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