Our experience indicates that members who understand their plans retain them longer. With a good understanding of each benefit you’ll be able to maximize value while minimizing your out-of-pocket costs.
Something as common as a broken leg or bad strain of the flu virus can easily land you in the hospital. The indemnity benefit for a hospital stay with a Core Health plan ranges from $250 to $1,500 per day, depending on the chosen plan. The richest plan, Platinum, pays a benefit amount of $3,000 per day for stays in an Intensive Care Unit (ICU) or Critical Care Unit (CCU). The hospital benefit is limited to a 31-day maximum per person on the plan, per plan year. Of those 31-days, 15 days can be used in the ICU/CCU.
It is important to keep in mind that there is a 12-month pre-existing condition exclusion for the Hospital benefits of the Core Health plans. This means that for the first 12-months from your plans effective date, any hospital confinement related to a pre-existing condition would be excluded. A pre-existing condition is something that you were treated for, consulted a medical practitioner for, or were prescribed medication for, in the 12-months prior to your plans effective date.
As with all Core Health benefits, the Hospital benefit provides first-dollar coverage with no deductible or co-insurance. The benefit amount will pay in-full for each eligible day of hospital confinement. This means that if the provider bill is less than the plan benefit amount, Core Health Insurance will pay the remaining benefit balance directly to the member. And as always, you can see any provider (physician or hospital) of your choice. If you see a provider in the Beech Street PPO Network you’re eligible for additional savings of up to 40%. Help ease the cost of unexpected hospital stays with the valuable benefits of a Core Health plan.
To learn more about the benefits of your plan, contact InsuranceTPA.com at 800-279-2290. InsuranceTPA.com is the plan administrator for Core Health Insurance. Already a member? Login to your account here.