About the New HospitalityCare Plans

Fixed Indemnity Medical Plan Descriptions

Accidental Death and Dismemberment--Payable to the insured or their beneficiary for the amount specified in the policy and is in addition to covered medical expenses owed to the insured. This benefit is payable for the loss of specific body parts, body functions, or death that occurs as a direct result of an accident.

Ambulance Services--This benefit is payable at the reflected fixed dollar amount for the use of ground or air ambulance transportation service, to or from a hospital as a result of an accident or illness.

Creditable Coverage--The limited benefits medical indemnity plan does not count as HIPAA qualified health coverage used to waive pre-existing conditions on a new plan or to establish a right to a guaranteed issued policy.

Diagnostic Lab--This benefit includes all diagnostic lab tests ordered or performed by a licensed practitioner when hospital confinement is not required. It is paid at a preselected fixed dollar amount. This benefit is not payable if test(s) are ordered or performed during an emergency room visit.

Diagnostic X-ray--This benefit includes all diagnostic x-ray ordered or performed by a licensed practitioner when hospital confinement is not required and is paid at a preselected fixed dollar amount. This benefit is not payable if test(s) are ordered or performed during an emergency room visit.

Emergency Room--This benefit is payable at a preselected fixed dollar amount for eligible services or supplies received in an emergency room when the visit results from an accident or illness.

Intensive Care Hospital Benefit--This benefit is payable per day for confinement in an intensive care unit. This benefit is paid in addition to the daily standard care hospital benefit, per covered person per policy year at the plan defined daily rate.

Physical, Occupational and Speech Therapy--This benefit is payable as a per visit fixed amount.

Physician Office Visits--This benefit is payable for visits to a doctor’s office, urgent care facility, and outpatient hospital for wellness, injury or illness services that are provided by a licensed practitioner. It is paid at a preselected fixed dollar amount. Diagnostic and X-ray services performed during a physician office visit are payable separately as per the benefit schedule.

Pharmacy Discount Program--A discount for prescription drug charges will be provided to eligible persons when prescriptions are purchased through a contracted pharmacy.

Standard Prescription Plan--For generic and brand prescriptions, the plan pays a fixed dollar amount per prescription up to the outpatient maximum for drugs dispensed by a pharmacist. Prescription drug coverage is not provided for drugs administered during a physician office visit or during a hospital stay.

Enhanced Prescription Plan--For generic and brand prescriptions, the plan pays a fixed dollar amount per prescription up to the monthly maximum for drugs dispensed by a pharmacist. Prescription drug coverage is not provided for drugs administered during a physician office visit or hospital stay. Under the Enhanced Prescription Plan benefits are not subject to the outpatient maximum.

Skilled Nursing--This benefit is payable per day after a hospital stay for a facility that primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing or rehabilitative services that would not otherwise be offered in a hospital.

Standard Care Hospital Benefit--Payable when a covered person is confined in a hospital as a result of an accident or sickness unrelated to work injury. This benefit is payable per day to the insured after 24 hours confinement in a hospital.

Surgical and Anesthesia--This benefit pays a preselected fixed dollar amount for surgeries performed by a licensed practitioner and provides for anesthesia administered by an anesthesiologist or anesthetist in connection with a covered surgical procedure. The benefits for surgery and anesthesia are paid at a preselected fixed dollar benefit plan amount.

Wellness--This a one-time payable benefit for all routine examinations, preventive testing and well-child care for outpatient services provided by a licensed practitioner. This benefit is paid in addition to any other benefit allowed under the policy and is payable per covered person per policy year.

Benefit Plans underwritten by BCS Insurance Company and 4 Ever Life Insurance Company, Oakbrook Terrace, IL, and Companion Life Insurance Company, Columbia, SC.