Florida
Pregnancy Insurance Guide
If you are already pregnant we can offer you a limited benefit health insurance plan. This is not full major medical, but it will cover a number of expenses associated with your pregnancy. It will also provide PPO repricing for all of your medical expenses including maternity.
Please
read this page BEFORE you call.
Our
number is 800-272-0512 and you can reach us from
9 AM to 8 PM EST Monday -Thursday and until 6 PM on Fridays
 Some
Basic Facts About Our Pregnancy Coverage
These are limited benefit health insurance plans. That means there is a schedule of benefits that are used to determine how much the plan will pay out.
But, before I describe the plan to you, I want you to read the next few points.
1. We will not take someone who is more than 3 months pregnant
2. The plan, with all of its benefits combined, pays out about $7,300 for a normal delivery with a two day stay in the hospital and about $11,000 for a four day stay.
3. Since you cannot get it past the third month, most of you will pay premiums for 7 to 10 months.
4. The premium for the NPX4 plan is $329 a month
5. This means that no matter what happens, the plan will be paying you more than you pay in by $4,000 to $9,000
So, you literally have to be a little dim-witted not to take the plan. I apologize for the remark but it is true. I can never understand why someone who is pregnant and now knows for certain they will have a claim that far exceeds what they pay for the plan, does not buy it. What goes through these people's minds?
The chart below shows that the plan will pay $75 a visit for a physician office visit, that is exactly what you will receive. They do not care what doctor you go to. They do not care what you are going for. They do not care what your bill is. If it says $75 per office visit for up to 5 visits per calendar year, that's it. That is what they pay.
The best plan is the NPX4. If you are already pregnant, this is the one that makes the most sense. It will pay $2,000 for the first day you are hospitalized and $1,000 for each day after than. It is pays some doctor visits, tests, etc.
The plan will pay the exact same amount for the baby.
Do you realize what I just told you. If you are in the hospital for two days and get $3,000, the newborn gets $3,000 as well. Just make sure you call to put the baby on the plan for at least one month.
Remember, there is no such thing as maternity insurance. This plan does not care if you are pregnant or having your appendix out.
Also, the plan uses the BeechStreet PPO network and you are entitled to the PPO discounted rate for all services when you use a network provider. To check providers go to www.beechstreet.com.
To enroll in any of these plans, click on the plan name at the top of each column. Below this chart are links that will take you to a special page where you can see more complete information and enroll.
| Benefit Descriptions |
NPX
1 |
NPX
2 |
NPX
3 |
NPX
4 |
| PREVENTIVE BENEFITS |
Physician Office Visit
- 5 visits per person per calendar year
- 10 visits per family per calendar year |
$50 per visit
$250 per year maximum |
$50 per visit
$250 per year maximum |
$75 per visit
$375 per year maximum |
$75 per visit
$375 per year maximum |
Health Screening Benefit
- 3 visits per person per calendar year
- Includes routine exams and preventive testing |
$25 per visit
$75 calendar year maximum |
$25 per visit
$75 calendar year maximum |
$50 per visit
$150 calendar year maximum |
$75 per visit
$225 calendar year maximum |
Routine Well Child Benefit
- Includes physical examinations and immunizations during the first 6 months following birth.
- 6 visits per covered child per calendar year |
$30 per visit
$180 calendar year maximum |
$40 per visit
$240 calendar year maximum |
$50 per visit
$300 calendar year maximum |
$60 per visit
$360 calendar year maximum |
Diagnostic, X-ray, & Lab Benefit
- 3 tests per person / 6 per family, per calendar year |
-
|
$50 per visit
$300 calendar year maximum |
$100 per visit
$600 calendar year maximum |
$125 per visit
$750 calendar year maximum |
Emergency Room Benefit
- 4 visits per person per calendar year |
$50 per visit
$200 calendar year maximum |
$100 per visit
$400 calendar year maximum |
$150 per visit
$600 calendar year maximum |
$250 per visit
$1000 calendar year maximum |
| HOSPITAL BENEFITS |
| Hospital Admission Benefit |
$250 per admission |
$500 per admission |
$750 per admission |
$1,000 per admission |
Hospital Confinement Benefit
- Pays per day for the first 30 days of Inpatient Confinement |
$250 per day |
$500 per day |
$750 per day |
$1,000 per day |
Intensive Care Unit Benefit
- Pays per day each day Insured is Confined in the Intensive Care Unit (first 30 days)
- Pays in addition to Hospital Admission Benefit and Hospital Confinement Benefit |
$250 per day |
$500 per day |
$750 per day |
$1,000 per day |
| SURGERY BENEFITS |
% of amount on Surgical Fee Schedule
Anesthesia (% of amount on Surgical Fee Schedule)
Ambulatory Surgery Center (per visit) |
-
-
-
|
100% of scheduled amount
25% of scheduled amount
$100 |
100% of scheduled amount
25% of scheduled amount
$150 |
100% of scheduled amount
25% of scheduled amount
$250 |
| OTHER BENEFITS |
Critical Illness (First Diagnosis)*
Invasive Cancer Benefit %
In Situ Cancer Benefit %
Heart Attack Benefit %
Stroke Benefit %
Renal Failure Benefit %
Coronary Bypass Surgery Benefit %
ADL Deficit Benefit %
|
-
-
-
-
-
-
-
-
|
$2,500
100%
25%
100%
100%
100%
100%
100%
|
$5,000
100%
25%
100%
100%
100%
100%
100%
|
$10,000
100%
25%
100%
100%
100%
100%
100%
|
| HOMELAND VALUE ADDED BENEFIT*** |
| Generic Prescription Card $10 or 50% co-pay**** |
Included |
Included |
Included |
Included |
| Consult A Doctor |
Included |
Included |
Included |
Included |
| EyeMed Vision Discount Program***** |
Included |
Included |
Included |
Included |
| Homeland Lab & Imaging |
Included |
Included |
Included |
Included |
| Accident Medical Benefit (per occurrence)****** |
$2,000 |
$2,000 |
$2,000 |
$2,000 |
*Critical Illness rider pays a lump sum benefit upon diagnosis of a specified critical illness after a 30-day waiting period.
**Covered fractures include pelvis, skull, neck, thigh, upper arm, ankle, lower leg, elbow, heel, shoulder blade, lower jaw, collarbone, forearm, wrist, vertebrae, sternum, kneecap, cheekbone, hand, foot, and coccyx.
***Homeland Health Care Value Added Benefits Program is neither underwritten nor provided by National Union Fire Insurance Company of Pittsburgh, PA.
****Underwritten by Markel Insurance Company
*****Vision Care Program is underwritten by National Union Fire Insurance Company of Pittsburgh, PA.
******Accident Medical benefit is underwritten by Markel Insurance Company. |
|
