Physician office Visit (coinsurance will not apply and is not subject to the deductible)
$50 Co-pay per each visit.
(Charges for Physician Office Visits, for Physician visit charge only. All other services received are subject to the remaining policy limits including Deductible, Co-Pay, Coinsurance, Benefit Maximums and other limits set forth in the Schedule of Benefits.)
Definition of Physician:
Physician means a person who is a qualified practitioner of medicine. As such, He or She must be acting within the scope of his/her license under the laws in the state in which He or She practices and providing only those medical services which are within the scope of his/her license or certificate. It does not include a Covered Person, a Covered Person’s spouse, or other Immediate Family.
There is an EXCLUSION for Immunizations and Routine Physical Exams in the Short Term Medical Insurance.
Short Term Medical Insurance Disclaimer:
Read the brochure and the Policy carefully. The brochure is a brief description of Short Term Medic al Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in Policy. Short Term Medical Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. Short Term Medical Policy does not meet Minimum Essential Coverage as mandated by the Affordable Care Act. Short Term, limited duration plans are not subject to certain provisions of federal health care reform, including the provisions related to Essential Health Benefits, lifetime limits, preventive care, guaranteed renewability, and preexisting conditions. The preexisting conditions exclusion for Short Term Medical Plans will apply for all insureds, including those under the age of 19. Know your plan. Short Term Medical plans offer medical coverage, are medically underwritten (so you can be declined) and do not provide Minimum Essential Coverage. What does this mean for the applicant? They may have to pay a tax penalty, depending on their income level and the cost of plans available. Examples of the claims Short Term Medical Plans do not cover are for most preventive care, mental health, and treatment related to medical conditions they had prior to the plan's effective date. Because these plans are not guaranteed renewable, the applicant may not be eligible for another short term plan after the plan's termination date; and the preexisting condition exclusion will apply to any conditions that arose during any prior short term plans.
Important: HealthyAmerica and United Business Association (UBA) are not authorized to pay claims or be involved in the claims decision process. All claim decisions are made by the TPA claims administrator and the insurance carrier.