A fixed benefit medical plan is unique in that you can choose any doctor in the MultiPlan Nationwide PPO, and can also self-refer to a specialist. You do not need to have any dedicated primary care physician.
Increases in major medical deductibles have led many people to seek alternative options to help cover their medical costs. Fixed benefit plans have been growing in popularity and may be just what you have been looking for to help offset their healthcare expenditures! Benefits of UnitedHealthOne co-branded Core Access fixed benefit hospital and surgical plans include:
- MultiPlan PPO Nationwide Network. Clients have the flexibility to choose any doctor or provider in the United States. Additional cost savings are available when your clients choose a provider who is part of the MultiPlan national network, but network providers are not required to receive benefits.
- Deductible choices to help lower premium. Core Access deductible options range from $0 to $5,000. By choosing a deductible greater than $0 your clients are agreeing to a reduction of benefits paid in exchange for a lower premium.
- Benefits available immediately, including preventative care, without a deductible. Preventive care is covered based with no waiting period for the selected benefit amount on all 4 Core Access plans and includes: routine physical examinations, including diagnostic tests, Pap smears, mammograms, immunizations, and prostate/ colorectal cancer screening.
- Maternity benefits. Maternity benefits are available on Core Access Value 2 and Core Access Premier 2 after a 12 month waiting period, before the onset of pregnancy.
- No coordination of benefits. Core Access plans do not coordinate benefits with other health insurance plans, so there is no waiting for benefits to be paid.
- Historically, no rate increases. Since inception of the product, there have been no increases in premiums for in-force business.
- Unlimited benefits for hospital confinements. All Core Access plans cover an unlimited number of hospital confinements.
- Pre-existing conditions covered after 12 months. Covered benefits for pre-existing conditions are payable after the insured has been covered by the policy for 12 consecutive months.
- No lifetime benefit maximum.* Overall cash benefits are not capped for as long as the plan is in effect.
- Guaranteed renewable. Your clients and their families cannot be singled out for a rate increase or cancellation based solely on changes to their health.
Fixed Benefit Health Insurance Plans
Are you considering obtaining fixed benefit health insurance? If so, it’s important to understand what you’re getting yourself into! First of all, fixed benefit health insurance is a supplemental health plan. Under this type of plan, you receive a specific cash payout in the event that you become ill or experience a serious injury.
Here at Custom Health Plans, we can help you find the most affordable and effective fixed benefit health insurance plan for you and your family, or your small business.We’ve been providing affordable solutions for various communities in Texas for over 30 years!
If major medical insurance is not an option for you, it’s time to explore fixed benefit plans. This may ultimately be the best solution for you. Here at Custom Health Plans, we’re here to help you figure out what the best option is, according to your personalized needs and finances.
Fixed Benefit Medical Plans provide a set amount of benefit for covered events per day, regardless of the amount the provider charges. Unlike regular individual health insurance, there is no open enrollment period, and unlike short term insurance, there is no 90 day limit on coverage. A fixed benefit medical plan provides hospital and surgical insurance benefits for you and your family.
Texas Fixed Benefits Plans
Sometimes, a fixed benefit plan is the all-around best option for you, your family, or your small business. This type of plan is affordable supplemental insurance that pays fixed dollar benefits for your health care — this includes regular doctor’s visits, hospital stays, medications, and more. If you want coverage that supplements your existing health insurance, a fixed benefits plan may be the proper solution.
Here at Custom Health Plans, we’re here to help you navigate the tricky waters of the healthcare industry, including selecting the right kind of fixed benefit plan. We know firsthand how challenging it can be to understand all facets of healthcare — you shouldn’t have to become an expert in the industry, though. That’s what the pros are for! We’re here to gather all the best affordable health insurance quotes and help you make a truly informed decision about your health. We offer plan to families and individuals across Texas including Dallas, Fort Worth, Austin, Houston and El Paso!
A fixed benefit medical plan will provide a fixed benefit for each covered event, as seen on the table below:
|Benefit||Core Access Value Plan 2||Core Access Premier Plan 2|
|Inpatient Services||(per day)|
|Deductible Choices||$0, $1,000, $2,5001, or $5,0001||$0, $1,000, $2,500, or $5,000|
|Inpatient Hospital Confinement||$1,500 (unlimited)||$3,000 (unlimited)|
|Hospital Intensive Care Unit or Critical Care Unit||$2,500 (unlimited)||$4,500 (unlimited)|
|Inpatient Physician Visits||$60 (1 per day)||$80 (1 per day)|
|Inpatient Surgical Services||(per surgery)|
|Total Benefit for Inpatient Surgical Service||$2,000 (unlimited)||$6,000 (unlimited)|
|Outpatient Surgical Services||(per surgery)|
|Total Benefit for Outpatient Surgical Service||$2,200||$3,900|
|Facility||$700 (unlimited)||$1,200 (unlimited)|
1Deductible only available in the following states: AR, AZ, GA, IL, KY, MI, MO, MT, NE, OK, OR, PA, SC, TX, VA, WI, WY. Benefits listed are subject to the per injury or illness deductible, if applicable.
*A fixed-benefit hospital and surgical plan may not be right for everyone. Core Access is not major medical insurance; it provides a fixed-indemnity benefit after the deductible, if any, for covered medical expenses, including outpatient surgery, and chemotherapy and radiation services. Carefully designed plan benefits keep plan premiums affordable. It is very important you review the plan information closely. You may still be responsible for the ACA shared responsibility payment (tax).
|Benefit||Core Access Value Plan 2||Core Access Premier Plan 2|
|Additional Covered Services|
|Ambulance (per trip) Ground or water||$300 (1 per year)||$500 (1 per year)|
|Ambulance (per trip) Air||$1,000 (1 per year)||$2,000 (1 per year)|
|Second Surgical Opinion||$100 (unlimited)||$100 (unlimited)|
|Chemotherapy and Radiation||$600 (100 per lifetime)||$1,000 (100 per lifetime)|
|Maternity (Pregnancy)||$3,000 (per pregnancy, 1 per year)||$5,000 (per pregnancy, 1 per year)|
|Outpatient Prescription Drugs||$4 generic, $20 name brand, $50 Specialty (6 per year of each)||$4 generic, $20 name brand, $50 Specialty (6 per year of each)|
|Health Maintenance Benefits||(per covered person)|
|Wellness and Preventative Care||$200 (1 per year)||$200 (1 per year)|
|Outpatient Physician Office Visit or Retail Health Clinic||$60 (4 per year)||$60 (4 per year)|
|Outpatient Urgent Care or Emergency Room Visit||$100 (1 per year)||$300 (1 per year)|
|Outpatient Diagnostic Testing||(per covered person)|
|Outpatient Diagnostic X-ray and Lab||$100 (1 per year)||$100 (1 per year)|
|Outpatient Advanced Studies||$300 (1 per year)||$700 (1 per year)|
1Covered Person receives Outpatient diagnostic X-ray or Lab Tests or Outpatient Advanced Study tests within 30 days following an Inpatient confinement or Injury. Refer to page 7 for more information regarding the per injury or illness deductible.
* See product brochure; there is a lifetime treatment maximum for chemotherapy and radiation.
Contact Custom Health Plans Today
Do you have questions or concerns about fixed benefit health insurance? Don’t hesitate to get in touch with Custom Health Plans today! Our team of experienced healthcare professionals across Texas are always happy to assist you. We look forward to speaking with you and helping you find the best fixed benefit plan for your health. Call us at (877) 749-2241 or contact or brokers online!