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Understanding Basic Health Insurance
by Tony Novak, CPA, MBA, MT
, revised 11/28/2011
Basic Health Insurance is a relatively new type of health insurance that provides a specific dollar amount of cash benefit that is paid in addition to other health insurance benefits. There is no deductible or co-payment. Treatment by all U.S. doctors and hospitals is covered with no need for pre-authorization. The costs of treating pre-existing medical conditions are covered after the policy has been in force for six months. Benefits are paid in cash directly to the policy owner unless that right was assigned to a medical provider through an “assignment of claim form” commonly used by doctors and hospitals.
There are no medical questions on the application. This is guaranteed issue coverage for all applicants except those individuals who are totally unable to work or perform their usual daily duties.
This insurance is commonly used to fill in the gaps left by other insurance or as a “last resort” when other health insurance is unavailable or unaffordable. This insurance is not meant to provide full protection for every possible medical claim, but rather focuses on covering a portion of the most commonly incurred types of medical bills in a simple and straightforward manner.
Coverage is available directly to individuals and through employer-sponsored plans. The benefits are the same, but the cost is lower through the employer-sponsored plans. This insurance is currently available in about half of the states.
Basic Health Insurance offers two levels of medical insurance benefits: “Value” and “Enhanced”. The insurance benefits can be enhanced with optional discount benefits for prescription drugs, dental and vision care. The chart below provides a basic summary of the benefits. The benefits may vary under specific state law, so see the specific listing below the personal quote page atwww.BasicHealthInsurance.net for a full listing of benefits.
Value Plan
Procedure:
Insurance Pays:
Doctor Office Visits
$30
Diagnostic Testing
$30
Child Wellness Visits
$30
Hospitalization
$100 a day
Intensive Care Unit
$200 a day
Surgery (Inpatient / Outpatient)
$500 / $200
Emergency Room
$100
Alcohol and Substance Abuse
$50 a day
Enhanced Plan
Procedure:
Insurance Pays:
Doctor Office Visits
$65
Diagnostic Testing
$65
Child Wellness Visits
$65
Hospitalization
$300 a day
Intensive Care Unit
$600 a day
Surgery (Inpatient / Outpatient)
$2,000 / $800
Emergency Room
$300
Alcohol and Substance Abuse
$150 a day
Status: available for reprint
Basic Health Insurance was replaced byCore Health Insurance by Freedom benefits in 2011 after the former was discontinued.
This article is available for republication in its entirety without charge after obtaining the express written permission of the author.
Pleasee-mail a request to the author that includes the name of the requestor (individual and corporate) and the intended destination of publication.
This Web site is independently owned and operated by Tony Novak operating under the trademarks “Freedom Benefits”, “OnlineAdviser” and “OnlineNavigator”. Opinions expressed are the sole responsibility of the author and do not represent the opinion of any other person, company or entity mentioned. Tony Novak is not a representative, agent, broker, producer or navigator for any securities broker dealer firm, federal or state health insurance marketplace or qualified health plan carrier and has no financial position in any stocks mentioned. Novak may act as and be compensated as an accountant, agent, adviser, writer, consultant, marketer, reviewer, endorser, producer, lead generator or referrer to the companies listed on this site or other commercial companies and non-governmental insurance exchanges. Information is from sources believed to be reliable but cannot be guaranteed. Any accounting, business or tax advice contained in this communication, including attachments and enclosures, is not intended as a thorough, in-depth analysis of specific issues or a substitute for a formal opinion, nor is it sufficient to avoid tax-related penalties.
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