When selling Health Insurance plans to your clients are you thinking about how they will pay the hospital, skilled nursing, ambulance and other co-payments?
These numbers can add up quick and could cause your client to have a very large bill to pay in just a short period of time. Here is a scenario that could be quite frightening to a senior consumer.
Your client is 65 years old, on a very limited income, and could not afford a traditional Medicare Supplement plan for $150 per month. Let’s say you or someone else sold this consumer an alternative plan that has:
- An annual maximum out of pocket limit of $3400
- A hospital co-payment of $250 per day for 7 days
- And an ambulance co-payment of $200
*This is one example of how this plan could help offset some of the extra expenses that a consumer could encounter. For additional examples of how to use this plan to help offset out of pocket costs with a group retirement health plan or a High Deductible Plan F, please contact one of our representatives.*
Your client has possibly been enjoying the benefits of a $0 premium alternative Medicare plan, a low cost group health plan with deductibles and co-payments or a low costing High Deductible Plan F, but a few months into the plan, they have an illness strike that causes them to be rushed to the hospital by ambulance and they spend 4 nights in the hospital.
Just the ambulance trip and hospital stay will equal $1,200 or more that will likely be due during just a one month period. Now remember, your client could not afford a $150 monthly premium for a Medicare Supplement. The question is, how are they going to afford a minimum of $1,200 during a one month period.That’s where our Advantage Plus plan comes into play*.For a small monthly premium of just $28.90 you could provide that same client with $250 daily hospitalization coverage and a $200 ambulance benefit. In the same scenario, your client would have had $1200.00 paid to them directly by the insurance company, which would have been plenty to offset the large bill they received.
*This plan is a limited benefit plan and is not specifically designed to supplement any other health insurance plan that a consumer might have. All benefits are paid directly to the insured. The insured may use any and/or all monies to cover additional health expense costs listed or not listed above, or may choose to use the money paid to them in any fashion they wish* This plan is not a Medicare Supplement policy.
Hospital Indemnity Plan
Daily Hospital Benefit (base)
This benefit will pay you a daily benefit amount between $100 to $600 per day should you be confined to a hospital. You can also choose either a 10-day or 21-day benefit period which will restore after 60 days of no hospital confinement. Benefits are paid in cash directly to your client and are paid in addition to any other insurance your client may have.
Ambulance Benefit Rider
This rider will pay your client $200 per ambulance trip to or from a medical facility up to four times a year and subject to a lifetime maximum of $2,500. No hospital confinement is required.
Lump Sum Cancer Rider*
The Lump Sum Cancer Rider will pay your client a cash benefit of $2,500, $5,000, $7,500 or $10,000 should they be diagnosed with cancer. This benefit is limited to a one-time lump sum payment.
With the NEW! Advantage Plus plan, The Lump Sum Cancer Rider will pay you a cash benefit of $2,500, $5,000, $10,000, $15,000 or $20,000 should you be diagnosed with cancer. It includes a benefit for Cancer In Situ and a $500 payment for Basal cell/Squamous cell skin carcinoma. Available in most states!
Skilled Nursing Facility Rider "A"
Your client's policy will pay $120 per day from days 21-100 if you are confined to a skilled nursing facility. This benefit applies if your client is admitted to a skilled nursing facility after they have been confined to a hospital for three consecutive days. GTL will pay benefits as long as confinement occurs within 30 days of hospitalization. This benefit restores after 60 days of no confinement in a hospital or skilled nursing facility.
Skilled Nursing Facility Rider "B"
Your client's policy will pay $100, $150, or $200 per day from days 1 through 50 if they are confined to a skilled nursing facility. This benefit applies if your client is admitted to a skilled nursing facility after they have been confined to a hospital for three consecutive days. GTL will pay benefits as long as confinement occurs within 30 days of hospitalization. The benefit restores after 60 days of no confinement in a hospital or skilled nursing facility.
Lump Sum Hospital Confinement Rider
Some primary health plans leave you with a lump sum hospital co-pay. A $250, $500, or $750 lump sum benefit can be used to help cover that cost. The benefit is payable once during any period of hospital confinement and restores after 60 days of no hospital confinement.
Outpatient Surgical Benefit Rider
This rider will pay your client $250, $500, $750, or $1,000 for a surgical procedure performed in an ambulatory surgical center or outpatient hospital facility. This benefit is payable up to two occurrences per year.
Short Duration Hospital Stay
Available with the NEW! Advantage Plus plan, This rider is available for those with a 10 or 21 day benefit period (it is included in the 3 or 6 day benefit period plans). It pays for a short hospital stay of 12 to 24 hours if you are admitted to a hospital for a covered sickness or injury. This includes time spent in a hospital as an inpatient, under observation or as an outpatient in the emergency room.
Available with the NEW! Advantage Plus plan, The Dental/Vision Rider will pay you an annual benefit of up to $400, $800 or $1,200 for services performed by a licensed dentist, ophthalmologist or optometrist after the first year, including $200 for prescription eye glasses or contact lenses.
Your client's policy will also pay $175 per day for up to seven days if you are confined to an inpatient mental health facility. In addition, the policy will pay 100% of the first $150 of emergency room expenses if you are admitted to a hospital within 24 hours following an emergency room visit due to accident or injury. These benefits are available to your client as part of your base policy.
Hospital Indemnity Plan
Daily Inpatient Hospital Benefits
Heartland National will pay the daily benefit your client selected for covered hospital stays that are due to an injury or sickness. They'll pay this benefit for each day your client stays in the hospital, up to the number of days your client has selected, for each period of care. Full inpatient hospital benefits are restored after your client have been out of the hospital for 30 days in a row.
Durable Medical Equipment Benefits
Heartland National will pay the expenses incurred for the purchase or rental of Durable Medical Equipment, up to the maximum benefit amount once each calender year. Durable Medical Equipment includes, but is not limited to wheelchairs, walkers, canes, etc. Heartland National will pay up to $2,500 during the client's lifetime.
The benefit will pay for ambulance transportation, including air ambulance, to and from a hospital for each period of care. This benefit will pay up to $2,500 during your client's lifetime.
Emergency Room Benefits
This benefit will pay the Emergency Room Benefit for each period of confinement for services your client receives in a hospital emergency room or hospital affiliated emergency care facility, for loss due to an injury, provided the emergency treatment is followed, within 24 hours, by a covered hospital stay.
Physician Visit Benefits
Heartland National will pay the Physician Benefit for follow up visits to a physician when the visit is directly related to a prior hospital stay and the visits are within six months after your client leaves the hospital. The benefit will pay for up to three visits per calender year.
Optional Lump Sum Cancer Benefits
For an additional premium, Heartland National will pay the cash benefit that your client has selected, if they are diagnosed with internal cancer for the first time while being covered under the policy.
Hospital Indemnity Plan
Plan Benefits (base)
Hospital Indemnity benefits will pay an amount if you are confined in a hospital. Includes observation stays in a hospital. The benefit is for one time per period of care and is available in $250 units, up to a maximum of $2,500.
More benefits to choose from (optional)
Daily Hospital Indemnity
This benefit will pay a daily hospital indemnity amount if you are confined in a hospital. Includes observation stays in a hospital. The benefit will be paid for each of confinement and is available in $10 units, up to a daily maximum of $300. Period of care is 20 days with a lifetime maximum of 365 days.
Daily Skilled Nursing Facility Indemnity
This benefit will pay a daily indemnity amount for skilled care received at a nursing facility. Skilled care services are services that can only be provided in a nursing facility, on a daily basis, and ordered by a doctor. Admission to the nursing facility must immediately follow a hospital confinement of at least 3 consecutive days, with the skilled care being received on a covered day/period of care. The benefit is available in $10 units, up to a daily maximum of $200. Choice of covered days/period of care includes: days 1-20, days 21-100, or days 1-100.
Doctor's Office Visit Indemnity
This benefit will pay an indemnity amount for a doctor's office visit for a covered illness or injury. The benefit is available in $10 units, up to a maximum of $60 per visit and up to 20 visits per year.
Outpatient Surgical Procedure Indemnity
This benefit will pay an indemnity amount for an outpatient surgical procedure performed at an ambulatory surgical center or outpatient surgical facility for a covered illness or injury. The benefit is available in $250 units, up to a maximum of $1,500 per surgical procedure, one time per year.
Hospital Emergency Room Visit or Ambulance Service
This benefit will pay an indemnity amount for either a hospital emergency room visit or an ambulance service. Services must be medically necessary and on an emergency basis. The maximum benefit amount for this services is $200 per visit/service, 2 times per year.