FAQs about the Limited Indemnity Plan

Q.   Is this a traditional "major medical plan?"
A.   No. The Plan is not a major medical plan; coverage is more defined. The Plan is an “Indemnity” plan which means that the benefit dollar amounts shown in the Sample Schedule of Benefits for each medical service is the amount one would be reimbursed for the service when used. This Plan is a relatively new insurance product that fills a real need.

Q.   Have Limited Indemnity Plans been around for a long time?
A.   No. In its present form what is known as a Limited Indemnity Plan is a relatively new insurance product that is getting rave reviews.

Q.   Why offer a Limited Indemnity Plan?
A.   This Plan has been created for those who do not have medical insurance because of its high cost or due to their part-time, seasonal or 1099 work status.

Q.   Are there medical exams or deductibles?
A.   There are no medical exam requirements and no deductibles, one is reimbursed from the first dollar of expenditure. However, if the Plan you choose provides an Excess Accident Expense Plan Benefit, there is a $100 deductible and this benefit pays in excess of all valid and collectable insurance.

Q.   Can a member use any hospital or doctor?
A.   Yes, but we offer a provider network under the discount benefits for additional savings.

Q.   Who is eligible for coverage?
A.   To be eligible one must be 18 - 64 years of age.

Q.   What happens when one becomes 65 years old?
A.   In this case the Plan coverage ceases because the Plan member can be covered by Medicare.

Q.   Who are eligible dependents?
A.   If a Plan member is married, then his/her spouse is covered (up to age 65), as well as full-time students up to age 25 and children up to age 18.

Q.   Your Plan allows for multiple visits to the doctor annually. If I enroll a family of four, how does this work?
A.   The Plan allows EACH COVERED PERSON to visit the doctor during his/her contract year the number of times shown by the various options in the Schedule of Benefits chart. Members can be enrolled only once. Duplicate or multiple memberships are not allowed.

Q.   Are pre-existing conditions covered?
A.   There is no pre-existing condition requirement as long as there is some form of medical insurance presently in place at the time of enrollment; otherwise, there is a twelve month waiting period for pre-existing condition coverage applicable only to hospital, surgery and anesthesia. All plans require a 12/12 pre-existing exclusion regardless of prior coverage.

Q.   Are the Discount Healthcare and Consumer Programs insurance benefits?
A.   No. All “discount” programs are not insurance, each is a discount program.

Q.   If I enroll and wish to cancel, how do I do so?
A.   Refer to our cancellation policy which can be found in our Terms/Conditions/Cancellations policy on our web site's home page.