Plan Detail

Plan Administrator: Independence Holding Company IHC | AM Best Rating: A-"Excellent" | Underwriter: Madison National Life Insurance Company

• After the deductible (Plan A: $250 deductible and Plans B and C: $500 deductible), benefits are payable for medical expenses incurred as the result of a covered accident, up to the selected maximum amount, minus the deductible, or the actual expense you incur, whichever is less.
• Critical Illness coverage only applies to the primary insured and their spouse, if also a covered person.
• This is a membership benefit and not an insurance benefit.
• Critical illnesses diagnosed in the first 30 days of coverage will have the lesser of a $500 benefit or 10 percent of the amount that it would have paid for the condition if first diagnosed more than 30 days after the insured person’s effective date. Refer to the Certificate of Insurance for complete definitions and diagnostic requirements of each covered critical illness. The amount payable will be reduced by 50 percent if the insured person is age 65 or older on the date a benefit becomes payable. Accident and Critical Illness coverage terminates at age 70. Hospital Confinement coverage terminates at age 65.

Benefits for inpatient hospital confinement and Critical Illness coverage are subject to the pre-existing condition limitation. A pre-existing condition is a disease, accidental bodily injury, illness or physical condition for which a covered person had treatment, incurred a charge, took medication or received a diagnosis or advice from a doctor during the 12-month period immediately preceding the covered person’s coverage effective date. Benefits are payable for a pre-existing condition after the person has been covered under the policy for 12 consecutive months. For the hospital confinement benefit, this does not apply to a newborn or newly adopted child placed for adoption under age 18 if such child is enrolled for coverage within 31 days from the date of birth or date of adoption or placement for adoption.