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Understanding Basic Health Insurance

by Tony Novak, MBA, MT, OnlineAdviser at Freedom Benefits revised 11/28/2011

Basic Health Insurance is a relatively new type of health insurance that provides a specific dollar amount of cash benefit that is paid in addition to other health insurance benefits. There is no deductible or co-payment. Treatment by all U.S. doctors and hospitals is covered with no need for pre-authorization. The costs of treating pre-existing medical conditions are covered after the policy has been in force for six months. Benefits are paid in cash directly to the policy owner unless that right was assigned to a medical provider through an “assignment of claim form” commonly used by doctors and hospitals.

There are no medical questions on the application. This is guaranteed issue coverage for all applicants except those individuals who are totally unable to work or perform their usual daily duties.

This insurance is commonly used to fill in the gaps left by other insurance or as a “last resort” when other health insurance is unavailable or unaffordable. This insurance is not meant to provide full protection for every possible medical claim, but rather focuses on covering a portion of the most commonly incurred types of medical bills in a simple and straightforward manner.

Coverage is available directly to individuals and through employer-sponsored plans. The benefits are the same, but the cost is lower through the employer-sponsored plans. This insurance is currently available in about half of the states.

Basic Health Insurance offers two levels of medical insurance benefits: “Value” and “Enhanced”. The insurance benefits can be enhanced with optional discount benefits for prescription drugs, dental and vision care. The chart below provides a basic summary of the benefits. The benefits may vary under specific state law, so see the specific listing below the personal quote page at www.BasicHealthInsurance.net for a full listing of benefits.

 

Value Plan

Procedure:

Insurance Pays:

 Doctor Office Visits

$30

 Diagnostic Testing

$30

 Child Wellness Visits

$30

 Hospitalization

$100 a day

 Intensive Care Unit

$200 a day

 Surgery (Inpatient / Outpatient)

$500 / $200

 Emergency Room

$100

 Alcohol and Substance Abuse

$50 a day

 

Enhanced Plan

Procedure:

Insurance Pays:

Doctor Office Visits

$65

Diagnostic Testing

$65

Child Wellness Visits

$65

Hospitalization

$300 a day

Intensive Care Unit

$600 a day

Surgery (Inpatient / Outpatient)

$2,000 / $800

Emergency Room

$300

Alcohol and Substance Abuse

$150 a day

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Status: available for reprint

Basic Health Insurance was replaced by Core Health Insurance by Freedom benefits in 2011 after the former was discontinued.

This article is available for republication in its entirety without charge after obtaining the express written permission of the author.

Please e-mail a request to the author that includes the name of the requestor (individual and corporate) and the intended destination of publication.