Frequently
Asked Questions (FAQs) |
What is CASA?
The Consumer Assistance Services
Association (CASA) is a non-profit member
association that strives to provide its members and
their families with consumer education resources and
access to affordable programs and services.
Founded in 2001, CASA is one of the largest
associations in the country that is focused on the
consumer, small business owner, self-employed
individual and their families. CASA's different
levels of membership are designed to provide each
member with freedom to select the level of
membership that best meets their needs.
What
are the benefits of membership in CASA?
The
privileges of CASA membership are specifically
designed to help individuals save money on the
purchase of a variety of personal, home, business
and healthcare goods and services designed to
enhance their quality of life. Based on the
membership level selected, CASA members can access 3
categories of benefits: Lifestyle Products &
Services, Discount Products & Services, and Limited
Medical and Supplemental Benefit Plans. The CASA
benefits included in the membership plan offered by
Lands Health include Vision Benefits, Lasik Eye
Surgery, Chiropractic Benefits, Diabetes Savings
Program and Family Legal Services. For more
information about CASA membership and its
privileges, go to:
www.casaassociation.com
What is Hospital
Indemnity Insurance?
Hospital indemnity
insurance pays a limited benefit up to maximum
amounts (usually a number of doctor visits, tests or
procedures, days in the hospital, etc.) for each
covered medical service or diagnosis. For each
covered service, a hospital indemnity plan pays a
fixed benefit regardless of the amount the insured
is charged for the services received. If a service
costs more than the benefit available under the
plan, the insured must pay the provider the balance
of the charges; if a service costs less than the
benefit payable, the insured keeps the balance of
the benefit.
How does hospital indemnity
differ from major medical insurance?
Major
medical insurance covers the expenses associated
with serious illness or hospitalization, as well as
the cost of preventative medical services such as
check-ups and screening tests. Major medical plans
usually include deductibles or set amounts the
patient is responsible to pay up front. Once that
is paid, the plan covers most of the remaining cost
of care, subject to co-pays or co-insurance paid by
the patient.
Unlike major medical
insurance, hospital indemnity insurance products pay
"first dollar" benefits; there are no co-pays,
deductibles or co-insurance. However, because of
the limits built into hospital indemnity plans, they
are not usually adequate to cover the costs of a
serious or chronic illness. While these plans pay
meaningful benefits that can help defray the cost of
basic medical services, a hospital indemnity
insurance policy is not a substitute for
comprehensive health insurance.
Why would someone choose a hospital
indemnity plan?
Group hospital
indemnity benefits are designed for people who are
not offered, are not eligible for, or simply cannot
afford major medical coverage. Examples include
seasonal, part-time, and recently hired employees,
along with their eligible family members. If you get
hurt or sick, hospital indemnity insurance pays
benefits that help to defray your out-of-pocket
medical expenses. If you already have major medical
insurance, indemnity benefits can help to offset
your deductibles, copayments and coinsurance
expenses. Hospital Indemnity insurance is not a
substitute for comprehensive health insurance, but
it can provide meaningful benefits in the event of
an unexpected accident, critical illness or other
medical emergency.
Is Transamerica Life Insurance Company a
reliable company?
The original Transamerica life
insurance company was founded in 1906. With more
than a century of experience, Transamerica has built
a reputation on solid management, sound decisions,
and consumer confidence.
Transamerica has
earned consistently high ratings as a direct
reflection of the care with which they manage their
business. Transamerica's life insurance subsidiaries
have received high ratings from the industry's most
respected independent rating services, including
their recent A.M. Best rating of A+ on April 27th,
2011.
Am I Guaranteed Coverage In The Plan?
Yes. CASA members and their eligible dependents
are automatically accepted for all Lands Health
Benefit plans available through CASA membership.
Plans are not available in all states. Not
available in CA, CT, HI, MA, ME, NH, NJ, NY, OR, SD,
or WA.
When does coverage begin?
Coverage begins 3 days after you enroll, with the
following exceptions.
- If you sign up on the 26th of the month, then your coverage starts on the 1st.
- If you sign up on the 27th of the month, then your coverage starts on the 2nd.
- if you sign up on the 28th-31st of the month, then your coverage starts on the 3rd.
Approximately ten days after
you enroll in the plan, you will receive a personal
I.D. card and a certificate of insurance booklet for
your insurance and non insurance benefits.
Can I Sign Up For Coverage At Any Time?
Yes
How Do I Enroll For Coverage?
To enroll, simply call toll free 888-629-4264.
Your enrollment will be complete upon your payment of a one-time non-refundable enrollment fee plus the first month's premium.
Can I Cancel Coverage At Any Time?
You can drop coverage at any time. However, if
you later decide to re-enroll, you will be
required to wait 9 months or until the next
December (whichever is longer) before re-enrolling.
Can I Go To Any Doctor Or Hospital?
Yes. There is no restriction of doctors or hospitals under the health indemnity plan. However, you can stretch your scheduled benefits by utilizing a provider in the PPO network.
What is a PPO Network?
A PPO is a type of arrangement between
health care providers (doctors, hospitals and
others) and an insurance company or third-party
administrator to provide customers with health
care services at discounted rates. Customers
with access to the PPO pay lower fees by
choosing providers within the PPO network.
Customers also have the flexibility to select
"out of network" providers and pay higher fees
for the services they obtain.
TransChoice® Plus group hospital indemnity
insurance that CASA has arranged for its members
includes the MultiPlan PPO. MultiPlan is the
nation's oldest and largest PPO. TransChoice
Plus also offers the ProCare Rx PPO for
prescription drug discounts.
How Do I Get Reimbursed When I Go To A Medical Provider?
If your provider accepts assignments of benefits, the provider will file a claim for their services and will be paid an amount equal to the benefits included in your plan and as shown in the Schedule of Benefits.
- If the provider bill is
less than the plan benefit, you will receive payment of the difference from your coverage.
- When the provider's charge exceeds the plan benefit, the provider will bill you directly for the balance after the plan benefits have been applied to their fee charge.
- If your provider does not accept assignment of benefits, you will be responsible for paying your health care costs at the time of service and for filing a claim under the plan to receive reimbursement.
What are Pre-Existing Conditions?
- Pre-Existing Condition means a disease or physical condition for which the Covered Person: had treatment; incurred expense; took medications; or received a diagnosis or advice from a Physician during the twelve (12) month period of time immediately before the Effective Date of the Covered Person's coverage.
- The term "Pre-Existing Condition" will also include conditions which are related to such disease or physical condition.
- The term "Pre-Existing Condition" will also include a condition that manifests itself in a way that would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment.
- Pre-Existing Conditions
are not covered for the first twelve (12) months
after coverage is effective.
This is a brief summary of TransChoice®
Plus Group Limited Benefit Hospital Indemnity
Insurance underwritten by Transamerica Life
Insurance Company, Cedar Rapids, IA. Policy
Form Series CPCH0200 and CCCH0200. Form and number
may vary by state. Not available in all
jurisdictions. Limitations and exclusions may apply.
Refer to the policy, certificate and riders for
complete details.
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