![Humana Humana](https://www.ilhealthagents.com/wp-content/uploads/2023/10/Humana-1.png)
Plan Details
closed accordion
What’s the deductible?
This plan offers 3 deductible options to choose from: $1,000 $2,500, and $5,000 for single, $2,000, $5,000, and $10,000 for family.
What’s the coverage for illness and injury visits?
After you meet your deductible, your expenses are covered by the plan at 100% for office visits to an in-network doctor.
What’s the coinsurance percentage for hospital services?
For both in-network inpatient and outpatient services, once you meet your deductible, this plan pays 100% coinsurance for covered medical services from in-network providers – This means you pay nothing for covered services after you meet your deductible.
What’s the coverage for emergency room services?
After you meet the deductible, your plan pays 100% coinsurance at an in-network emergency room.
Does the plan include prescription drug coverage?
Prescription drug coverage is integrated with the medical plan. The plan pays 100% after you meet your deductible.
Benefit Summary
Plan Feature | In-Network | Out-of-Network |
---|---|---|
PPO Network | ChoiceCare PPO Network
-Includes over 400,000 doctors and hospitals nationwide | N/A |
Lifetime Maximum Benefit | $2,000,000 per person | |
Deductible Per individual, per calendar year. No individual will be required to satisfy the more than the individual deductible amount toward the family deductible amount. | $1,000 per individual / $2,000 per family $2,500 per individual / $5,000 per family1 $5,000 per individual / $10,000 per family1 | |
Coinsurance The level of coverage provided by the plan after the calendar year deductible has been satisfied. | 100% | 75% |
Out-of-Pocket Expense Limit The amount of money an individual pays toward covered hospital and medical expenses during any one calendar year. Does not include deductible. | $0 | $5,000 |
Family Out-of-Pocket Expense Limit | $0 | $10,000 |
Office Visits | 100%1 | 75%1 |
Inpatient/Outpatient Physician Medical/Surgical Services | 100%1 | 75%1 |
Emergency Room | 100%1 | 75%1 |
Maternity | Not covered | |
Inpatient Hospital | 100%1 | 75%1 |
Prescription Drug Benefit | 100% after medical deductible is met | 75% after medical deductible is met |
1 After deductible is met. |
FAQ
closed accordion
Who is eligible for Humana short term plans?
- Illinois residents at least 60 days of age and under 65 years of age
- U.S. citizens or non-U.S. citizens living in the United States for at least two years (a copy of your Alien Registration Receipt Card must be submitted with your application)
Should I get a short term medical plan instead of COBRA?
What’s Included with Short Term Plans?
- Coverage for major hospital, medical, and surgical expenses
- Coverage for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care
- Although you can go to the hospitals and doctors of your choice, your benefits under any insurance plan will be higher, and your costs lower, when you use the services of participating PPO providers that includes over 90% of doctors and hospitals in Illinois.
- As with all individual Humana plans, the freedom of not having to select a primary care doctor or obtain a referral to see a specialist
- Choice of deductible amount, payment type and length of benefit period (30 – 365 days)
Prescription Drug Coverage
- For the Humana short-term plans, there is a prescription drug card benefit that pays for 100% or 80% of prescriptions after satisfying the deductible. All prescription costs incurred go towards satisfying the medical deductible.
- The short term medical plans do not include a mail service program.
What if I need coverage longer than my plan?
- Short term health insurance plans are for individuals and families who need temporary coverage.
- If you become disabled or treated for a condition before your plan expires, you will receive an extension of benefits for those conditions until you are released from the hospital or your doctor certifies you no longer need treatment.
- If you need temporary coverage for an additional period of time, you may apply for a second contract term.
- If accepted, any pre-existing condition incurred during the first contract will not be covered with the new contract.
- If you need a long-term health insurance solution, please consider our other individual and family coverage options.
What if I don’t know how long I need coverage?
If you are between jobs and not sure how long you need short-term health insurance, you can apply for the maximum length of coverage (365 days). If you obtain health insurance coverage from another source such as an employer before your 180 days of coverage expires, you can cancel your policy at any time and Humana will reimburse the amount of unsused coverage.
For example, if you purchased a policy for 180 days and obtained coverage from an employer after 90 days, Humana will reimburse the unused 90 days of coverage if you cancel your short-term policy on the 90th day of coverage.
0 Comments