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Health Access

Benefits | Exclusions | Free Quote | Apply Online

 

All Assurant Affordable Health Access Plans are limited-benefit plans. This means the plans have specific dollar limits on coverage to make them more affordable. Even after you reach your plan's limits, you still benefit from network discounts. These plans use the Private Healthcare Systems Limited Payor Plan (PHCS LPP) network. When you use a PHCS LPP preferred provider, you can save an average of 40% for health care services.

  Plan B
Limited benefits for everyday needs
Hospital Benefits: $100,000 maximum		 Plan C
Limited benefits for everyday needs
Hospital Benefits: $200,000 maximum
Provider Network
PHCS/ Multiplan

Office Visit Copay1

(Preventive exams2 included)


You pay your copay and the plan pays 100% of the remaining cost of an eligible office visit up to $150 per visit for examination, consultation, evaluation, development of a treatment plan, immunizations and allergy shots. An office visit during which you receive only an immunization or allergy shot does not apply to your four-visit annual limit; however, your copay and the $150 maximum per visit still apply.
  • You pay a $25 copay for each office visit to a primary care physician, retail health clinic, specialist or health care practitioner
  • Copay applies to each of four office visits per person per calendar year
  • We pay up to $150 per office visit
  • You pay a $25 copay for each office visit to a primary care physician, retail health clinic, specialist or health care practitioner
  • Copay applies to each of four office visits per person per calendar year
  • We pay up to $150 per office visit
Prescription Drugs3
  • You pay a $10 copay for generic drugs
  • You pay a $50 copay for preferred brand-name drugs
  • You pay a $75 copay for non-preferred brand-name drugs
  • We pay up to $250 in benefits per calendar year
  • You pay a $10 copay for generic drugs
  • You pay a $50 copay for preferred brand-name drugs
  • You pay a $75 copay for non-preferred brand-name drugs
  • We pay up to $750 in benefits per calendar year
Outpatient Medical Services
(Preventive services2 included)
  • You pay a $200 deductible4
  • We pay 80% of covered charges up to $500 per person per calendar year
  • You pay remaining 20% of covered charges Includes office visit services, outpatient hospital, surgical center or urgent care facility.
  • You pay a $200 deductible4
  • We pay 80% of covered charges up to $500 per person per calendar year
  • You pay remaining 20% of covered charges Includes office visit services, outpatient hospital, surgical center or urgent care facility.
Limited Benefit Surgical Services    
Surgeon
  • Includes surgeon benefits for both inpatient and outpatient surgery paid to the scheduled benefit amount. Benefits paid per surgery vary greatly.
  • Includes surgeon benefits for both inpatient and outpatient surgery paid to the scheduled benefit amount. Benefits paid per surgery vary greatly.
Assistant Surgeon
  • We pay up to 20% of amount paid for surgery
  • We pay up to 20% of amount paid for surgery
Anesthesiologist
  • We pay up to 20% of amount paid for surgery
  • We pay up to 20% of amount paid for surgery
Ground and air ambulance
  • We pay up to $100 ground/$1,000 air - per trip, up to two trips per calendar year
  • We pay up to $100 ground/$1,000 air - per trip, up to two trips per calendar year
Emergency Room
  • We pay up to $250 in benefits for each of two visits per calendar year after $100 emergency room fee5
  • Fee is waived if admitted to the hospital
  • We pay up to $750 in benefits for each of two visits per calendar year after $100 emergency room fee5
  • Fee is waived if admitted to the hospital
Inpatient Benefit Facility Charges
  • We pay up to $750 in benefits per day for sickness
  • We pay up to $1,000 in benefits per day for injury
  • We pay 80% and you pay 20%, up to $100,000, in benefits per calendar year based on the daily inpatient limits. You pay any balance.
  • We pay up to $2,000 in benefits per day for sickness
  • We pay up to $4,000 in benefits per day for injury
  • We pay 80% and you pay 20%, up to $200,000, in benefits per calendar year based on the daily inpatient limits. You pay any balance.
Other non-surgical/non-facility Inpatient Services
  • Considered under the inpatient per day maximum
  • Coinsurance applies
  • Considered under the inpatient per day maximum
  • Coinsurance applies
Life Insurance6
  • We pay a $10,000 benefit, for the primary insured only
  • We pay a $10,000 benefit, for the primary insured only
lifetime Maximum
  • $1 million
  • $1 million
Medical Questions for Qualification
  • Limited medical questions to qualify
  • Limited medical questions to qualify
Pre-existing Conditions
  • Covered after you have been continuously insured under this plan for 12 months
  • Covered after you have been continuously insured under this plan for 12 months

 

Copayment Notice : Your actual expenses for covered services may exceed the stated copayment because actual provider charges may not be used to determine the policy and Covered Person payment obligations. The Covered Person is responsible for all charges in excess of any maximum benefit limitation under the plan.Plans provide limited benefits and all covered services are subject to calendar-year maximums. These are not major medical health plans and are not replacements for them. The amount of benefits depends upon the plan selected, and the premium will vary with the amount of benefits. Read all coverage documents carefully upon receipt. For a complete listing of benefits, limitations and exclusions, please refer to your coverage documents.

Benefits and availability vary by state.

  1. Office Visit Benefit - IL has a $600 calendar year maximum instead of a 4 visit per calendar year maximum
  2. Preventive services include annual exam, mammograms, Pap smears, routine colonoscopy/sigmoidoscopy, colorectal cancer screening, human papilloma virus vaccination, well-child care and prostate cancer screening.
  3. Prescription Drug Benefits are not available in AZ.
  4. Family deductible maximum is $400 and is met collectively by two or more persons.
  5. The $100 emergency fee is not applicable in IL.
  6. Life insurance is not available in FL, GA, IL, KS, LA, NC and TX.

Learn more about the Health Access plan:

 

Benefits | Exclusions | Free Quote | Apply Online