Hybrid Health Insurance Plans

Hybrid 70

  • After the per hospital confinement deductible, the plan pays PPO hospital expense benefit maximums of $750, $1,000 or $1,500 per day of hospital confinement.
  • Pays 70%, of the first $10,000 of covered expenses, then 100% thereafter for inpatient medical and surgical services and outpatient surgical services received at a participating provider, after chosen deductible level (not to exceed aggregate maximum benefit per illness or injury or lifetime maximum benefit).
  • Pays 80%, not to exceed your chosen benefit maximum (after $100 deductible), for outpatient medical expenses received at a participating provider.

    • In-Patient and Out-patient Benefits

    • Deductible per hospital confinement (PPO and non-PPO deductibles accumulate serparately)
      • In-PPO: Choice of $200 or $400
      • Out-of-PPO: deductible is two times PPO deductible Maximum benefit per day for inpatient hospital expenses (includes room and board, supplies, drugs, etc,. no limit on days of confinement)- Choice of $750, $1,000 or $1,500

    Outpatient Expense Benefits

    • Calendar year deductible
      • In-PPO: $100
      • Out-of-PPO: deductible is two times PPO deductible
    • Physician office visit maximum benefit for covered out-patient expenses- $50 per visit
    • Prescription Drugs- Subject to separate $100 Rx deductible per person, per calendar year.
      • Generic- $15 or 50% of the drug’s cost, whichever is greater. Brand name drugs are not covered.

    Optional Benefits Enhancements to suit your needs

    You can increase your coverage with these options (available at an additional premium):

    • Cancer Benefit Option
      • This optional rider provides a maximum of $50 per day for in-hospital visits by a physician
      • Up to $200 per day for treatment provided during a hospital confinement or on an outpatient basis for radiation therapy and chemotherapy
      • Up to $2,500 per calendar year for charges made by a hospital or physician for experimental treatment or procedures provided during a hospital confinement or outpatient basis
      • Limited hotel and transportation reimbursements for a family member
      • Up to $75 per day for hotel/motel charges
      • Up to $750 per mile for roundtrip
      • Up to $100 per covered person per calendar year for eligible diagnostic screening tests
      • Up to $4,000 for the eligible charges in relation to surgical benefits (based on the surgical schedule)
      • After a $500 deductible, pays for Radiation Therapy and Chemotherapy treatment and pays 80/20, up to $10,000, with a maximum benefit of $50,000 per illness or injury.
    • Term Life Benefit Option
      • The Term Life Benefit Rider provides you and or your spouse with annually renewable term life insurance coverage in benefit amounts of $10,000, $25,000 or $50,000

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