment, the policy can be renewed every year until attained age 70.
3 The Platinum Plan Daily Room Benefit...$500 Per day up to 365 days Indemnity Benefit...$1,000 Pays upon first visit hospital confinement each year. Rider (CUL-HRLS). First Hospital Confinement Benefit (6 days)...$10,000 Pays upon first hospital confinement each year per insured. Rider (CUL-HRFHC). Doctor Office Sick Visits - $100 per visit 4 visits per year for insured and 4 visits for spouse. A max of 4 visits per year shared between all children. Rider (CUL-HROS) ER/Urgent Care/Doctors Office - Accident Benefit - $200 per Accident 4 visits per year each adult and a max of 4 visits per year for all children. Rider (CUL-HREA) Specified Injury Benefit - pays $25-$2,000 Depending on the injury. See rider for specific amounts. Rider (CUL-HRSI). Not in GA/NC Wellness for Women - $400 Mammogram & $100 Pap Smear 1 mammogram and 1 pap smear per year. Rider (CUL-HRSUR+). Not in PA. Maternity Benefits - covered as any other condition Begins 10 months after effective date for hospital & delivery costs, not pre or post natal expenses. Rider (CUL-HR- SUR+). Or PA Rider (CUL-HRSUR). Surgery Benefit - up to $10,000 per surgery Inpatient/Outpatient Unlimited medically necessary covered surgeries. Amounts vary based on the complexity of the surgery, and are a percentage of the surgical max. See surgical schedule. Rider (CUL-HRSUR+). Or PA Rider (CUL-HRSUR). Anesthesia Benefit 25% of Surgical Benefit paid. Maximum of $2,500. Rider (CUL-HRSUR+) or PA Rider (CUL-HRSUR). Intensive Care Unit - $2,000 per day This is paid in addidtion to the daily room benefit. Max $40,000 & 20 days per confinement. Rider (CUL-HRICU). Private Duty Nurse Benefit - $250 per day Up to $7,500 per confinement. Max 30 days per confinement. Rider (CUL-HRPN). In-Hospital Injury Indemnity - $200 per day Up to $73,000 per confinement. Max 365 days per confinement. Rider (CUL-HRHI). Not in GA. Accidental Dealth & Dismemberment - $30,000 Max benefit for primary insured. Lesser amounts for spouse and children if insured. Rider (CUL-HRADD). $ $ $ Consult the policy for full description of coverage details, limitations and exclusions. $ Example: These three benefits would pay $14,000 for your first six days in the hospital. Days 1, 3, 4, 5 & 6 $2,500 per day Day 2-$1,500 Then, days pay $500 per day. $193,500 Total Annual Max Visit Any Doctor Any Hospital No Deductible No Copays!
4 The Gold Plan Daily Room Benefit...$400 Per day up to 365 days Indemnity Benefit...$700 Pays upon first visit hospital confinement each year. Rider (CUL-HRLS). First Hospital Confinement Benefit (6 days)...$10,000 Pays upon first hospital confinement each year per insured. Rider (CUL-HRFHC). Example: These three benefits would pay $13,100 for your first six days in the hospital. $2,100 Day 1, $1,400 Day 2 $2,400 Days 3-6 Then, days pay $400 per day. $156, 700 Total Annual Max Doctor Office Sick Visits - $75 per visit 4 visits per year for insured and 4 visits for spouse. A max of 4 visits per year shared between all children. Rider (CUL-HROS) ER/Urgent Care/Doctors Office-Accident Benefit - $150 per Accident 4 visits per year each adult and a max of 4 visits per year for all children. Rider (CUL-HREA) Specified Injury Benefit - pays $25-$2,000 Depending on the injury. See rider for specific amounts. Rider (CUL-HRSI). Not in GA/NC Wellness for Women - $200 Mammogram & $50 Pap Smear 1 mammogram and 1 pap smear per year. Rider (CUL-HRSUR+). Not in PA. Maternity Benefits - covered as any other condition Begins 10 months after effective date for hospital & delivery costs, not pre or post natal expenses. Rider (CUL-HR- SUR+). Or PA Rider (CUL-HRSUR). Surgery Benefit - up to $5,000 per surgery Inpatient/Outpatient Unlimited medically necessary covered surgeries. Amounts vary based on the complexity of the surgery, and are a percentage of the surgical max. See surgical schedule. Rider (CUL-HRSUR+). Or PA Rider (CUL-HRSUR). Anesthesia Benefit 25% of Surgical Benefit paid. Maximum of $1,250. Rider (CUL-HRSUR+). Or PA Rider (CUL-HRSUR). Intensive Care Unit - $1,000 per day This is paid in addidtion to the daily room benefit. Max $20,000 & 20 days per confinement. Rider (CUL-HRICU). Private Duty Nurse Benefit - $150 per day Up to $4,500 per confinement. Max 30 days per confinement. Rider (CUL-HRPN). In-Hospital Injury Indemnity - $150 per day Up to $54,750 per confinement. Max 365 days per confinement. Rider (CUL-HRHI). Not in GA. Accidental Dealth & Dismemberment - $20,000 Max benefit for primary insured. Lesser amounts for spouse and children if insured. Rider (CUL-HRADD). $ $ $ $ Visit Any Doctor Any Hospital No Deductible No Copays!
5 The Traditional Supplement Daily Room Benefit...$100 Per day up to 365 days Indemnity Benefit...$500 Pays upon first visit hospital confinement each year. Rider (CUL-HRLS). First Hospital Confinement Benefit (6 days)...$5,000 Pays upon first hospital confinement each year per insured. Rider (CUL-HRFHC). Example: These three benefits would pay $6,100 for your first six days in the hospital. Days 1, 3, 4, 5 & 6 $1,100 per Day Day 2-$600 Then, days pay $100 per day. $42,000 Total Annual Max Doctor Office Sick Visits - $25 per visit 4 visits per year for insured and 4 visits for spouse. A max of 4 visits per year shared between all children. Rider (CUL-HROS) ER/Urgent Care/Doctors Office-Accident Benefit - $100 per Accident 4 visits per year each adult and a max of 4 visits per year for all children. Rider (CUL-HREA) Specified Injury Benefit - pays $25-$2,000 Depending on the injury. See rider for specific ammounts. Rider (CUL-HRSI). Not in GA/NC Wellness for Women - $200 Mammogram & $50 Pap Smear 1 mammogram and 1 pap smear per year. Rider (CUL-HRSUR+). Not in PA. Maternity Benefits - covered as any other condition Begins 10 months after effective date for hospital & delivery costs, not pre or post natal expenses. Rider (CUL-HR- SUR+). Or PA Rider (CUL-HRSUR). Surgery Benefit - up to $5,000 per surgery Inpatient/Outpatient Unlimited medically necessary covered surgeries. Amounts vary based on the complexity of the surgery, and are a percentage of the surgical max. See surgical schedule. Rider (CUL-HRSUR+). Or PA Rider (CUL-HRSUR). Anesthesia Benefit 25% of Surgical Benefit paid. Maximum of $1,250. Rider (CUL-HRSUR+). Or PA Rider (CUL-HRSUR). Private Duty Nurse Benefit - $200 per day Up to $6,000 per confinement. Max 30 days per confinement. Rider (CUL-HRPN). $72.19 $ $ $ Consult the policy for full description of coverage details, limitations and exclusions. Visit Any Doctor Any Hospital No Deductible No Copays!
6 The BMC Super Supp Daily Room Benefit...$100 Per day up to 365 days Indemnity Benefit...$500 Pays upon first visit hospital confinement each year. Rider (CUL-HRLS). First Hospital Confinement Benefit (6 days)...$5,000 Pays upon first hospital confinement each year per insured. Rider (CUL-HRFHC). Example: These three benefits would pay $6,100 for your first six days in the hospital. Days 1, 3, 4, 5 & 6 $1,100 per Day Day 2-$600 Then, days pay $100 per day. $42,000 Total Annual Max ER/Urgent Care/Doctors Office - Accident Benefit - $200 per Accident 4 visits per year each adult and a max of 4 visits per year for all children. Rider (CUL-HREA) Specified Injury Benefit - pays $25-$2,000 Depending on the injury. See rider for specific ammounts. Rider (CUL-HRSI). Not in GA/NC $42.68 $83.61 $66.46 $ Consult the policy for full description of coverage details, limitations and exclusions. Visit Any Doctor Any Hospital No Deductible No Copays!
7 LIMITATIONS AND EXCLUSIONS The policy (including any Rider(s) attached does not pay Benefits for conditions caused by or resulting from: a. treatment of alcoholism or drug addiction; or b. except in OK, being legally intoxicated or being under the influence of any drug unless prescribed by a Physician; or c. attempted suicide while sane or insane or willful and intentional self-inflicted injury; or d. being exposed to war or any act of war, declared or undeclared or while serving in the armed forces (in OK, being exposed to does not apply); or e. engaged in an illegal activity; or f. Dental Treatment or plastic surgery for cosmetic purposes. This exclusion does not apply if the treatment or surgery is: (1) due to an Injury; or (2) to restore normal bodily functions; or g. care that is primarily for rest, convalescence or rehabilitation; or h. treatment of Mental or Nervous Disorders without demonstrable organic disease; or i. treatment which is rendered outside the United States, its possessions, or Canada, except for emergency care for acute onset of Sickness or Injury sustatined while traveling for business or pleasure; or j. any Pre-Existing Conditions as defined in the Policy; or k. conditions specifically excluded by amendment or endorsement. The Policy (including any Rider(s) attached) does not pay any Daily Benefit amount(s) if there is no Hospital room and board charge. PRE-EXISTING CONDITIONS The Policy and any attached Rider(s) do not cover Pre-Existing Conditions whether disclosed in the application or not, for the first 12 months (in TX, 6 months for an Insured who is age 65 or older on the Policy Effective Date) beginning on the date that person becomes an insured on the Policy or Rider. By Pre-Existing Conditions, we mean those conditions for which medical advice or treatment was received or recommended or that could be medically documented within a 12-month period immediately preceding the Policy Effective Date. Conditions specifically named or described as excluded in any part of this Policy are never covered. TERMINATION All coverage under this Policy and any attached Rider(s) shall terminate when this Policy ceases to be in force. The Policy will end on the earlier of: a. when you fail to pay premiums within your grace period; or b. when you die; or c. the policy anniversary date you no longer meet the renewal condition as defined on the cover of the Policy; or d. the date you notify us in writing to end this Policy. Coverage for Insured Dependent will end on the date such Insured ceases to be an Eligible Dependent Child or Eligible Spouse as defined in this Policy. When such Insured s insurance ends, we will: a. retund any premium accepted for the period the insured ceases to be an Eligible Dependent Child or Eligible Spouse; and b. consider any claim that began before the insurance ended; and c. allow a conversion policy for an Eligible Dependent Child or Eligible Spouse, as set forth in the Conversion Privilege. 30 DAY RIGHT TO EXAMINE POLICY You have thirty (30) days to examine the policy. If you are not satisfied, you may return it to us and have your premiums refunded. Policy Form Numbers: Rider Form Numbers: CUL-HPH12010, CUL-HPH K, CUL-HPH12010-TX (including state variations) CUL-HRICU, CUL-HRLS, CUL-HRFHC, CUL-HRFHC-TX, CUL-HRHI, CUL-HRHI-TX, CUL-HRSUR+, CUL-HRSUR CUL-HRPN, CUL-HRADD, CUL-HRSI-OK, CUL-HREA, CUL-HROS (including state variations). Benefit exclusions and limitations apply to the policy. For costs or complete details of coverage, contact your agent of the company. Central United Life Insurance Company Houston, TX
8 The Platinum Plan Georgia Pennsylvania N. Carolina Colorado & S. Dakota $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ The Gold Plan Georgia Pennsylvania N. Carolina Colorado & S. Dakota $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ The Traditional Supplement Georgia Pennsylvania N. Carolina Colorado & S. Dakota $72.19 $68.69 $61.19 $68.69 $66.26 $ $ $ $ $ $ $ $ $ $ The BMC Super Supp Georgia Pennsylvania N. Carolina Colorado & S. Dakota $42.68 $39.18 $42.68 $39.18 $38.96 $83.61 $78.36 $83.61 $78.36 $76.32 $66.46 $61.21 $66.46 $61.21 $60.74 $ $ $ $ $ $ $ $ $ $98.10
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