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Deductible is a reduction of benefits that    is calculated after all in-hospital benefits have applied..

The deductible applies to all in-hospital and surgical benefits with the exception of outpatient Hospital or Ambulatory Surgical Center surgery, which is waived for the first claim incurred in a calendar year when surgery is performed under general anesthesia.

SURGICAL BENEFIT                                     

The reimbursement schedule is paid based on the schedule for 1 unit and is similar to what is payable under the 2013 Medicare physician fee  schedule for surgeries in the Houston area 

Up to three units are available based on the total number of units selected for the plan.

Same reimbursement method applies to Inpatient Pathologist / Radiologist

OUTPATIENT BENEFITS                              

-$50 calendar year outpatient deductible        

– 4 chiropractor visits included out of the 20 doctor  visits per calendar year per insured.

No Optional Riders are available, bit you can still add standalone Critical Illness, Accisent, and Dental to the HSPIII on the same app.

Reduces the First Day benefit amount for Hospital Confinement and Intensive Care. (one reduction per calendar year per covered person may apply) Four options to choose from:

• 100% – Pays 100% of the Hospital Confinement and ICU Benefit
• 80%  – Pays 80% of the First Day Hospital Confinement and ICU Benefit  2nd day and thereafter pays the full benefit selected
• 50% – Pays 50% of the First Day Hospital Confinement and ICU Benefit  2nd day and thereafter pays the full benefit selected 
• 20% – Pays 20% of the First Day Hospital Confinement and ICU Benefit  2nd day and thereafter pays the full benefit selected

SURGICAL BENEFIT                                      The reimbursement schedule is the Medicare RBRVS (Resource-Based Relative Value Scale) per procedure based on your providers location

Up to three units are available based on the total number of units selected for the plan.

Same reimbursement method applies to Inpatient Pathologist / Radiologist.

OUTPATIENT BENEFITS

– No calendar year outpatient deductible

– 6 chiropractor visits included out of the 20 doctor  visits per calendar year per insured.

Optional Critical Illness and Optional Family Term Life Available with just a click of the mouse.  The applicant only needs to varify one set of questions for eVarification or telephone interview.