Guaranteed Issue Health Insurance - Value Access Guarantee

Value Access Guarantee

Underwritten By: Companion Life Insurance Company

Rated A+ Superior by AM Best

Guaranteed Issue Limited Medical Insurance

•	Guaranteed Issue for members and their spouse's ages 18 through 64. Coverage terminates at age 70.
•	Pays Indemnity Benefits – There are NO Deductibles or Co-pays
•	Pays Benefits for Doctors Office Visits, Hospitalization, ICU or CCU, Surgery, Anesthesia, Preventive Care, Emergency Room Care, Lab and X-Ray Testing, and Ambulance Services*
•	Dependent Child Coverage is available to age 21 if the child is dependent on the parent member; or to age 23 if attending an accredited school full-time.
•	Save money through access to Beech Street PPO Network
•	Or you can use your own Doctor, Hospital or Licensed Provider
•	Pays Benefits in Addition to any Other Insurance Coverage
•	Pre-existing Conditions Incurred within the 12 Month Period Preceding the Effective Date are not covered until you have the plan for 12 consecutive months.. The Pre-existing Conditions Limitation is waived under the Outpatient Doctors Office Visits Indemnity Benefit**

* This plan is not available in all states and benefit options vary by state.

Click Here to Get a Quote or Apply

Plan Available in the Following States: AL, AK, AZ, AR, CO, DC, DE, FL, GA, IL, IA, KS, KY, LA, ME, MA, MI, MS, MO, NE, NV, NM, NC, ND, OH, OK, PA, RI, SC, TN, TX, UT, VA, VT, WI, WY

BENEFITS DETAILS

HEALTH INDEMNITY BENEFITS. Subject to the provisions of this Policy, the Company will pay Covered Benefits for one or more of the following::

Daily In-Hospital Indemnity Benefit

If a Covered Person, while insured, is Confined in a Hospital as a result of Accident or Sickness, the Company will pay the Daily In-Hospital Indemnity Benefit amount, as shown in the Schedule, for each day of Confinement, for up to the Maximum Number of Days of Confinement, as shown in the Schedule. No benefit will be paid during any period the Covered Person is not under the regular care and attendance of a Physician.

Hospital Intensive Care Unit Confinement

(Applicable only if this benefit is not excluded on the Schedule) If a Covered Person, while insured, is confined in a Hospital Intensive Care Unit, the Company will pay the Intensive Care benefit amount, as shown in the Schedule of Hospital Intensive Care Unit Confinement Benefit. If the covered person is confined in a Hospital Intensive Care Unit and is confined to a hospital intensive care unit again within 90 days for the same or related condition, it will be treated as a continuation of the prior confinement. If more than 90 days have passed between the periods of confinement in a Hospital Intensive Care Unit, it will be treated as a new confinement. The Hospital Intensive Care Unit Confinement and Hospital Confinement benefit will not be paid concurrently.

Surgical Indemnity Benefit

If a Covered Person has a covered surgery performed, the Company will pay the Surgical Indemnity Benefit amount. This amount is based on the Payment Factor amount, as shown in the Schedule of Surgical Indemnity Benefits, times the number of Surgical Procedure Units, as shown in the Schedule.

If two or more procedures are performed through the same incision or operative field, payment will be made only for the procedure of the larger benefit. If more than one procedure is performed but each through separate incisions or in a separate operative field, the amount payable shall be the specified amount for the primary procedure plus 50% of the amount payable for all other surgical procedures performed.

Unlisted Procedures: In addition to the procedures listed in the Schedule of Surgical Indemnity Benefits, amounts shall be payable for any other covered operations. The amounts for such procedures shall be determined by the Company in amounts consistent with those listed in the Schedule of Surgical Indemnity Benefits.

Anesthesia Indemnity Benefit

If the Surgical Indemnity Benefit is payable, the Company will pay the Anesthesia Indemnity Benefit amount, as shown in the Schedule, for the administration of anesthesia.

Outpatient Physician Office Visit Indemnity Benefit

The Company will pay the Outpatient Physician Office Visit Indemnity Benefit, as shown in the Schedule, for a Physician office visit as a result of Sickness or Accident, not to exceed the Maximum Number of Office Visits per Calendar Year, as shown in the Schedule.

Outpatient Diagnostic X-Ray and Laboratory Indemnity Benefit

The Company will pay the Outpatient Diagnostic X-Ray and Laboratory Indemnity Benefit, as shown in the Schedule, when a Covered Person has diagnostic x-ray and laboratory tests performed. This benefit is limited to once per day of testing, not to exceed the Maximum Number of Testing Days per Calendar Year, as shown in the Schedule. These include tests that show a need for treatment or that are made because of definite symptoms of Accident or Sickness.

Emergency Room Visit Indemnity Benefit

(Applicable only if this benefit is not excluded on the Schedule) The Company will pay an Emergency Room Visit Indemnity Benefit for services that result from a Sickness or Injury that are Medically Necessary and are provided on an Emergency basis that do not result in Hospital Confinement. Emergency Room Visit Indemnity Benefits will be paid for an Insured or a Dependent. The Emergency Room Visit Indemnity Benefit amount is shown on the Schedule of Benefits. Benefits payable will not exceed the Calendar Year maximum benefit amount shown on the Schedule of Benefits. A Covered Person shall have free choice of any Physician and the Physician-patient relationship shall be maintained.

Preventive Care Indemnity Benefit

(Applicable only if this benefit is not excluded on the Schedule)
Preventive Care Indemnity Benefit will be paid for a Covered Person as described below:

Preventive Care Indemnity Benefit will be paid for a Covered Person as described below: A. The Company will pay the indemnity benefit shown in the Schedule of Benefits for an annual physical examination for the Insured and his covered Dependents up to the Calendar Year maximum shown on the Schedule of Benefits. These services will only be covered to the extent that the services are provided by, or under the supervision of, a single Physician during the course of one (1) visit. Services include:

1. A history;

2. Physical Examination;

3. X-rays;

Laboratory services including, but not limited to, a Pap test, colorectal screening and prostate cancer screening.

B. The Company will pay the indemnity benefit shown in the Schedule of Benefits for a low-dose screening mammogram for any nonsymptomatic woman covered under the Policy/Certificate with the following frequency.

1. One (1) baseline mammogram for women aged thirty-five (35) through thirty-nine (39);

2. One (1) every two (2) years for women aged forty (40) through forty-nine (49); and

3. One (1) annually for women age fifty (50) AND OVER.

C. The Company will pay the indemnity benefit shown in the Schedule of Benefits for well child care from the moment of birth to Age six (6) years. Benefits will be limited to one (1) Physician’s visit at the following specified age intervals: 1 visit at age 30 days to 1 year, and annually thereafter, up to Age 6. Covered well child care is the periodic review of a child’s physical and emotional status. This periodic review will only be covered to the extent that the services are provided by, or under the supervision of, a single Physician during the course of one (1) visit. A review shall include:

1. A history;

2. Complete physical examination;

3. Developmental assessment;

4. Anticipatory guidance;

5. Appropriate immunizations;

6. Laboratory tests; and

7. Hearing and vision screening;

In keeping with prevailing medical standards.

Such services must be provided within one (1) month prior to or after reaching each Age without benefit or carrying over any visitations. In the event an appropriate immunization, lab test or portion of an examination cannot be performed at a particular Age, such service shall be deemed to be covered upon the next scheduled visit.

If a benefit is already shown for one of the above-described benefits, the benefit terms of the Policy/Certificate will control to the extent the terms are not consistent with the above described benefit.

The benefits described above will be paid directly to the provider of services. To authorize the benefit payment to the Covered Person, the Insured must make the proper authorization on the medical claim form.

Ground Ambulance Service Indemnity Benefit

(Applicable only if this benefit is not excluded on the Schedule) If a Covered Person requires the use of Ground Ambulance Service for transportation to or from a Hospital as a result of Accident or Sickness, the Company will pay the Ground Ambulance Service Indemnity Benefit, as shown in the Schedule, up to the maximum number of trips, as shown in the Schedule. Air ambulance transportation will be payable only if medically necessary and to the nearest facility equipped to handle the Covered Person’s Accident or Sickness.

* This plan is not available in all states and benefit options vary by state.

** Pre-Existing Conditions: No benefits will be payable for expenses incurred as a result of a Pre-Existing Condition until coverage has been in effect under the Policy for 12 consecutive months. This Pre-Existing Conditions Limitation is waived under the Outpatient Physician Office visit Indemnity Benefit.

About Companion Life:

Companion Life Insurance Company has specialized in group benefits for more than 35 years. They have earned an A.M. Best rating of A+ (Superior) due to their fiscal strength, investment practices and sound management. Now, Companion Life wants to earn your trust by giving you the highest level of service and responsiveness possible.

10 Day Right To Return:

If not completely satisfied with the coverage provided, simply return the certificate within 10 days after it is received, and all moneys' received will be refunded.

Important Notice::

The policy terms and conditions are briefly outlined in this marketing overview. Complete provisions pertaining to this insurance are contained in the Master Policy on file with Value Benefits of America (VBA). If you would like to see the policy in its entirety, please contact your agent or VBA at 800-366-2467. In the event of any conflict between this information contained herein and the Master Policy, the Policy will govern.

Value Access Guarantee members also have access to one of the nationals largest Preferred Provider Organizations.

Beechstreet PPO Network Providers:

Beech Street Corporation has over 50 years of reliable service in the healthcare industry and has a network of over 400,000 respected doctors, 3,800 hospitals and over 52,000 ancillary network providers. Beech Street provides cost containment Network Services, URAC accredited and NCQA certified Clinical Services, and healthcare financial Specialty Services. More information about Beech Street can be found at www.beechstreet.com.

VALUE BENEFITS OF AMERICA MEMBERSHIP BENEFITS *

CallMD:

Members have access to a nationwide network of medical doctors available 24 hours per day / 7 days per week for consultation or routine medical needs through the convenience of a toll free phone number, without having to take time to make an appointment or wait in line at a doctor's office. CallMD maintains members' electronic medical records (EMR) in a highly secured, Internet accessible environment and makes this information available to our network doctors prior to a doctor consultation. Furthermore, a CallMD Doctor can write a prescription where allowed by law when sufficient medical history is available.
(CallMD cannot write prescriptions for narcotics or DEA controlled substances.)

The Dividend Club:

Members will earn Dividends (paid quarterly to you) on Merchandise, Services, Travel & Entertainment when you shop from our On-line Mall and make a purchase. Choose from retailers like these, just to name a few, and get the dividends: Walmart.com, Target.com, BestBuy.com, CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com, Brooks- Brothers.com, Brookstone.com, Buy.com, EddieBauer.com, LizClairborne.com, FOA.com, FOSSIL.com, HotelDiscounts. com, Jcrew.com, etc.

Included at no charge:

Discounts at over 55,000 pharmacies for your prescription drugs as well as lab tests and x-ray imaging services

Rewards Network:

America’s Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off every meal plus up to 15% off your hotel room rate

Refund Sweepers:

Free Merchandise, Bargains, On-line Coupons, Rebates, Sweepstakes & more

Car Rental Services:

Provides discounts at Alamo, National, Hertz and Avis

DISCOUNTS AND DIVIDENDS ARE NOT INSURANCE BENEFITS*