Total Health Solutions and Total Health Plus are supplemental medical expense policies that cover portions of the expenses employees incur due to treatment of injuries and illnesses under their major medical plan as a result of deductibles/coinsurance. The benefits provided help employees deal with the burden brought on by high out of pocket expenses. Implementing Crescent Total Health Solutions is an innovative and creative approach to employee benefits that can benefit both employers and employees. An underlying major medical plan is required. This product does not pay 100% of out of pocket expenses.
Basic product features:
• Two separate buckets of benefits allowing plan designs that correspond with the insured’s major medical plan:
• Inpatient Benefits ($500 - $10,000 per covered person per calendar/benefit year)
• Outpatient Benefits ($250 - $4,000 per covered person per calendar/benefit year)
• Provides coverage for medically necessary eligible out-of-pocket expenses related to the insured’s major medical plan’s coinsurance
and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for an injury or sickness.
• Uses itemized bills and primary major medical plan’s EOB (explanation of benefits) as a basis for determining what is covered.
• Provides the insured with a medical card to present to the provider who can then verify coverage and file the claim.
• Expenses must be covered by the insured’s major medical plan for benefits to be paid under this product.
• Basic product benefits are for in-hospital charges only, including emergency room treatment for an injury or for a sickness, if the
sickness results in a hospital confinement within 24 hours. Outpatient treatment is considered optional, although regularly elected.