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HEALTH CARE PROTECTION
VALUE ADDED SERVICES
More Than Just Great Savings!
We have designed a program that is more than just great savings on healthcare services when you need them. We have put together a complete healthcare management program. This starts with a focus on alternative and preventive modalities, supported by a patient advocacy program, psychological counseling and a health information program.
We encourage you to take advantage of our complete healthcare management program and make use of these important value-added services.
PATIENT ADVOCACY
PlanB for Health has contracted with an association that provides a Personal Patient Medical Advocacy service dedicated to assisting the uninsured or underinsured to responsibly resolve their larger (over $5,500 for one provider) medical bills. Over the last seven years, they have worked with large groups and thousands of individuals nationwide, saving them millions of dollars. Our provider researches the availability of and helps provide access to:
Our approach to Patient Advocacy is "hands-on, high touch". Patients have direct access to a Personal Advocate to help them manage their larger costs. Even with savings available on physician and other health care services, many people are often still unable to pay their medical bills. In addition to locating potential sources of funding to ;assist with medical bills, the provider will attempt to negotiate discounts, payment plans, and secure discounts in advance of services. This service is provided on a case-by-case situation based on best efforts (no guarantees are implied).
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ALTERNATIVE AND PREVENTIVE
We believe that anycomplete health care program must include a strong focus on preventive and alternative modalities. Our total solution includes one of the largest and most versatile networks of preventive and alternative practitioners in the United States. With more then 25,000 providers, easy access to a healthy lifestyle now becomes more affordable.
We are devoted to continually expanding our preventive and alternative networks with additional modalities that will focus on promoting good health with opportunities for increasing health awareness, knowledge, motivation, and skills to support change which leads to healthier lifestyles, habits and behaviors rather than only offering savings. PlanB for Healthprograms help our customers effectively manage health care by promoting preventative, alternative and natural healing modalities. Many insurance programs overlook the benefits of these services.
An ounce of prevention is worth a thousand cures!
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PHYSICIANS REFERRAL
Our Physicians Referral Programoffers an essential value-added customer service benefit. One of the most frequently reported concerns with many other healthcare savings programs is that their members have difficulty receiving savings from physicians and hospitals. To help alleviate this PlanB for Health provides the Physicians Referral Service.
Before scheduling appointments for some of the more costly services such as hospital, physician and chiropractic care, we request that members call our customer service agents for assistance. We will verify that the healthcare practitioner is still in the network and will honor the program savings. This will make it easier for PlanB for Health Members to receive.
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CRITICAL ILLNESS DIAGNOSES BENEFIT
The Company will pay this benefit, subject to the Reduction Schedule and Benefit Payment Conditions listed below, if while the Policy is in force, an Insured Person is first Diagnosed with a Critical Illness by a Physician. Once 100% of the Maximum Benefit Amount has been paid for an Insured Person, benefit terminates and no further benefits are payable for that Insured Person. Maximum Benefit is $5,000.00
Benefit Payment Conditions...
Payment of benefits upon first diagnosis of the critical illnesses listed below is subject to the following:
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the Insured Person survives for at least (30) days after the date the critical illness is diagnosed;
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the diagnosis is made within the United States;
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the diagnosis is made while the Insured Person's benefit is in force under the Policy; and
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payment is not precluded by any general or specific exclusion set forth in the Policy or any failure to meet any condition precedent set out below.
Critical Illness includes...
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Life Threatening Cancer
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Heart Attack
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Kidney (Renal) Failure
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Stroke
Enhanced Diagnosis...
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Coma
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Coronary Artery Bypass Graft
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Loss of Sight, Speech, or Hearing
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Major Organ Transplant
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Paralysis
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Severe Burn
Reduction Schedule...
The amount payable for critical illness will be reduced by 50% if an Insured Person is age 65 or older on the date the benefit becomes payable. The amount payable for critical illness will be reduced to 0% if the Insured Person is over the age of 70.
"Age" as used above refers to the age of the Insured Person on the Insured Person's most recent birthday, regardless of the actual time of birth.
Diagnostic Requirements...
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All Critical Illnesses - The Company reserves the right to have any critical illness diagnosis reviewed by a physician of its choosing. Any such diagnosis must be definitive and unequivocal. In the event of any dispute or disagreement regarding the appropriateness or correctness of the diagnosis, the Company shall have the right to request an examination of either the Insured Person or the evidence used in arriving at such diagnosis by an independent acknowledged expert selected by the Company in the applicable field of medicine. The opinion of such expert as to such diagnosis shall be binding on both the Insured Person and the Company.
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FAMILY / EAP COUNSELING
Our telephone counseling service is available 24 hours a day 7 days a week and supported bythree 55 minute personal visits per year with a professional counselor.We provide members with a confidential source to discuss problemsand personal situations they may be experiencing at home and at work. Callers speak immediately with trained professional counselors whoprovide immediate services. If an emergency exists, the counselor will offer crisis intervention and help the caller develop a safety plan. If the caller does not speak English, we offer foreign language capabilities. In non-emergency situations, callers speak with a counselor over the telephone and may address a number of life issues, including, but not limited to:
| Child Care/Adolescent Behavior |
Learning Stress Difficulties |
| Anxiety & Depression |
Elder Care |
| Relationship Issues |
Financial Concerns |
| Marital Concerns |
Family Communication |
| Alcohol & Drug Abuse |
Career Exploration |
When additional treatment or assistance is necessary from outside the program, referrals are coordinated with the appropriate resources. These resources may include coordinating care with your personal medical insurance, referring you to resources within your community, or referral to a behavioral health provider in your area at savings up to 30%.
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24-HOUR NURSE HOTLINE
Forthe timeswhen you or a family member need a healthcare concern addressed quickly at home or while traveling, PlanB for Health has contracteda service to provide you 24-hour access to registered nurses that canhelp you with answers on a variety of health topics.
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Symptom assessment (do you need to seek medical care now, or is there something you can do at home)
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Information about self care techniques for common symptoms
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Information on diagnostic and surgical procedures
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Prescription and over-the-counter medication information
Note: Nurses do not diagnose nor prescribe medical treatment.
The 24-Hour Nurse Hotline staffs Registered Nurses who are specially trained to provide prompt, confidential health information.
Topics include:
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General Health - Aging, Cancer, Exercise and fitness
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Parental Advice - Accident Prevention, Infant Care, Injuries and Sleep Problems
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Women's Health - Allergies, Gynecology, Menopause and Obstetrics
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Complementary Medicine - Herbal Medicine and Aromatherapy
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And much more...
This 24-hour Nurse Hotline value added service is included free of charge with many of our programs and is tailored to emphasize prevention as well as cost containment. We feel this is an essential component to a total healthcare management program.
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TRAVEL ASSISTANCE
As a PlanB for Health member you will have access to a worldwide network of medical personnel whenever you travel. Travel Assistance and Emergency Medical Evacuation Services are available when you are traveling 100 miles from home and are faced with a serious injury or illness or a travel related emergency. This benefit includes......
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Emergency medical evacuation and medically necessary repatriation
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Air transportation of member's escort when there is an emergency medical evacuation or repatriation
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Transportation for one family member to the Hospital where the member is confined when hospitalization will be for more than 7 days
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Vehicle return service
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Overseas medical assistance with lost documents, insurance coordination, emergency cash transfers and advances
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And much more
All travel assistance benefits and services must be pre-arranged by our Program Medical Advisor.
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ACCIDENT MEDICAL AND AD&D BENEFIT
Accidents are going to happen, it's just a part of life. Whether it's something as simple as twisting your ankle or something more serious like a work or sports related injury, you can relax knowing that PlanB for Health's Accident Medical plan is there to help.
As a member of PlanB for Health, you and your family are eligible to participate in our 24-hour Accident Medical Reimbursement Expense Benefit.
Available Benefit Levels By Plan(Each plan has a $100 deductible):
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Value Care/ PlanB Business
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Medical Plus
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Total Care/Business Plus
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Senior Care
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$2,500
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$5,000
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$5,000
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$7,500
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This plan is designed to pay medical treatment expenses directly to you as a result of an accidental injury. All enrolled and approved PlanB for Health members and their spouses and children are eligible. (See note below)*
Accidental Death & Dismemberment Benefit
PlanB for Health members have the opportunity to be included under the Accidental Death and Dismemberment Master Insurance Policy issued to the Direct Medical Benefits Association. The policy provides the member up to $10,000 Accidental Death and Dismemberment benefits to age 70. For members who are over the age of 70, please refer to the "Upon Attainment of Age" section located in your membership material.
Available Benefit Levels By Plan:
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Value Care/ PlanB Business
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Medical Plus
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Total Care/Business Plus
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Senior Care
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$2,500
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$5,000
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$7,500
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$10,000
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If you elect to include your family, your spouse and/or children are also included.
For a brief summary of Accident Medical Expense and AD&D Benefits (PDF format), click here. You can also request a complete, detailed description of the policy by sending an e-mail to Client Services.
*NOTE: There is a 15-20 day membership waiting period in order to qualify to use the Medical Accident/AD&D benefits. If you become an individual member you must give us 45 days notice in writing by certified mail when adding any additional family members that were not on your original PlanB for Health membership application in order for them to be covered. Please carefully review the full benefit disclosure documents online and in your manual.
Also: Members of PlanB for Health are automatically enrolled in the Consumer Assistance Services Association (CASA). As a member you have access to the limited insurance policies listed above provided by the association (CASA). These programs are not Major Medical Insurance and are underwritten by an A.M. Best "A" Rated Insurance Company.
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EMERGENCY RESCUE
If you are injured and need to be moved by helicopter, this service can be very valuable. In the event that an eligible member suffers from a certified injury that requires emergency medical transportation by helicopter in accordance with EMS protocols, the program will reimburse the participant up to a maximum of $4,000 per occurrence.
Reimbursement includesthe cost of medically necessary or life threatening helicopter transportation from the scene of an accident to the nearest medical facility capable of treating the injuries or from one medical facility to another medical facility (the latter item needs to be approved by the medical officer in charge of this service).
Provisions:
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One beneft will be paid per occurence
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Benefit is in excess of all other valid collectible insurance
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Coverage is world wide
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Policy includes $1,000 of scheduled airline Accidental Death and Dismemberment (AD&D) benefits
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Transportation is by helicopter only
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Vitamin and Nutritional Supplement Benefit
Medical studies prove beyond a reasonable doubt that there are many substantial health benefits resulting from a comprehensive and well maintained regimen of daily vitamins.
More and more people are joining with medical professionals in creating their own vitamin and mineral supplement program. Every day there is renewedevidence of thesaying that "an ounce of prevention is worth a ton of cure."
To that end, a well-considered daily vitamin intake should be considered an essential part of an overall lifetime health strategy.
Member Benefits
PlanB for Health provides you access to WholeHealthMD, which is the Internet's leading source for althernative health information. PlanB for Healthmembers, throughWholeHealthMD, are provided with credible, actionable solutions to chronic health and wellness concerns, such as:
- Foundational
- Women's Health
- Men's Health
- Energy
- Digestion
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- Immune Support
- Bone Health
- HeartHealth
- Mood/Relaxation/Sleep
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As a PlanB for Health member you have access to a quality supplier of vitamins and Natural Health supplements at a25% discount.
COMING SOON:
20% Savings on New Chapter Supplements
New Chapter, Inc. features a wide array of herbal formulas that are designed to strengthen the physiology against illness and optimize personal health.
New Chapter products are the finest grade organic, whole-foods-based supplements on the market. They are produced according to the highest organic standards, with no syntheitic ingredients. Pure ingredients are gathered from all parts of the world and then blended into formulations that are unsurpassed in vitality and effectiveness.
They are sold at some of the best health food stores in the U.S., and are considered by many experts to be the premier supplement available on the market.
New Chapter has a comprehensive system of health, dietary and skin care formulations. Some of their products include:
- Anti-Aging Formula
- Cold and Flu
- Sensitive Colon support
- Every Man
- Every Woman
- Everyone's Multiple
- Perfect Prenatal
- Skin & Hair Nutrients
- Stress Support
- Estrotone
- GarlicForce
- Headache Relief
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- Prostate 51x
- Smokeshield
- St. Johns's SC27
- Stress Advantage
- Supercritical Antioxidents
- Tranquilnite
- Breathe!
- Host Defense
- Liver Force
- BioFlora
- Hair Rush
- Zyflamend
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To order online or for more information about these and other New Chapter products, watch this site, or call 1-800-641-9081,extension 18.
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Cosmetic Surgery
More and more people are taking advantage of advances in cosmetic surgery in order to correct skin and other conditions that have developed due to aging, injury, or the effects of environmental exposure.
As the technologies have improved, both the variety and the ease of treatment have been enhanced. With PlanB for Health , you can enjoy the benefits of hese advances at the lowest possible prices.
A wide variety of procedures are now available at a significant savings, including
- Laser skin resurfacing
- Breast augmentation
- Breast reduction
- Liposuction
- Botox treatment
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- Pigmented skin lesion removal
- Stretch-mark removal
- Port-wine mark removal
- and more
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Select the "Find a Provider" link on the left, search on "Physician" and select one of the following subspecialties to see where we have practitioners in your area: dermatologist, plastic surgeon and/or reconstructive surgeon.
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MEDIFILE
Medifile is a personal medical record storage & retrieval plan which provides instant and possibly life saving personal medical information by telephone, fax or computer whenever you need it.
Comprehensive medical history will be provided from one convenient source. Information on medical conditions, allergies, insurance, immunizations, medications, physicians and emergency contact will be available to healthcare providers within minutes of your call.
Medifile also provides a convenientway to transfer medical information to new doctors or your child's school. Medifile has a complete system of security controls to ensure that records are released only with the member's authorization.
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