Highlights of the program features are listed below. Click, the "Details" button for additional information on the benefits, including exclusions and limitations. Click here to download the pdf brochure.
Physician/Hospital Benefits
Hospital Room & Board and General Nursing Services** $2,000 per day This benefit is payable for up to 31 days per policy year, when a Covered Person is admitted to a hospital due to a covered Injury or Sickness. This benefit is in lieu of the Intensive and Cardiac Care Unit Benefit.
Intensive and Cardiac Care Unit Benefit** $2,000 per day This benefit is payable up to 31 days per policy year, when as the result of a Covered Injury or Sickness, a Covered Person is confined to a Hospital ICU or CCU unit. This benefit is in lieu of the Hospital Room & Board and General Nursing Services Benefit.
Surgery: (Inpatient/Outpatient)** See Surgical Schedule This benefit is payable for Covered Expenses due to an Injury or Sickness and pays according to the surgical schedule as set forth in the Certificate of Coverage. Maximum of one surgery per Covered Person per policy year.
Anesthesia: (Inpatient/Outpatient)** See Surgical Schedule This benefit is payable for Covered Expenses due to an Injury or Sickness and pays according to the surgical schedule as set forth in the Certificate of Coverage. Maximum of one treatment per Covered Person per policy year.
Doctor Office Visit: Pays $105 per visit, 5 visits maximum per individual, 10 visits maximum per family per policy year. Benefits are paid if a Covered Person visits a doctor’s office for medically necessary treatment or care of an injury or sickness covered under the policy. No network restrictions, see providers of your choice. This benefit is not subject to a waiting period for pre-existing conditions.
Provider Locator
Wellness Exam: Pays $105 per visit, 1 visit maximum per person per policy year at the age intervals listed below. Benefits are paid if a Covered Person visits a doctor’s office for routine wellness care covered under the policy. No network restrictions, see providers of your choice. This benefit is not subject to a waiting period for pre-existing conditions. • Adult Wellness Visit (ages 6-64) • Child Wellness Visit (ages birth-5)
*Limited Medical Indemnity benefits are underwritten by United States Fire Insurance Company, rated "A" by AM Best 2010, and are subject to the terms, definitions, conditions, exclusions and limitations of the group policy. Coverage is not provided for loss due to pre-existing conditions for 12 months from the Covered Person's effective date for Hospital Room & Board, ICU/CCU, Surgery and related Anesthesia benefits only. Coverage is not provided for members age 65 or over. Coverage will terminate at the end of the monthly billing cycle prior to turning age 65. Members can be enrolled only once. Duplicate or multiple memberships including United States Fire Insurance Company benefits, is not allowed.
*The association membership fee you will be charged include insurance premiums which are paid to United States Fire Insurance Company for limited medical indemnity insurance coverage as well as non-insurance fees for products and services offered by and paid to the Association.
THIS IS NOT BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE AND IS NOT DESIGNED AS A SUBSTITUTE FOR BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE. NOT AVAILABLE IN AK, CT, KS, MD, ME, MT, NC, NH, NJ, NY, OR, RI, VT AND WA.
Diagnostic Tests, X-Rays, and Laboratory
Doctor Office Visit: Pays $75 per sitting or draw, 1 sitting or draw maximum per Covered Person per policy year. Benefits are paid for a Covered Person when x-rays, laboratory and other diagnostic tests are ordered or performed by a Doctor, coverage is provided for such tests, including the services of a radiologist or radiology group and for services of a pathologist or pathology group for interpretation of diagnostic tests or studies that are Medically Necessary due to an injury and sickness or care of an injury or sickness covered under the policy. This benefit is not subject to a waiting period for pre-existing conditions.
Wellness Office Visit Benefits are paid for routine wellness diagnostic testing, X-rays and laboratory testing. Wellness diagnostic testing, X-rays and laboratory testing include but are not limited to pap test, colonoscopy, prostate cancer screening, mammography and bone density screening. Covers 1 visit per Covered Person per policy year as follows; • Adult Wellness Visit (ages 6-64) $105 per visit • Child Wellness Visit (ages birth-5) $105 per visit
Emergency Room: $100 per visit When Medically Necessary treatment by a Doctor in a Hospital Emergency Room for a Medical Emergency due to an Injury or Sickness, is required, coverage is provided for treatment of $100 per Policy Year, 1 visit Maximum per Covered Person. This benefit is not subject to a waiting period for pre-existing conditions.
Physical Therapy Visits: $25 per visit When as the result of a Covered Injury or Sickness, a Doctor certifies that a Covered Person requires Physical Therapy. Maximum of 10 visits per Covered Person per Policy Year. This benefit is not subject to a waiting period for pre-existing conditions.
Ambulance Benefit: $300 per trip When as the result of a Covered Injury or Sickness, a Covered Person requires the services of a licensed professional ambulance company for transportation to or from a Hospital. For Medical Emergencies only. Maximum of one trip per Covered Person per Policy Year. This benefit is not subject to a waiting period for pre-existing conditions.
Hospice Benefit: $100 per day This benefit is payable, when a Doctor certifies that as the result of a Covered Injury or Sickness, the Covered Person’s life expectancy is not more than 6 months. Maximum of 20 days per Covered Person per Policy Year. This benefit is not subject to a waiting period for pre-existing conditions.
Coverage for accidental injuries that require medically necessary care.
Accident Medical/Dental Expense Benefit: $5,000 When a Covered Person sustains an accidental Injury that requires Medically Necessary care by a Doctor, coverage is provided, less a $200 deductible, up to $5,000, for treatment, services and supplies for such Injury. Maximum of one occurrence per member per Policy Year. Initial treatment for the Injury must be received within 30 days of the Injury.
These benefits are underwritten by United States Fire Insurance Company and are subject to the terms, definitions, conditions, exclusions and limitations of the group policy. Coverage is not provided for loss due to pre-existing condition for 12 months from the Covered Person’s effective membership date. Coverage is not provided for members age 65 or over.
THIS IS NOT BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE AND IS NOT DESIGNED AS A SUBSTITUTE FOR BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE. NOT AVAILABLE IN AK, CT, KS, MD, ME, MT, NH, NJ, NY, OR, RI, VT AND WA.
24 Hours a Day, 365 Days a Year, Worlwide Accident Protection; Paid in Addition to Other Insurance; Covers Accidents in the Course of Business or Pleasure, on or off the job.
Members are insured for Accidental Death & Dismemberment 24 Hours a Day, 365 Days a Year, anywhere in the world. This benefit is paid in addition to other insurance you may have and; covers accidents in the course of business or pleasure, on or off the job. The benefit amount is $10,000 for each member, $5,000 for each spouse/domestic partner, and $2,500 for each unmarried dependent child.
100% of the Benefit Amount is payable for Accidental: Loss of Life; Loss of Speech and Loss of Hearing; Loss of Speech and one of: Loss of Hand,Foot or Sight of One Eye; Loss of Hearing and one of: Loss of Hand, Foot or Sight of One Eye; Loss of both Hands, both Feet, loss of Sight or anycombination thereof; 50% of the Benefit Amount is payable for Accidental: Loss of Hand, Foot or Sight of One Eye (any one of each); Loss of Speech or Loss of Hearing; 25% of the Benefit Amount is payable for Accidental: Loss of Thumb and Index Finger of the same hand. If an Insured Person suffers multiple losses as a result of one accident, this benefit only pays the single largest benefit amount applicable to all such losses.
Reduction of Benefit Amount: The benefit amount reduces to 65% at age 70; to 45% at age 75; to 30% at age 80; and to 15% at age 85. Thebenefit amount cannot be increased after age 70.
Medical Evacuation and Repatriation Benefit** If accidental bodily injury, disease or illness causes an insured person to require medical evacuation and/or repatriation while on a covered trip more than 100 miles from home and lasting no more than 180 days, this coverage will pay for covered expenses up to a maximum of $50,000. The medical evacuation or repatriation must be ordered by a physician and arranged by the Assistance Services Administrator. This benefit will also: a) guarantee payment of the charge made by a hospital prior to and as a condition of an insured person’s admission for emergency medical treatment up to $5,000 (Hospital Admission Guaranty); b) $100 per day up to a maximum of 5 days for the costs for temporary lodging and meals incurred by an immediate family member who travels to be with a hospitalized insured person (Family Travel Expense); c) pay for an accompanying dependent child to return to his or her residence if the insured person is hospitalized while on a trip (Return of dependent Child).
EXCLUSIONS Applicable to the AD&D and Medical Evacuation and Repatriation Benefit Insurance does not apply to any Accident, Accidental Bodily Injury or Loss when the United States of America has imposed any trades sanctions prohibiting the insurance, or there is any other legal prohibition against providing the insurance. In addition no benefits will be paid for any Accident, Accidental Bodily Injury or Loss caused by or resulting from any of the following: 1) An insured Person being in, entering, or exiting any aircraft:: a) owned, leased or operated by the Sponsoring Organization or on the Sponsoring Organizations’s behalf; or b) operated by an employee of the Sponsoring Organization on the Sponsoring Organization’s behalf. 2) an Insured Person, or exiting any aircraft while acting or training as a pilot or crew member. This exclusion does not apply to passengers who temporarily perform pilot or crew functions in a life-threatening emergency. 3) an Insured Person’s emotional trauma, mental or physical illness, disease, pregnancy, childbirth or miscarriage, bacterial or viral infection, bodily malfunctions or medical or surgical treatment or diagnosis thereof. This exclusion does not apply to the Insured Person’s bacterial infection caused by an Accident or by Accidental consumption of a substance contaminated by bacteria. 4) while the Insured Person is incarcerated. 5) an Insured Person participating in military action while in active military service with the armed forces of any country or established international authority. However, this exclusion does not apply to the first sixty (60) consecutive days of active military service with the armed forces of any country or established international authority. 6) an Insured Person traveling or flying on any aircraft engaged in Specialized Aviation Activities. Specialized Aviation Activity means use of a properly certified aircraft for the following: acrobatic or stunt flying, exploration, racing, pipeline inspection, any endurance tests, power line inspection, any flight on a rocket propelled or rocket launched aircraft. livestock herding, bird flock management, crop dusting, aerial photography, crop seeding, banner towing, crop spraying, or any test for experimental purpose. 7) an Insured Person’s suicide, attempted suicide or intentionally self-inflicted injury. 8) This insurance does not apply to any Accident, Accidental Bodily Injury, Loss, Covered Loss, or Loss of Property caused by or resulting from, directly or indirectly, a declared or undeclared War.
**AD&D and Medical Evacuation and Repatriation insurance are underwritten by Federal Insurance Company, a member of the Chubb group of Insurance Companies. This literature is descriptive only. actual coverage is subject to the language of the policies as issued. Exclusions apply. Chubb, Box 1615, Warren, NJ 07061-1615.
Pays the beneficiary $10,000 upon the primary Member's death. This amount is doubled if the loss of life is due to an accident.
Member becomes eligible for this benefit six months after the membership effective date.
Accidental Death and Dismemberment Exclusions - ReliaStar Life does not pay benefits for loss directly or indirectly caused by any of the following:
Coverage provided under a Group Term Life Insurance Policy issued by ReliaStar Insurance Company, a member of the ING USA Life Group. All benefits are controlled by the terms and conditions of the group Policy. Not available in ID, NH, NC, VT or WV. Coverage is not provided to members age 65 or older or to individuals that are not citizens or legal residents of the United States, its territories and protectorates.
Save 30 - 80% on Major Surgery Costs with BridgeHealth
BridgeHealth, the premier provider of medical travel services, connects you with domestic and international hospitals and doctors to provide you with excellent quality and pricing that is substantially lower than anything you can find on your own. We provide you with a connection to our pre-screened network of providers, we schedule the surgery/procedure for you, and provide personal assistance throughout the entire experience--from the initial contract with the surgeon, to trip planning, updates to friends and family, and follow-up care.
www.bridgeHealthMedical.com/USAHC
RX coverage through Fidelity Security Life
Fidelity Security Life Rx
This benefit is provided to USA+ members by a group policy issued to USAHC by Fidelity Security Life, an A- (Excellent) rated carrier by A.M. Best. Some provisions, benefits, exclusions or limitations listed herein may vary depending on your state of residence.
A brief list of exclusions includes the following: injectables, experimental drugs, vitamins, infertility, cosmetic drugs and brand name drugs. Please contact the Association at 1-800-872-1187 for a complete list of exclusions and limitations. Underwritten by Fidelity Security Life Insurance Company, Kansas City, MO. The plan is goverened by M-9031. Policy PD-245.
*NOT APPLICABLE TO RESIDENTS OF CT. THIS BENEFIT IS NOT AVAILABLE IN AL, FL, MA, MD, ME, MN, NH, NY, SD AND WA.
CareMark Mail Service Pharmacy
Save Time and Money when you use Mail Order. CareMark is an industry leader that provides a high quality, dependable and convenient mail order prescription program.
Order long term medications through Caremark and save up to 50% off the regular retail price.
How it works:
Due to the time required for mail order shipments, this program is not suitable for one-time prescriptions needed for emergencies or temporary conditions
Certain terms and conditions apply and are subject to the Exclusions and Limitations. See your membership handbook for details.
This is a discount program only. USA+ has no liability for providing or guaranteeing service or for the quality of service rendered.
*The following drugs are excluded from this discount program:
Click on the following link for look-up: www2.caremark.com/micro/usahc/cda/index.html To obtain a quote, Participant 3163 should be selected for retail quotes and Participant 8 should be selected for mail quotes.
In the event that an eligible member suffers from a “certified injury” that requires emergency medical transportation by helicopter in accordance with EMS protocols, the program will reimburse the participant up to a maximum of $7,000.00 per occurrence. Reimbursement includes expenses incurred from the cost of “Medically Necessary” or “Life Threatening” helicopter transportation from the scene of an accident to the nearest medical facility capable of treating the injuries or from one medical facility to another medical facility. Claims for “Medically Necessary” transports from one medical facility to another medical facility are subject to review by Lifeguard’s Medical Officer. Provisions include: • One benefit will be paid per occurrence. • Benefit in excess of all other valid collectable insurance. • Coverage is worldwide. • Transportation by helicopter only.
This benefit is provided to USA+ members by Lifeguard Emergency Travel, Inc. Certain terms and conditions apply and benefits are subject to the Exclusions and Limitations. See your membership Handbook for the details.
Patient Advocacy service provides a comprehensive solution that goes well beyond the benefits that a stock PPO discount can provide.
The Karis flagship Patient Advocacy service could be the most cost effective and valuable health benefit we provide to take care of your self-pay balances. Karis mediators work directly with patients and providers to resolve bills, allowing patients to focus on their health while Karis focuses on the most cost effective solutions.
WATCH THE INTRODUCTORY VIDEO TO LEARN MORE
Facts and figures say a lot about what Karis does. Stories about the people that Karis helps everyday say even more. Below you will find personal stories describing what Karis does for patients, and how their knowledgeable and attentive staff has impacted their lives.
John owned his company and medical insurance was unfortunately low on the priority list. When a symptom-free aneurysm burst and caused a stroke, John had to be airlifted to his local care hospital where it was decided that he needed more extensive care at a regional center. Four weeks later the total bills – including the flight, two hospitals and rehab – exceeded $46,000. John did not qualify for Medicaid and lacked the funds to pay bills of this size. After much negotiation, we reached a settlement with all of the parties involved, averting financial ruin for John. Savings: Over $42,000.
Brandon cut and dislocated his finger playing hockey. He drove himself to the emergency room where he waited for two hours before a doctor saw him. The doctor put his finger back in place and stitched up the cut. The whole procedure took less than thirty minutes. Two weeks later Brandon received a bill for $5,500. We contacted the doctor who agreed to reduce the bill to $2,500 and accept monthly payments to pay off the balance. Savings: $3,000.
Hannah broke her hip following a nasty fall a year ago. The hip had to be replaced, resulting in medical bills of $44,000. We managed to obtain a 50% discount off the hospital bill. The doctor’s bill of $6,500 was reduced by 25%. Hannah now needs to have her other hip replaced. Both the hospital and the doctor have agreed to give her the same discounts as before. Savings: $47,250 plus ongoing savings.
To maintain patient privacy, names and other sensitive information has been changed or removed.
An annual Comprehensive Wellness Exam (CWP™), at no charge!
A simple inexpensive blood test could save your life. Serious Medical Conditions such as heart disease, prostate cancer, diabetes, thyroid disease, and more, can go undetected for up to two years - without noticeable symptoms.
The earlier a problem is detected, the easier and more likely it is to be treatable. A Comprehensive Wellness Exam (CWP™), is not a physical, but includes a Complete Blood Count, Liver Profile, Kidney Panel, Thyroid Panel, Lipid Profile, Bone and Minerals, Fluids & Electrolytes and Diabetes, costs over $500. Direct Labs provides direct access to major clinical labs across the USA for these important blood tests one time annually at no charge for each enrolled member and the member’s spouse, if enrolled.
New York Residents: a kit wil be sent to you with location choices for blood draw, instructions for the phlebotomist on handling the specimen, and an overnight package. Extra fees apply.
This benefit is NOT available in Illinois, New Jersey or Rhode Island.
Comprehensive Wellness Profile (CWP™) with 50+ results includes CBC’s, lipids, kidney, liver, glucose, electrolytes, bones and minerals.
This benefit is not available until the 61st day following effective date.
Save time and money spent in a physician's office by engaging in a telephone consultation with a nurse and a physician at no charge.
This benefit will save you time and money that might otherwise have been spent in a physician's waiting room or office. With this service, you can use a toll-free number that connects you with a nurse and ultimately with a physician, who will discuss symptoms with you and where allowed by law, may write a prescription for non-narcotic or non controlled medications at any time day or night.
Click here to download the CallMD Medical History Application.
Click here to access the interactive website
Speak with a caring staff of registered nurses toll-free, 24 hours a day, 7 days a week at no charge.
As a USA+ member, receive easy access to a team of registered nurses, 24 hours a day - at no additional cost.
This toll free access provides a valuable resource that can help you make decisions when faced with health related challenges.
How it works: Call the toll free number at 1-866-850-6215 for immediate access to a registered nurse who can address your concerns. Refer to your member's handbook for additional information in accessing the Audio Library. You may also access additional information through the Health Forums site Audio messages and interactive internet forums give you additional access to a wealth of reliable health and well-being information. www.healthforums.com
Listening to Audio Messages - Optum gives you another convenient way to access health information. Simply call the same toll-free number to listen to the Health Information Library's recorded messages on a wide variety of health and well-being issues. A sample of the more than 1,100 topics is available. Ask a Optum nurse about additional topics.
A high level second opinion to confirm diagnosis and treatment from one of 50,000 of the leading medical specialists in over 400 subspecialties of medicine at no charge.
You and your doctor have access to the medical guidance of over 50,000 of the leading medical specialists in over 400 subspecialties of medicine. This benefit provides you with the following services:
InterConsultation™ — a high level second opinion, to confirm diagnosis and treatment. FindBestDoc™ — assistance in locating doctors in your area that have been identified as ‘best’ by their peers to treat specific medical conditions. FindBestCare® — arranging access to hospitals and treatment.
InterConsultation™ — a high level second opinion, to confirm diagnosis and treatment.
FindBestDoc™ — assistance in locating doctors in your area that have been identified as ‘best’ by their peers to treat specific medical conditions.
FindBestCare® — arranging access to hospitals and treatment.
Best Doctors, Information when it matters most, the Best Doctors Logo, FindBestDoc, Interconsultation, and FindBestCare are trademarks or registered trademarks of Best Doctors, Inc. in the U.S. and other countries, and are used under license.
How it works: Simply call 1-888-362-8677 and a Best Doctors Personal Advocate will help you receive the information needed to get the right treatment the first time.
Internet tool provides quality ratings for hospitals and pricing for medical procedures.
The most comprehensive consumer health information tool available. With MyHealthCompass™, you'll have access to detailed information about healthcare providers, and be better equipped to make healthcare decisions. As a member of MyHealthCompass, you'll benefit from:
Login here to access your benefit!
How it works:To obtain information and compare the performance of medical providers, go online and follow the prompts or should you have any questions, feel free to contact USA+ Member Services at 1-800-872-1187.
Health resources to help you achieve your personal goals.
MyeWellness.com is a comprehensive health resource that helps individuals achieve their personal goals.
Click here to get started
Our Benefits Protector Program helps cushion the impact of economic downturns.
How you benefit Many individuals lose their job due to a company re-location, company downsizing or as the result of natural disasters. For most individuals, loss of employment also means a monetary loss.
The Benefits Protector program helps cushion the impact of economic downturns that occur. Should you lose your job through no fault of your own, we will be there for you. Your membership dues will be waived and your membership benefits will continue for three (3) months. (Certain Terms and Conditions Apply. Please refer to your Membership Handbook for complete details.)
How to use your benefit 1. Notify USA+ within 20 days of the loss of employment. Notice must be submitted to USA+ at the following address:
P O Box 200905 Arlington, Texas 76006-0905
2. Upon receipt of your written request, USA+ will send you a Benefits Requests application to complete and return to USA+.
3. When the completed form is received, USA+ will contact your former employer and validate the reason for separation.
4. If the employer confirms that the loss of employment was not the result of misconduct connected with your work and you did not voluntarily quit, you will receive a letter from USA+ confirming the continuation of your USA+ membership.
5. If the employer is not able to confirm your loss of employment, you will receive a letter from USA+ stating that we are unable to continue your USA+ membership.
Dental coverage for basic and preventive services, based on a schedule of benefits, plus a Rewards Program that increases the annual coverage maximum each year.
You receive the following benefits: NO Deductible for Type 1 Preventive Services, $50 Deductible for Type 2 Basic Services, No more than 3 deductibles per calendar year, Maximum Benefit – $2,500 annually Per Family Member, Benefits Are Paid Based On Schedule of Eligible Expenses, No waiting period on preventive and basic services, Choose any dentist nationwide or select from one of nearly 65,000 provider access locations.
Find a Provider
Dental Rewards - Rewards insureds that care for their teeth and use only a portion of their annual maximum benefit in a year. With its increasing maximum feature, each insured member and dependent earns additional money toward his or her next year’s annual maximum.
To get the maximum carryover for the next year, you must meet the following requirements: 1) Visit your Dentist between Jan. 1st and Dec. 31st. 2) Submit claim for payment prior to April 1st of the next year. 3) Total benefits paid for current year visits must be less than $500.
• If you meet all 3 requirements you will have an additional $250 available in Annual Maximum for the next year. • In future years if you have benefits paid of less than $500, additional amounts of $250 will be added to the carryover. However, the most you can accumulate in the maximum carryover is $1,000. • Your annual maximum will be $2,000 in four years if you continue to visit the dentist once each year!
These benefits are provided to USA+ Members by a group Dental Expense policy issued to USA/HC by Ameritas Life Insurance Corp. Certain terms and conditions apply and benefits are subject to the Exclusions and Limitations. A complete description is contained in the Certificate of Coverage. Ameritas Group, a division of Ameritas Life Insurance Corp. a UNIFI Company, offers group dental and eye care products nationwide. Ameritas Group’s dental and eye care products (9000 Ed. 01-05) are issued by Ameritas Life.
Free eye exam once per year per family member from participating providers.
You receive the following benefits and more: Free eye exam once per year per family member from participating providers; 20% discount on lenses, frames, and other hardware; Up to a 25% discount on laser surgery; There are 32,000 VSP providers nationwide; There’s a VSP provider within ten miles of the homes of 90% of the United States population; Find a VSP provider near you at www.ameritasgroup.com
Contact a helpful Team Corp agent...
Type: IndividualMonthly Price: $370.00Setup Fee: $100.00
Type: Member/SpouseMonthly Price: $659.00Setup Fee: $100.00
Type: Member/ChildMonthly Price: $639.00Setup Fee: $100.00
Type: FamilyMonthly Price: $865.00Setup Fee: $100.00