The HealthMax Plus is the premier plan in the limited benefit market. It is as close to full major medical as you can get. No medical questions.
Doctor's Office Visits:
For treatment of injury or sickness per covered person per calendar year. This benefit can also be used as an emergency room benefit.oom benefit. |
$100 Per Visit |
Number of Office Visits:
Per person per year |
7 |
Diagnostic Testing or X-ray:
Medically necessary diagnostic tests and x-rays performed in a doctor's office or outpatient facility. E.g. MRI, CAT Scan, EKG, Mammography |
$400 Per visit
5 per year |
Preventative Care Benefit:
Covers 1 preventative test per year. |
$150 Per Visit
1 per year |
Regular Inpatient Stay:
A maximum of 100 days per year |
$1,000 Per Day |
ICU/CCU:
An Extra Daily Benefit, paid per day |
$1,000 15 days |
Hospital Admission:
An Extra Benefit for the first day admitted in the hospital |
$2,000 per stay |
| Critical Illness Included |
$5000 for primary & spouse |
Surgery:
Inpatient/Outpatient
Plan pays as a % of Medicare Reimbursement |
100% |
Surgery Maximum:
Maximum annual benefit for surgery |
Unlimited |
Anesthesia Benefit:
As % of surgery benefit |
25% |
Accident Rider:
One accident covered per person per year. Costs must be incurred within 90 days of accident or injury. |
Optional |
AIM Rx Card:
50% Mail order discount Brand or Generic |
Included |
RX Card Rider:
Walk-In
Generic: $10 Copay / $1500 Yearly Max |
Optional |
Plan Network
For Physician and provider lookup |
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Again, this is the most benefit you can obtain on a guaranteed issue basis that is not a full major medical plan.