Assurant Health – Basic Plans


Assurant Health - Basic Plans
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RightStart Plan, SaveRight Plan – Plan Benefits

Plan FeatureRightStartSM PlanSaveRightSM HSA Plan
Plan DesignUnless otherwise noted, all deductibles, maximums and benefit amounts are applied per person and are reset each January 1.
Individual Deductible
Amount you pay toward covered expenses before the plan pays benefits
$500, $1,000 or $2,500$2,000, $3,000 or $5,100
Family DeductibleFamily deductible maximum is three times the individual deductible and is met collectively by three or more persons.Family deductible maximum is two times the individual deductible and is met collectively by two or more persons.
Benefit Percentage
Percentage of covered expenses the plan pays after the deductible is met
75% or 50%100%, 75%, or 50%
Coinsurance
Percentage of covered expenses you pay after the deductible is met
25% or 50%0%, 25% or 50%
Coinsurance Out-of-Pocket Maximum*
After this maximum is met, the plan pays 100% of covered expenses
$2,000 with the 50% coinsurance plan
$3,000 with the 25% coinsurance plan
$0 to $3,000 depending on coinsurance
Outpatient Services Maximum
The annual maximum amount the plan pays toward outpatient services
$2,500, $5,000 or $10,000 (All outpatient benefits are subject to this maximum.)$15,000 or $25,000 (All outpatient benefits are subject to this maximum.)
Annual Maximum
The total annual maximum amount the plan pays
$50,000, $100,000 or $250,000 (All benefits are subject to this maximum.)No Maximum>/b> – the plan pays inpatient benefits up to the lifetime benefit maximum.
Lifetime Benefit Maximum
The total maximum amount the plan pays
$2 million$2 million
Outpatient BenefitsBenefits are subject to deductible and coinsurance unless otherwise noted.
Prescription Drugs – Generic$15 copay (no deductible)
– $2,000 maximum for brand and generic combined
– Buy-up option: annual maximum amount for brand and generic combined
Covered (subject to deductible and coinsurance)
– $2,000 maximum for brand and generic combined
– Buy-up option: lifetime maximum amount for brand and generic combined
Prescription Drugs – Brand name$500 deductible / $25 copay + 50% coinsurance (Family deductible maximum is $1,000 and is met collectively by two or more persons)
– $2,000 maximum for brand and generic combined
– Buy-up option: annual maximum amount for brand and generic combined
Covered (subject to deductible and coinsurance)
– $2,000 maximum for brand and generic combined
– Buy-up option: lifetime maximum amount for brand and generic combined
Preventive Services
Mammograms, Pap smears and PSA screening
Covered after you have been insured for 12 months.Covered after you have been insured for 12 months.
Other preventive services, office visits and immunizationsUp to $500 in benefits — after you have been insured for 12 months.
– Copay, if selected, applies to office visits and immunizations
Covered after you have been insured for 12 months
Office VisitsCoveredCovered
Office Visit Copay
Optional benefit
$25 copay for each of two network office visit per person
– Visits for illness, injury and (after 12 months) preventive services are eligible
– Additional visits are covered subject to deductible and coinsurance
Not available
Diagnostic Imaging and Laboratory ServicesCoveredCovered
Outpatient Hospital, Surgical Center or Urgent Care FacilityCoveredCovered
– Outpatient facility fee: $0 or $200 per outpatient surgery.
Professional Ground and Air AmbulanceUp to $1,000 for one tripUp to $1,000 for one trip
Emergency RoomCovered
– $75 emergency room fee — waived if admitted to the hospital.
Covered
– $75 emergency room fee — waived if admitted to the hospital.
Health Care Practitioner ServicesCoveredCovered
Outpatient Physical Medicine$50 per visit for up to two visits
– Chiropractic not covered
$50 per visit for up to two visits
– Chiropractic not covered
Home Health CareNot coveredNot covered
Inpatient BenefitsBenefits are subject to deductible and coinsurance unless otherwise noted.
Inpatient HospitalCoveredCovered
Inpatient Rehabilitation Facility$100 per day for up to 50 days$100 per day for up to 50 days
Subacute Rehabilitation and Skilled Nursing FacilitiesUp to 30 daysUp to 30 days
TransplantsCoveredCovered
Behavioral Health and Substance AbuseNot coveredNot covered
Optional FeaturesOptional features are available at an additional cost.
Optional Benefits and Discount Programs
Discount programs are not insurance
SuiteSolutions, Office Visit Copay, Accident Medical Expense and Dental/Vision Discount CardSuiteSolutions, Accident Medical Expense and Dental/Vision Discount Card
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