Your plan comes with non-insurance benefits providing you with extra savings on services that help stretch your dollar.
When you Get A Quote, you will see a chart of benefits listing the discounts and savings that come with your plan.
Click on a question below to get an answer.
Health insurance is part of this plan, but the package consists of more than just that. Through a partnership with an association, AHP can offer these packages that include the limited benefit health insurance.
Yes. All of our limited benefit plans are offered through Associations as part of their mission to provide quality and relevant goods and services to their members. The Insurance Carrier issues a group policy to an Association; the Association can then offer coverage under that policy to its current and prospective members. The Association generally packages the limited benefit coverage along with other benefits and services (including other insurance policies, often at varying levels) in order to offer its membership an array of options. You may, of course, join the Association without selecting a membership level that contains an LB policy. Similarly, if you select a membership level that has an LB policy and want to terminate the policy, you can remain a member of the Association.
When you fill out the form and press “Get Quote” you will see our pricing page which will display which carrier will cover you. Our affordable pricing and availability is determined by the state in which you live. Not every carrier offers coverage in each state.
Yes. There is no restriction of doctors or hospitals under the group health insurance indemnity plan. However, you can reduce your out of pocket expenses by utilizing a provider in the PPO network.
There are over 500,000 doctors that are in the PPO network, so there is a strong chance your doctor is in the network. To check, go to www.pickclickcovered.com. At the bottom of the page there is a link that says “find doctors”: here you can enter your zip and search to see if your doctor is in the network. Whether you use a doctor in the network or out of the network, your insurance benefit will be the same. Again, when using a PPO provider you’re out of pocket expenses will be reduced.
You will receive your insurance cards and packet within 5-7 business days after your payment has been funded. Depending on when you signed up, your effective date will be listed on your ID card as well as stated to you during your enrollment. If you do not get your ID card by your assigned effective date, you may request an electronic version while we send you a new packet.
Yes.
To enroll, simply go to
www.pickclickcovered.com or call toll free 1-800-367-8501. Your enrollment will be complete upon your payment of a one-time enrollment fee plus the first month’s premium.
You can drop coverage at any time by notification in writing.
If your provider accepts assignment of benefits, the provider will file a claim for their services and will be paid the benefits as shown in the Schedule of Benefits.
- If the provider bill is less than the plan benefit, you will receive payment of the difference between your providers charge and what your insurance benefit is.
- When the providers charge exceeds the plan benefit, the provider will bill you directly for the balance after the plan benefits have been applied.
- If your provider does not accept assignment of benefits, you will be responsible for paying your health costs at the time of service and for filing a claim under the plan.
We do not cover Pre-Existing Conditions for the first twelve (12) months after coverage becomes effective. Pre-Existing Condition means a a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received from a physician within a 12 month period preceding the effective date of coverage of the Covered Person.
This insurance policy provides limited benefits; it is not major medical insurance . The extremely large medical bills associated with major crisis such as heart attack, extended hospital stays, or other long-term illnesses are generally considered catastrophic or major medical issues. For those types of concerns, we recommend a major medical or catastrophic coverage.
NO. This health insurance is considered a fixed indemnity limited benefit coverage and has a defined list of benefits (found on the pricing page when you get started). This is not meant to replace major medical. In fact, if you currently have that type of coverage and can continue to pay the major medical premium rates, we suggest you keep your major medical insurance policy. If you are looking for a more affordable alternative then we may be the answer for you.
Limited Benefit plans (also known as Limited Medical or Mini-Med plans) provide coverage that is generally less expensive than most Major Medical plans. Further, they are guarantee issue, which means the consumer cannot be turned down for coverage, unlike many Major Medical plans. In order to make these plans affordable and accessible, the benefit payouts are less than typical Major Medical plans, resulting in greater consumer out-of-pocket expenses. The term limited is used to help differentiate these types of plans from Major Medical coverage.
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996; among its provisions are protections afforded consumers when switching health insurance plans. The objective of this provision is to prevent consumers from losing coverage for preexisting conditions solely as a result of a change in their health insurance policy. Major Medical carriers are not allowed to enforce a preexisting condition on any new enrollees if they have creditable coverage just prior to enrolling. The definition of creditable coverage can be complicated, but the general rule of thumb is that plans that provide coverage on a covered expense basis - which means that the benefit payment varies based on the amount billed by the provider - are considered creditable. Major Medical and most employer-sponsored plans are considered creditable. Plans that are pure indemnity, which pay a flat amount regardless of covered expense, are generally not considered creditable. Most, but not all, of the plans offered by AHP are considered creditable because they contain plan design elements that qualify them as such. For these plans, should you decide to terminate your policy, you will receive a Certificate of Creditable Coverage to provide as evidence of your coverage for your new policy. For additional information you can refer to the following Web site:
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.htmlAHP limited benefit packages are not designed to coordinate with Medicare coverage. The federal government has regulated the types of plans that can be offered to Medicare beneficiaries and there are a great many insurance companies and agencies available that specialize in offering these plans that will be more suitable for you.
RBRVS stands for Resource-Based Relative Value Scale and it is the methodology used by the federal government to pay physicians for care rendered to consumers with Medicare. RBRVS varies by region but is generally well understood as a payment basis by the provider community. The payment is based on the address of the provider and the benefit covers the physician expense, not the facility. Some of AHP’s products use a surgical schedule which is based off RBRVS and usually pays each qualifying claim at some percentage of the schedule up to the aggregate annual dollar limit listed in your policy documents. Please note that the percentage listed in your benefit schedule is not coinsurance; you are responsible for reimbursing the provider for the difference between the insurance payment and the provider’s charges, or the discounted charge if a network was utilized.
