First Choice Health Insurance plan by Central United Life A GUARANTEED RENEWABLE HEALTH INSURANCE POLICY OFFERED IN 28 STATES. CUL IS A SUBSIDIARY OF THE MANHATTAN INSURANCE GROUP, HOUSTON, TEXAS THE FOLLOWING IS A BRIEF SUMMARY DESCRIPTION OF BENEFITS OFFERED UNDER THE FIRST CHOICE PLATINUM PLAN. PLEASE CONSULT THE POLICY FOR COMPLETEDESCRIPTION OF COVERAGE, EXCLUSIONS AND LIMITATIONS.
Great News!Primary applicants who work an average of 30 hours per week, will be eligible for the FirstChoice Limited Benefit Guaranteed Issue health plan that offers benefits for the premium dollar.Whether sold as primary health coverage for those who cannot afford and/or who cannot medically qualify for a Major Medical plan …Or, when offered as a Supplemental or “Gap” coverage in combination with a higher deductible Major Med plan …… We believe that you‟ll find that our FirstChoice plan offers an affordable, dependable, health coverage value unlike any other GI health plan being sold today.
Features You’ll Like! If the sound of an “Any Doctor/Any Hospital” plan is appealing to you – then consider FirstChoice!!FirstChoice NEVER pays less because you didn‟t go a “preferred” or “network” doctor.We DO offer options/resources to our Platinum and Gold plan policyholders that allow clients to access their health care through a list of optional PPO providers that will help save you money on covered claims.
Features You Won’t Miss!Important Features of all FirstChoice plans: No Deductible No Coinsurance No Copays No Utilization Review No Preauthorization No Pre CertificationNo Application, Enrollment or Admin Fees! It‟s “First Dollar Coverage” on all covered medical services.
As Secure as it Gets!The FirstChoice plan is Secure in 2 ways: AM Best rates CUL as “Secure,” their highest of the 4 categories utilized for evaluating insurance companies.Since our plan is a “Guaranteed Renewable Insurance Policy” unlike most health companies, we CAN‟T cancel policy holders‟ coverage.Once issued, the plan is yours until the first renewal after age 65 whether you continue working or not – unless you cancel us or decide to stop paying your premiums!Your plan is also “Conditionally Renewable” annually, after age 65, if you continue working 30 hours a week, for up to 5 additional years. See policy for complete coverage details.
As Stable as it Gets!Our specific plan design has been used by several different companies for many years and to our knowledge none of those plans has ever had a single rate increase on an in force policy – ever.We don‟t promise we‟ll never will have a rate increase, but that level of stability is unusual with health insurance! In a market where health companies routinely “come and go” and where premium rates go “up and up and up” … isn‟t it nice to find a plan with this kind of Stability and Security?!
BENEFITS: Hospital Room CoverageDaily Hospital Room – Platinum PlanIn our “Platinum” plan, a blend of 3 different benefits provides $14,000 of coverage over your first 6 continuous days in the hospital each year.* Afterward, CUL pays $500 per day for the balance of 365 days.In addition, CUL pays $2000 per day the first 20 days of confinement in an Intensive Care Unit. ( ICU )If your hospitalization is due to an injury, CUL pays an additional $200 per day, up to 356 days. (except in GA.)*Ask your agent to show you how 3 “Hospital Room” benefits are combined to provide this great coverage after you complete your application. They‟ll be glad to do so!
BENEFITS: Our Surgical CoverageOur Surgical Schedule one of the deepest of it‟s kind for any guaranteed issue/limited benefit plan anywhere!It goes to a max of up to$10,000 per medically necessary “In” or “Out Patient” surgical event – as often as needed.Obviously, the more serious the surgery, the greater the surgical benefit.*In addition, we pay the Anesthesiologist 25% of whatever we pay for the Surgical fee. Again, we‟ll also pay the Anesthesiology fees as many times as medically necessary each year.*Ask your agent if you‟d like to view our “Surgical Schedule.” It would be our pleasure to educate you on how it works. Sorry, we don‟t cover “elective” or “cosmetic” surgeries, only those categorized as “medically necessary” and covered by the policy. Please refer to policy for all coverage details. Medically necessary surgical procedures not listed on our schedule will be evaluated by our Medical Director and will be covered as treatment of comparable severity.
BENEFITS: Wellness & Sick VisitsWe provide $400 for Mammograms and $100 for Pap Smears up to one time per year.*Each adult insured on the policy will have four $100 doctor “sick visits” annually.If you have to go to the ER because of sickness, we‟ll pay $150, and it will count as one of your 4 annual sick visits.* ( 4 for primary insured, 4 for spouse, if covered, and four for all covered children, combined, per year )CUL doesn‟t care who files the claim – you or your doctor. They‟re paying $100 fee either way - if it‟s filed/coded as a “sick visit.” If you choose to use a network provider discount, you‟ll enjoy an even better value for your dollar. Ask your agent to explain “how to buy your covered medical services wholesale.”* Not in PA.
BENEFITS: Accidental Injury3 kinds of accidental injury benefits can be accessed by First Choice policy holders when they have an accident:The “Specified Injury Rider” (SIR) pays a scheduled benefit of up to $1800 for each injury.*The ER Accidental Injury benefit provides $200 per accidental injury, up to 4 times per year, per insured adult (4 total to share among children)Again, the Hospital Injury Indemnity pays an additional $200 per day in the hospital if your admission is due to injury/accident.**Of course, accidental injuries may often require Surgical, Anesthesiology, Hospital and ICU benefits (as previously described) in addition to the benefits noted.*SIR not available in GA/NC **HII not available in GA. Agent would be happy to show you the SIR schedule.
BENEFITS: PDN, ADD & MaternityIf your hospitalization requires the services of a Private Duty Nurse (as in an ICU or “Step Down” unit) CUL will pay $250 per day for up to 20 days of hospital confinement only ( no “home‟ benefit here.)For Accidental Death or Dismemberment, CUL pays $30,000 to a primary insured. ( Platinum )10 months after the policy effective date, CUL provides benefits for Maternity expenses (all appropriate Hospital Room Benefits, ICU, Surgical and Anesthesiology benefits) for normal or complicated delivery.
BENEFITS: Pre-existing LimitationIf you‟ve had any medical treatment (including prescribed medications) or symptoms (for which an ordinarily prudent person would have sought medical treatment for) within 12 months prior to your policy effective date, those specific conditions will not be covered the first 12 months after your effective date.After the policy has been effective for 12 months, all pre ex conditions will be covered as provided for in the policy.You‟ll enjoy coverage for all other covered medical benefits immediately upon your effective date.
Beechstreet PPOCUL plans provides a non CUL affiliated PPO network, Beechstreet, as a free benefit to all First Choice “Platinum” and “Gold” policy holders.You can go to www.beechstreet.com and access comprehensive and current lists of all providers.PPO discounts can greatly reduce the amounts you owe on medical services. FirstChoice plans pay the same, regardless of whether or not a provider is “in network.” For maximum savings, please try to utilize their large, national list of providers.
Let Us Help Protect & SaveOur aim is to provide both thebest insurance options that you can both qualify for and afford, and to educate you, soyou‟ll get your needed medical services at the best prices.
How to Apply for FirstChoicePlease discuss with our agent which FirstChoice plan option is best for you and your particular needs.Your agent can help you to complete a „paper‟ application, or walk you through our online enrollment portal, ACE.Thank you for your consideration. We look forward to the privilege of working with you in the future.