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AME provides first dollar coverage for
treatment of an accidental injury before any deductible or coinsurance
is applied.
- Benefit amounts per accident (must be
equal to the Short Term Medical deductible chosen):
- 6 Month Plan: $250, $500, $1,000, $2,500
- 12 Month Plan: $500, $1,000, $2,500, $5,000
- Treatment must occur within 90 days of
the accident
- If selected, all family members on the
policy receive the AME benefit
- Benefits are payable directly to the
provider
Note: Your Short
Term Medical plan deductible and coinsurance must still be met when a
claim amount exceeds the AME benefit payout.
Example: (For
illustrative purposes only)
John Smith purchased a family Short Term Medical policy with the AME
optional benefit. He chose a $500 deductible and the 80/20 rate of
payment (coinsurance) option. His son falls and breaks his arm.
John has not yet met any of his deductible. The claim would be
paid as follows:
Total Claim: $2,000
— AME benefit: $500 paid directly to the provider
— John needs to pay his $500 deductible plus 20% of all remaining
expenses
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$2000
|
Total claim |
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- $500 |
AME benefit |
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-
$500 |
John’s
deductible amount |
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$1000 |
Amount still owed |
|
|
|
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- $200 |
Rate of
payment amount to be paid by John (20%) |
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-
$800 |
Rate of payment
amount to be paid by Assurant Health (80%) |
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$0 |
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John’s total out-of-pocket expenses =
$700
It's
a small price for additional peace of mind.
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