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Last Updated
Friday, February 23, 2001
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The Fortis Preferred 1000 plans provide comprehensive major medical
coverage for individuals and families. The affordable Preferred 1000 rates reflect the good health of you and your family.
With Preferred 1000, you can also impact your premium through good health and healthy habits. Take a look at the strong benefits and features of Preferred 1000.
Fortis uses some of the biggest PPO network is each area. PHCS,
Sagamore and HealthLink are among some of the networks in Illinois and Indiana.
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Plan Options Available:
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Maternity
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Yes
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Dental
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No
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Life
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Yes
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Disability
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No
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Plan Availability:
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- Deductible Options: $500 to $5000, 80% and 50% plans. And MSA plans.
- Maximum Lifetime Benefit: $5,000,000
- Strengths: PHCS Network, copay’s, cost, 2x dedcutibles per family maximum
- Weakness: Tough underwriting - ( not necessarily a negative for those in good health)
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Benefit Description
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In Network Benefits
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Out of Network Benefits
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Calendar Year Deductible
(2x per family)
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$500 to $5000
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Common deductible
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Coinsurance
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80%
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60%
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Out of pocket max.. plus deductible, (2x per family)
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$1000, or $2000
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$ 2,000 or $4,000
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Benefits
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Hospital Facility and Services
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Covers semi private room, if none available, pays Private room rate
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Intensive Care
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Covered at charged rate
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Ambulatory Outpatient surgical Service
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At a hospital or other licensed medical facility
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Emergency Room
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Covered subject to an additional $50 copayment for all emergency room visits. If admitted, copayment will be waived.
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Physician Services
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Treatment for covered
injury or illness including surgery and anesthesia services.
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Office Visits
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Deductible waived. $20 copayment, balance at 100%.
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Lab & Xray
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100% coverage for outpatient lab and x-ray up to $100 per calendar year, thereafter, deductible and coinsurance applies.
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Ground /Air Ambulance
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For emergency treatment to nearest hospital that can treat.
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Wellness Services
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$500 per covered person per calendar year. .
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Mental Nervous Disorder
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- 50% benefit after deductible
- $2500 inpatient max/calendar year.
- $500 outpatient max/calendar year.
- Coverage for family and marriage counseling.
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- Outpatient Rehab Services
- Inpatient rehab
- Home Health Care
- Skilled Nursing facility
- Spine/Neck/Back Treatment
- TMJ
- Organ Transplants
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- Occupational ,physical, speech and cardiac Rehab to $3000 per year.
- 100% coverage for 30 days
- 100% coverage, 160 hours/year.
- 100% coverage . 30 days
- $750 calendar year max.
- $1000 Lifetime max
- $5,000,000 lifetime at designated provider, $100,000 lifetime per organ at non designated provider
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LIFETIME MAXIMUM
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$5,000,000
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Optional Benefits
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Prescription Drug Program -mail order available with 3 month supply for copayment.
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$10 copay for generics
$15 copay for brand name
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Materntity - if selected-
covered as any illness. No coverage if conception takes place prior to being insured for 270 days.
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Maternity services include
- Prenatal Care
- Normal delivery Services
- routine newborn nursery at hospital.
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Accidental injury benefit
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Option of $300, $500, or $1000 per incident.
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- 12 month rate guarantee
- Dependents covered until age 19, or ’til age 24 if full-time student.
- Dependents may convert to individual plans without evidence of insurability if they lose eligibility.
- If no prior coverage, there is a 15-day waiting period for coverage.
- No preexisting condition for any condition disclosed on application and not excluded. Otherwise, 12 months.
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