1 / 19

Med Max tm Health Insurance

Med Max tm Health Insurance. The Solution. Med Max tm. The Health Insurance Crisis 2000 the first round of mini-meds For groups only 2002 followed with the individual mini-meds Very limited individual coverage We conducted our own study with these results:

venus
Download Presentation

Med Max tm Health Insurance

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. MedMaxtmHealth Insurance The Solution

  2. Med Maxtm • The Health Insurance Crisis • 2000 the first round of mini-meds • For groups only • 2002 followed with the individual mini-meds • Very limited individual coverage • We conducted our own study with these results: • Benefits are too limited and don’t provide sufficient coverage • Premiums are affordable but do not offer adequate protection • Eligibility requirements are too restrictive relative to the risk • Lack of Flexibility – product design not addressing the real need with a very narrow range of features and options • Accessibility – not available to both individuals and groups The Solution

  3. Med Maxtm • The Solution is Med+Max Health Insurance designed for: • The uninsured • 2006 Census Bureau revealed that between 2000 and 2005 the number of uninsured had an unprecedented increase of 6.8 million from 39.8 to 46.6 million • The underinsured • Group plans reduction in benefits, increased contributions, deductibles and co-pays results in underinsurance • This plan is not comprehensive major medical insurance but it can increase employee loyalty and reduce turnover The Solution

  4. Med Maxtm • Why should I sell it? • Provides basic benefits or supplemental coverage • Fills the gaps created by deductibles and co-payments AFORDABLE Our plans are the answer to the high cost of, and the lack of access to, traditional plans ACCESSIBLE Benefits available on a voluntary basis FLEXIBLE Three health plans with dental benefits, critical illness, accident medical and optional prescription plan The Solution

  5. Med Maxtm • Advantages of Med+Max Health Insurance Coverage • Instant approval – No medical questions or physical exams to qualify • Guaranteed issue to individuals or small groups • Guaranteed renewable • Any doctor or choose one from our MultiPlan network • Assignable benefits • Stable affordable rates • First dollar coverage (no deductibles, no co-pays) • Portable, HIPPA compliant – “Creditable Coverage” • Fully insured by top rated carriers • Same rates in all states • Available in 50 states • No waiting periods • No prohibited industries • Voluntary • No minimum contributions • No minimum participation The Solution

  6. Med Maxtm • Med+Max Health Insurance Benefits • High Hospital & Surgical Benefit • Daily Hospital Benefit up to $1,000 and 100 Days Annually • ICU Benefit up to $1,000 per day, up to 5 Days Annually • Surgeon’s Charges (in patient and out-patient) up to 100% of Medicare/RBRVS per Surgery • Anesthesia Benefit up to 20% of Surgeon’s Benefit • Maternity Benefit • Critical Illness Benefit up to $10000 • Up to $75 per Doctor’s Office Visit, 5 Annually • Up to $150 for Preventive Care • Up to $150 for Lab & X-ray • Dental • Up to $5,000 Accident Medical • Life Insurance Two additional options for: • Dependant Critical Illness • Rx Plan The Solution

  7. Med Maxtm • Medical Care The Solution

  8. Med Maxtm • Hospitalization The Solution

  9. Med Maxtm • Dental The Solution

  10. Med Maxtm • Critical Illness The Solution

  11. Med Maxtm • Accident The Solution

  12. Med Maxtm • Life The Solution

  13. Med Maxtm • RX Plan The Solution

  14. Med Maxtm The Solution

  15. Med Maxtm The Solution

  16. Med Maxtm The Solution

  17. Med Maxtm • FAQS • WHEN SHOULD I ENROLL MY DEPENDENTS? • Eligible dependents must be enrolled within 31 days of the date the dependent becomes eligible (enrollment date • of Member, birth or adoption). • WHAT ARE THE MEDICAL UNDERWRITING REQUIREMENTS? • The Med+Max Insurance policy is a group policy. As a member of the Association (CPAI), you may be • eligible to enroll in the plan. All individual and family members of the Association who satisfy the eligibility • requirements listed above are automatically accepted. • WHERE IS THE PLAN AVAILABLE? • THE PLAN IS AVAILABLE IN ALL 50 STATES. • HOW DO I PAY FOR MY COVERAGE? • Monthly billings will be sent to the insured. A modal billing fee of $10.00 will be reflected on each Monthly bill. • Alternatively, monthly premiums may be charged to the insured’s Bank account (EFT=electronic funds transfer). • There is no modal administrative fee charged for this method of payment. • WHEN DOES COVERAGE BEGIN? • Eligible Members will be effective on the first day of the month following approval of the application and receipt of • the first premium. Coverage is not effective on the date of the application. The effective date for the dependent of • an enrolled Member will be the same as the Member’s (unless the Member adds additional dependent coverage • at a later time). Only first of the month starts are available The Solution

  18. Med Maxtm • WHEN DOES COVERAGE END? • An insured Member’s coverage ends when the Member is no longer eligible, premiums are discontinued • (subject to the grace period), when the policy terminates, Member reaches age 70, or when the Member • is no longer in good standing with Association (CPAI), whichever occurs first. Coverage on a dependent • ends on the earliest date they no longer meet the definition of an eligible dependent or on the date the • Member’s coverage terminates, whichever occurs first. • WHO FILES THE CLAIMS UNDER MY COVERAGE?You are responsible for paying the provider at the time of service (or, if the provider allows, upon receipt of the bill). You then file a claim form (at least one per year) and your bill(s) with claims administrator, Triad Benefits administrator. Your claim will be processed and benefits payable are sent directly to you. Instructions for filing a claim are provided on your member ID card. • CAN MEMBERS USE ANY DOCTOR, CLINIC OR HOSPITAL?Yes. Covered members and dependents can use any licensed medical provider. OR to take advantage of the network pricing use the Multi Plan Network (over 500,000 providers in 50 states). To select a provider go to “Providers Link” in our website or call the number in your ID card for customer assistance. • ARE PRE-EXISTING CONDITIONS COVERED?Benefits under the Hospitalization or Surgery provisions of the plan are not payable for a “pre-existing condition” for the first 12 months following an insured’s effective date. If an insured has a HIPPA certificate they will be given credit for credible coverage for the total amount of months shown on the certificate.WHAT IS A PRE-EXISTING CONDITION?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 which would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment. The Solution

  19. Med Maxtm The Solution

More Related