HEALTH ESSENTIAL

We have what you need for your:

• Uninsured - Clients that can't afford the higher cost of major medical
• Uninsurable - Clients that have been declined 
• Underinsured - Fill benefit gaps on HSA or high deductible major medical plans 
• Employers - Who want to offer quality health care benefits - but without the cost of group major medical

Why Health Essential is your best choice?

*The 12 month pre-existing conditions limitation does not apply to these benefits.

 Health Essential Forms:

(not available in AK, CT, KS, MD, ME, VT)
Health Essential  Brochures and Application

  You can select the NEW option to change the Doctors Office Visit benefit from an
Indemnity to a $30 or $20 Co-Pay Benefit when you apply online.

Value Access Guarantee
VBA Members Limited Medical

• Guaranteed Issue for members and their spouse's ages 18 through 64. Coverage terminates at age 70.

• Pays Indemnity Benefits – There are NO Deductibles or Co-pays

• Pays Benefits for Doctors Office Visits, Hospitalization, ICU or CCU, Surgery, Anesthesia, Preventive Care, Emergency Room Care, Lab and X-Ray Testing, and Ambulance Services*

• Dependent Child Coverage is available to age 21 if the child is dependent on the parent member; or to age 23 if attending an accredited school full-time.

• Save money through access to Beech Street PPO Network

• Or you can use your own Doctor, Hospital or Licensed Provider

• Pays Benefits in Addition to any Other Insurance Coverage

• Pre-existing Conditions Incurred within the 12 Month Period Preceding the Effective Date are not covered. The Pre-existing Conditions Limitation is waived under the Outpatient Doctors Office Visits Indemnity Benefit**

* This plan is not available in all states and benefit options vary by state.
** Pre-Existing Conditions: No benefits will be payable for expenses incurred as a result of a Pre-Existing Condition until coverage has been in effect under the Policy for 12 consecutive months. This Pre-Existing Conditions Limitation is waived under the Outpatient Physician Office visit Indemnity Benefit.

Value access Forms:

Value Access Guarantee Brochure & Enrollment Forms
(Not available in: CA, CT, HI, ID, IN, MT, NH, NJ, NY, OR, SD, WA, WV)

Value Access Guarantee Surgical Schedule

Beech Street PPO Network

Agent Contracting

Value Plans Draft Dates & New Business Time Lines


Download Adobe Acrobat Reader

Value Med Insurance Plan

Sickness & Accident, Hospital & Medical Insurance

THIS POLICY PROVIDES LIMITED BENEFITS  

Value Med  is now available in:  AK, AL, AR, AZ, CA, CO, DC, DE, FL, GA, IA, ID, IL, IN, KY, LA,  MI, MO, ND, NE, NM, OH, OK,  OR, PA, SC, SD, TN, TX, UT, VA, VT, WI, WV & WY

Select the state listed below and click on "VIEW"to view and download the ValueMed Kit.

Alabama Alaska Arizona Arkansas California Colorado Delaware Dist of Columbia Florida Georgia Idaho Illinois Indiana Iowa Kentucky Louisiana Maryland Michigan Mississippi Missouri Nebraska Nevada New Hampshire New Mexico North Dakota Ohio Oklahoma Oregon Pennsylvania South Carolina South Dakota Tennessee Texas Utah Vermont Virginia West Virginia Wisconsin Wyoming




Be patient these files will take a few minutes to download.

---

Download Adobe Acrobat Reader

* The benefits may be paid directly to the hospital or other health care facility if an assignment of benefits is made by the policyholder.

** Pre-existing conditions are those medical conditions disclosed or not disclosed on the application which were diagnosed or for which medical advice or treatment was recommended or received from a Doctor within a 12-month period immediately preceding the Effective Date of Your coverage. Any loss due to a pre-existing condition is not covered unless the loss begins more than 12 months* after the Effective Date of coverage. *The pre-existing condition waiting period is 6 months in Idaho and Oregon.

Wyoming Applicants Only - Your Pre-existing Conditions Limitation reads:
The policy will not cover loss resulting from pre-existing conditions during the first year that your policy is in force. A "pre-existing condition" is any sickness or injury diagnosed for which You received medical advice and /or treatment was received from or recommended by a Physician within the 90 day period immediately before the effective date of Your coverage, or the effective date of an increase in coverage, whichever is applicable

*** The insurer has the right to increase premium rates of all like policies in your state.

**** Instead of age 19 the following states have higher limits: Indiana age 24, New Mexico age 25, North Dakota age 22 and Utah age 26.

***** Hospital confinement must be medically necessary because of injury or sickness. Our definition of hospital excludes (a) a convalescent home, convalescent, rest or nursing facility; or, (b) a facility or portion thereof used primarily for the care of the aged, the terminally ill, drug or alcoholic rehabilitation, or primarily affording custodial, long-term nursing, convalescent or educational care.
 

Value Health USA

This sickness and accident indemnity limited medical plan offers very impressive benefits at a very competitive premium for your clients.  The Platinum plan provides:

• Physicians Office Visit benefit of $75 each for up to 10 per year for each insured adult, 5 per year for each insured child.  There is a limit of one visit per week per insured. 
• Daily Hospital Confinement from to 1st day up to 1 year per confinement of as much as $1,000 per day.
• Intensive Care or Coronary Care from the 1st Day up to 30 days per confinement of as much as $4,000 per day (this amount includes the Daily Hospital Confinement Benefit).
• Pays scheduled amount for surgery due to a covered sickness or injury up to a maximum of $20,000.
• Pays scheduled expenses for administration of anesthesia during a covered surgery up to a maximum of $4,000.
• Pays expenses incurred for ambulance services due to a covered injury and sickness up to $500.
• Pays expenses incurred for emergency treatment due to a covered injury up to $250.

Benefits illustrated are for individuals under age 65.  Benefit amounts will be reduced 50% at age 65.  Coverage will remain in force as long as you are under age 75, pay your premiums and are not in active military duty and your policy is in force. 

Value Health USA Kit

• Generic Kit  (All states except AL, CT, KY, LA, ME, NJ, OR, UT & WA)

• Alabama Kit

• How is the sugery benefit on Value Health USA paid?

• Value Plans Draft Dates & New Business Time Lines

• Value Plans State Apporval List

• Agent Contract

• Direct Deposit Form

• Commission Assignment Form

• List Bill Forms - Value Health, Value Hospital & Value Med Plans (GEM will process the monthly billing.)

Download Adobe Acrobat Reader