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Last Updated
Friday, February 23, 2001
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QuickStat
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PPO Net
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Maternity
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6.5
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First Health
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Partial
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The Provident SolutionTM is designed to give maximum flexibility through a wide range of plan options. The Solution plan utilizes the the AFFORDABLE Medical networks. Nine of the highest rates American Hospitals listed in the August 12, 1996 edition of U.S. News and World Report are
members of the
AFFORDABLE Network.
Solution Plus has three basic plan options. Plan "C" is the most cost
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Maternity
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Yes
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Dental
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Yes
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Life
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Yes
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Disability
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No
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effective with a Hospital and Physician PPO. Plan "B" gives you the choice of a doctor who is not in network but still wants cost savings with a Hospital PPO. Plan "A" is the
traditional indemnity design with the freedom to use any hospital or doctor..
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* $5 Million Comprehensive Major Medical Plan for Individuals and Families
* Benefits Paid Both IN or OUT of the Hospital**
* Optional Initial 12-Month Rate Guarantee
* Premiums Vary Depending on the Deductible and Plan Selected
**All benefits payable are subject to the policy exclusions and limitations
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by Provident American Life & Health Insurance Company
and Provident Indemnity Life Insurance Companyavailable in the following states:
AZ, CO, DE, FL, IL, IN, MS, MO, NE, OH, TN, TX, VA, WV
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Annual Deductibles
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Plan
Options
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Physician Office Visit Copay*
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Physician Office Visit, X-Ray, Lab & Diagnostic Tests Copay*
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Prescription
Drug Card
Benefit
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Featuring
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Optional Benefits
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$250 $500 $1000 $1500 $2500 $5000
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PLAN A: Traditional--Any Physician, Any Hospital
* 80/20 to $5000
* 50/50 to $2500**
PLAN B: Any Physician, PPO Hospital
* Any Physician, PPO
Hospital - 90/10 to $5000; Non-PPO Hospital - 70/30 to $5000
* Any Physician, PPO Hospital - 80/20 to $5000; Non-PPO Hospital - 60/40 to $5000
* Any Physician, PPO Hospital - 50/50 to $2500**
PLAN C: Hospital and Physician PPO
* 90/10 PPO and 70/30 Non-PPO to $5000
* 80/20 PPO and 60/40 Non-PPO to $5000
* 50/50 PPO and Non-PPO to $2500**
**Not available in Georgia.
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Plan A: $20
Plan B: $20
Plan C: $15 PPO, $40 Non-PPO
*Available on all plans with deductibles of $1500 or less.
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$15 for expenses up to $200
*Available on Plan C (PPO) with deductibles of $1500 or less.
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Generic Medications: $5 copay
Brand Name Medications: $15 copay
$250 Maj. Med. Ded. = $50 Rx Ded.
$500 Maj. Med. Ded. = $75 Rx Ded.
$1000-$5000 Maj. Med. Ded. = $100 Rx Ded.
$2500 calendar year maximum per insured.
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Average semi-private room-and-board rate
Intensive care (3x semi-private room rate)
In-hospital miscellaneous services and supplies
Physicians' and surgeons' fees for diagnosis, treatment and surgery
Physical exam benefit up to $100 per covered insured after first 24 months
Common accident deductible, family deductible, calendar-year deductible carryover
Mammogram (ages 35 and over)/prostate exam (ages 50* and older)--one per calendar year, pap smear exam
*45 in Georgia.
Ground/air ambulance service to the nearest qualified hospital
Inpatient/outpatient psychiatric care
Organ transplants
Medical emergencies considered for
payment at PPO coinsurance levels for Plans B and C
Laboratory tests
Children-only coverage available, child(ren) wellness benefits
X-ray, radioactive, physical, speech or respiratory therapy
Blood and plasma, artificial limbs, casts, splints, crutches
Convalescent nursing facility care
Home health care/hospice benefit
24-hour coverage included (when eligible by your state law)
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Initial 12-Month Rate Guarantee
Normal Pregnancy Rider
Supplemental Accident Rider
Dental Rider
Life & AD&D* (optional on spouse)
*Not available in Florida, or for children.
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