Discover the Advantages of Defined Benefit Medical Plans
When you're looking at health insurance, be sure to look beyond standard major medical plans and consider a defined benefit plan.
Compare How the 2 Plans Deal With Real Health Events
Major Medical Plan
- Outpatient surgery - deductible must be met
- MRI, labs, and X-rays - deductible must be met
- Doctor visits - co-pays and or deductibles
- Prescription drugs - Rx co-pays of $15 for generics and $35 to $75 for brand-name drugs; Rx co-pay does not count towards calendar year deductible
- Emergency room - $100 to $1,100 access fee plus full deductible must be met for additional benefits
- PPO network - mandatory use by client
- Penalty - doubles your deductible and coinsurance penalty applied
- Telemedicine - some charge fee per use
- Additional riders - none offered
Defined Benefit Medical Plan
- Outpatient surgery - no deductible to meet
- MRI, labs, and X-rays - Immediate benefit and no deductible
- Doctor visits - Immediate benefit and no co-pays or deductibles
- Prescription drugs - Net Rx cost to patient equivalent or better than that of a co-pay
- Emergency room - $400 to $800 benefit up front - $4,000 additional if there for accident
- PPO network - you choose your doctor and hospital
- Penalty - no out-of-network penalties
- Telemedicine - free and unlimited
- Defined benefits - you choose coverage for catastrophic accidents, critical illnesses, and specified diseases
