Fixed Benefit Plan

Americas Health Options provides a Fixed Benefit plan and not a major medical insurance plan. Fixed Benefits are provided for hospital confinement, specified medical, surgical, and out-patient events. These benefits are paid in specific amounts and do not provide expense reimbursement for charges based on your health care provider’s bill.

FEATURES
$5,000,000 Lifetime maximum Choose from three benefit options:- Pick your Base Plan Deductible Calendar year benefit maximum level Number of benefit Units to fit your needs Use any Doctor or Hospital you choose or select PPO option to take advantage of greater savings

HOSPITAL FIXED BENEFITS
HOSPITAL CONFINEMENT Sickness: $1,500 – $4,500 Injury: $3,000 – $6,000
HOSPITAL ICU Sickness: $2,250 – $6,750 Injury: $3,000 – $6,750
MENTAL ILLNESS, ALCOHOL & / OR SUBSTANCE ABUSE $200 – $600
REHABILITATION FACILITY / & SKILLED NURSING FACILITY $750- $2,250
OUT PATIENT RADIATION & OR CHEMOTHERAPY $750 – $2,250
OUT PATIENT HOSPITAL OR & AMBULATORY SURGICAL CENTER $1,500 – $4.500

PROFESSIONAL SERVICES
SURGICAL BENEFITS 1, 2 or 3 X policy fee schedule depending on the plan you choose
IN-PATIENT PATHOLOGIST / RADIOLOGIST 1, 2 or 3 X policy fee schedule depending on the plan you choose
PHYSICIANS CARE FIXED BENEFIT NON-SURGICAL $50 – $150
DAILY ASSISTANT SURGEON & SURGICAL SERVICES FIXED BENEFIT FOR COVERED SERVICES $100 – $300*
DAILY ANESTHESIA FIXED BENFIT FOR COVERED SERVICES $125- $375*

*Arkansas, Georgia & North Carolina

OUT PATIENT BENEFITS
CALENDAR YEAR OUTPATIENT DEDUCTIBLE $50 per insured
AGGREGATE CALENDAR YEAR MAXIMUM $2,000 – $6,000
DAILY OUTPATIENT PHYSICIANS FIXED BENEFIT $40
OTHER OUTPATIENT DAILY FIXED BENEFIT (PER DAY) MRI, CAT Scan or Nuclear Testing $175 – $525 Other Diagnostics Testing / X-rays $40 – $120 Laboratory Testing $10 – $30 Injection$5 – $15
DAILY GENERIC PRESCRIPTION FIXED BENEFIT $5 – $15
DAILY BRAND NAME & PRESCRIPTION FIXED BENEFIT $10 – $30
EMERGENCY ROOM BENEFIT $100 – $400
URGENT CARE CENTER BENEFIT $100
PREVENTATIVE CARE BENEFIT $125 per calendar year
DAILY EMERGENCY AMBULANCE & FIXED BENEFIT $500 ground / $1,500 air

ANNUAL MAXIMUM BENEFIT
MAXIMUM COVERED BENEFITS PER COVERED PERSON PER CALENDAR YEAR $100,000 – $1,000,000 Annual Maximum per insured

FIXED BENEFIT PLAN

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