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DesignMED
COMPLETE
Explanation of Benefits
* Total Daily
Room Benefit Days 1 and 2 Days 3 – 6
Days 7 – 180
$900
each $1,400 each $400 each
Intensive Care
$1,200 per day for 20 days per period of Confinement
Private Duty Nursing
$100 per day for 30 days per period of Confinement
Emergency Accident
Up to $200 per accident, 4 per person per year. All eligible dependent
children count as one person.
Accidental Death, Dismemberment, and Paralysis
$50,000 on primary insured. ( $25,000 on spouse, if covered. $5,000
per child, if covered )
Outpatient Sickness
Actual cost up to $100 at Physician’s office or Out-of-Hospital
facility for sickness. Up to $150 for Emergency Room. 4 per person
per year. Children count as 1 person.
Surgical Schedule, Anesthesia & Additional Benefits
up to $5,000. Includes Mammogram, PAP, and PSA ( Prostate Screening )
Employee Employee/Spouse Employee / Children Full Family
$138.34
$266.18 $222.49
$350.33
*All premiums include an $8 monthly
administration fee
* The “Total Daily Room Benefit” is actually a combination of 3
separate policy features. The first is the basic Daily Room Benefit of
$250.00 per day. This benefit is available for 180 days per calendar
year. The second is an additional $150.00 per day provided by Hospital
Indemnity Rider Form AAW-DR224, also for 180 days. The balance of the
total benefits expressed above comes from the First Hospital Admission
Rider, Form AAW-DR236. This benefit pays for the first continuous
Hospital Confinement or several Hospital Confinements for the same or
related cause, which are separated by less than 90 days from the date
of discharge. This is not a cumulative benefit and will not exceed
$5,000 for each Insured for each calendar year.
This is a brief outline of policy
benefits and features. Intensive Care benefits are paid in addition
to these amounts. Please see the actual policy for complete details.
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Apply Now!
Complete and mail to:
David Lowe Insurance Agency
PO Box 12723
Florence SC 29504 |