If you have an optional supplemental UBA Gap Product that includes Group Hospital Fixed Indemnity Insurance which includes any of the following benefits:
- Daily Hospital Confinement Benefit
- Emergency Room Visit Benefit
- Daily Physician Office Visit Benefit
- Daily Outpatient Diagnostic Radiology & X-Ray Benefit
- Daily Outpatient Diagnostic Laboratory Test Benefit
Since this is an indemnity claim and not an excess benefit, your claim will be paid directly to you once the claim is approved based on the Certificate of Insurance and benefit maximum amounts and after the claim form and all appropriate requests for documentation are made to the Claims Administrator and they have determined it to be a covered claim. Please note: If the bill submitted has an assignment of benefit, then the provider will be paid.
You need to pay the provider at the time of service and then submit a claim form and appropriate documentation for reimbursement up to the benefit maximum amount.
Please note that with Emergency Room Visit Benefit - you must meet the definition of Medical Emergency in order to qualify for the Emergency Room Visit Benefit.
If you are looking to do minor and non-emergency visits to an urgent care or emergency room, try using MeMD, a non-insurance benefit that is available as part of your paid optional supplemental UBA Gap Product that includes Benefit Boost Subscription services instead. You can use the $0 Cost* Virtual Urgent Care and Virtual Talk Therapy Visits as many times as you like 24 hours a day and 365 days a year.
(Note - the MeMD non-insurance benefit is not part of the insurance provided by United States Fire Insurance Company).
*Visits are paid by HealthyAmerica and not by you.
Note: To find out exactly what is covered including definitions, limitations, exclusions, schedule of benefits, go to the Member Portal to view your product(s) Certificates of Insurance and Member Guide.
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.