The Daily Physician Office Visit benefit of the Group Hospital Fixed Indemnity Insurance underwritten by United States Fire Insurance Company is NOT a copay that you pay at the doctor's office. (If you purchased a Short Term Medical Plan the Doctor Office Visit benefit is different.)
How does it work?
You go to the doctor's office, pay the bill at the doctor's office and then file the claim along with any required forms the claim administrator needs to complete the claims process. If the claim is considered a covered expense and is eligible to be paid, then the $125 for the 1 visit or the $125 for the 1 wellness* visit, will be paid directly to you from the claims administrator as a reimbursement (as long as the bill did not have an assignment of benefits to the provider - if there is an assignment of benefits to the provider, the claim will be paid directly to the provider).
*Wellness Visit is not available in MI.
Don't forget about MeMD!
(A non-insurance benefit available as part of your paid membership in the United Business Association (UBA)
Don't forget that as part of your paid UBA Gap Product that included Benefit Boost Subscription services, you also have $0 Cost^ Virtual Urgent Care & Virtual Talk Therapy Visits with a Medical Provider over the phone through MeMD. This non-insurance benefit is a great way to access doctor visits after you have already met your visits under the Group Hospital Fixed Indemnity Insurance Daily Hospital Office Visit Benefit for common health issues or talk therapy. There is nothing to file with MeMD. You just use the link on your ID card or in your Member Guide and then set up your account. It is just that simple.
^ Visits are paid by HealthyAmerica and not by you.
Note: United States Fire Insurance Company is not affiliated with the additional non-insurance benefits and services including MeMD as provided as part of membership in the United Business Association.
Read the Certificate(s) of Insurance carefully. The brochure is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this Help Guide article provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
Important: Healthy America 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.