Secure Lite

Plan Detail

Plan Administrator: Independence Holding Company IHC | AM Best Rating: A-"Excellent" | Underwriter: Standard Security Life Insurance Company of New York.

Plan best suited – Available to all members of communicating for America.
Ages – 18 year to 64 years , their spouses and dependent children up to age 26.
Coverage: 30 days to 12 months.
Maximum Benefit: $750,000 is the maximum amount of covered charges that will be considered under the Secure Lite plan per covered person, per coverage period
Secure Lite is available to residents of ID, IN, KS, LA, ME, MD, MN, MT, ND, NH, NV and SD on an individual basis and not through CA. Therefore, membership is not required in these states
Pre-Existing -- Secure Lite will not provide benefits for any loss caused by or resulting from a pre-existing condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered person effective date of coverage.

Benefits Description Pre-existing Coverage Exclusions Claim Provider Network

Benefits

Deductible

The selected deductible amount must be paid by the insured person before plan benefits begin. The deductible applies per covered person, per coverage period.

Family deductible

When 3 covered persons in a family each satisfy their deductible, the deductibles for any remaining covered family members are considered satisfied for the remainder of the coverage period.

$500
$1,000
$2,500
$5,000

Coinsurance

The selected coinsurance is the percent paid by the Secure Lite plan after the deductible has been met.* Once $10,000 in covered charges have been applied to the coinsurance percentage, additional covered charges within the coverage period are paid at 100 percent up to the $750,000 coverage period maximum benefit. The out-of-pocket amount is the responsibility of the insured person.

80% of the next $10,000 ($2,000 out-of-pocket after deductible)
50% of the next $10,000 ($5,000 out-of-pocket after deductible)

Maximum benefit

$750,000 is the maximum amount of covered charges that will be considered under the Secure Lite plan per covered person, per coverage period.

Covered expenses¹

Covered expenses are limited by the usual, reasonable and customary charge as well as any benefit-specific maximum. If a benefit-specific maximum does not apply to the covered charge, benefits are limited by the coverage period maximum. All benefits are subject to the selected plan deductible and coinsurance.

Covered expenses include treatment, services and supplies for:

Physician office visits - up to $25 per visit, up to four visits per coverage period. The balance due above the $25 per visit benefit is subject to plan deductible and coinsurance up to $1,000 per coverage period.
Inpatient hospital regular care – up to $1,000 per day; includes daily room and board and miscellaneous charges2
Inpatient hospital intensive care or critical care – up to three times the average semi-private room rate with a $1,250 maximum benefit per day; includes daily room and board and miscellaneous charges2
Outpatient hospital surgery and ambulatory surgical center services – up to $1,000 per day; includes cost of operating room and miscellaneous charges2
Outpatient emergency room services – up to $500 per day; includes the emergency room physician charge, 24-hour surveillance and miscellaneous charges2
Inpatient physician visits - up to $500 per hospital stay
Surgeon and anesthesiologist services - up to $2,500 per procedure with a $5,000 maximum per coverage period
Outpatient or physician office miscellaneous charges - up to $1,000 per coverage period
Ambulatory services - up to $250 per trip
Organ transplants - up to $150,000 per coverage period
Acquired Immune Deficiency Syndrome (AIDS) - up to $10,000 per coverage period 3
Mammography and Pap smear - subject to deductibles, coinsurance and any specific limits Inpatient covered expenses
Room, board, doctor visits and general nursing care up to the most common average semi-private room rate
Intensive care or specialized care unit up to three times the average semi-private room rate
Prescription drugs administered while hospital confined

1 Benefits may vary by state

2 Miscellaneous charges include X-rays, scans, laboratory, blood, therapy, oxygen, casts, splints, medicines, injections, chemotherapy and medical supplies.

3 The AIDS maximum of $10,000 per coverage period does not apply to policies/certificates issued to residents of AZ, CA, CO, DC, ID, MD, ME, MO, NH, NC or ND. The maximum benefit in KS is $75,000 per coverage period.