Provident Indiana Health Insurance

Back to this Carrier’s Main Page

[Illinois-Solution]

[Indiana-Quest]










	Last Updated 01/08/99


	Click here to go up one level

QuickStat	PPO Net	Maternity
7.0	Sagamore	Partial

Sagamore Directory not yet online.

It’s hard to find much wrong with this plan. Provident offers three different PPO plan options. A 90%, 80% and 70% in network feature, 20% less coinsurance out of netwo

Plan Options Available:
rk. Plans with deductibles of $1200 or less receive a physician copay benefit of $15 at

Maternity

Yes

Dental

No

Life

Yes

Disability

No

SAGAMORE providers and $30 with non-network providers. A prescription card is also included with plans with a $1200 deductible or less.

Dental and maternity are available, although the maternity benefit leaves something to be desired.

Plan Availability:

Indiana Only


	Deductible Options: $250 to $10,000. Maximum Lifetime Benefit: $2,000,000 Strengths: Cost, Sagamore network, copay's. Weakness: No well care 1st year., underwriting can be slow.

		Provident Quest Plans

Benefit Description	In Network Benefit Levels	Out of Network Benefit Levels
Calendar Year Deductible	$250 to $1,200	$250 to $ 1,200
Preferred Network	Sagamore
Deductibles per family	3x	3x
Coinsurance	90%	70%
Maximum out of pocket - not including deductible, per person.	$ 500.00	$ 1,500.00
Number of coinsurance's per family maximum	2x	2x
Inpatient and Outpatient hospital services.	After deductible, paid at 90% until out of pocket maximum, then 100%.	After deductible, paid at 70% until out of pocket maximum, then 100%.
Inpatient and Outpatient diagnostic services. (xray, lab, etc..)	After deductible, paid at 90% until out of pocket maximum, then 100%.	After deductible, paid at 70% until out of pocket maximum, then 100%.
Medically Necessary Office Visits	Deductible Waived. $15 copay, balance covered at 100%	Deductible Waived. $30 copay, balance covered at 100%
Preventive Care ($100 per person, per annum, max.)After insured one year, within 60 days of anniversary.	Covered at 100%	Covered at 100%
Supplemental Accidental Injury Benefit.	1st $300 per incident covered at 100% without deductible.	<<<<<<<<
Mental Health Benefit- $2000 inpatient, $1100 outpatient max, per year	Outpatient Covered at 50% up to a maximum of $20 per visit.	<<<<<<<<
Maternity Coverage - Up to $3000 maximum benefit. No coverage for 12 months, $2000 max months 13-23.	Paid to maximums without deductible or coinsurance.	<<<<<<<<
Prescription Drug Coverage - ( most pharmacy chains)	No calendar year deductible: Generics at $10 per prescription ; Name Brand at $20 per prescription.	<<<<<<<<
Lifetime Maximums	$ 2,000,000	<<<<<<<<

Preexisting condition clause - WAIVED for anything mentioned on application and not excluded, otherwise 12 months prior not covered until on plan for 12 months.

Pre-certification - Notification required prior to all elective hospital admissions. Emergency required within 1 business day of admission.

Underwriting is by health statement and takes 3-5 weeks. There is a $25 non refundable application fee.

Optional Dental - $0 deductible

$750 Annual Maximum.

Coverage "A"- Routine care at 80%.

Coverage "B" Basic - waiting period 6 months. Paid at 50% month 7/-12, 60% 2nd year, 70% 3rd year, 80% 4th and after.

Coverage "C" Major - waiting period 12 months. Paid at 50%- Annual component maximum $500.

The following summary is NOT a solicitation to sell you insurance. Solicitations can only be made with state, and insurance company, approved brochures. Information contained in this web may contain generalities or inaccuracies. Please read the brochures and policies for specific limitations and exclusions.