Presentation on theme: "United American Insurance Company Proudly Serving Americans Since 1947 UAUHP R704 Agent Training."— Presentation transcript:
United American Insurance Company Proudly Serving Americans Since 1947 UAUHP R704 Agent Training
What United American Stands For… Stability — Meeting the life and health insurance needs of the public for over half a century Financial Strength Quality Protection — Insurance coverage to protect you and your family now as well as in years to come Superior Service — One-on-one personal service for the life of your policy, backed by Home Office support staff That’s our way… the United American way. “A+ Superior” financial strength rating from A.M. Best* “AA Very Strong” financial strength rating from Standard & Poor’s* *ratings as of 6/04
What are the headlines saying? Health care costs still rising faster than the economy! & More people uninsured! Sources: Health Affairs, June 2003 AHIP, “2004 Elections: Medicare, the Uninsured, and Rising Costs Take Center Stage in Health Care Debate”, January/February 2004
Americans Face a Healthcare Crisis! Health care costs continue to advance much faster than the rest of the U.S. economy: a 8.5% increase in 2001 a 9.3% increase in 2002 Sources: Health Affairs, June 2004 National Coalition on health Care, “Facts on Health Insurance Cost,” 2003 These costs are more than 5 times the rate of general inflation!
The Cost of Health Care Insurance premiums have risen at a rate even greater than the rate of health care inflation. According to experts, “Consumers can expect to pay more for greater access to health care.” Sources: PricewaterhouseCoopers, April 2002 Factors Driving Rising Costs in Healthcare 2001-2002
Persons Without Health Insurance Rising costs in health care are pushing up health insurance premiums and forcing Americans into the ranks of the uninsured. 1988 — 30.6 million 1992 — 34.1 million 1996 — 40.9 million 2002 — 41.2 million 2003 — 43.6 million It becomes a problem if you are a Member of the Uninsured! Source: United States Department of Commerce News, September 30, 2003
United American Insurance Card In order to receive non-emergency or post-stabilization treatment, consumers must demonstrate an ability to pay … This is when your United American health insurance card is most valuable! Name: PAULA C. HOLDERPolicy Number 57300876888Effective 01-25-03 The Problem becomes finding affordable health insurance.
Where Do the Largest Medical Expenses Occur? Hospital Confinement Surgical Expenses Emergency Room Charges Source: American Medical Association 2001 Annual Report
Hospital Confinement vs. Doctor’s Office Bills Odds are 1 in 7 that you or a family member will have a hospital stay this year. Average hospital confinement includes room/board, surgical, miscellaneous and emergency expenses. Average cost of a 5-day hospital stay is $17,032 Source: Current Trends in Health Care and Dental Costs Utilization, 2003 Edition, Mutual of Omaha As compared to the Larger Medical Expenses above, the average cost of a Doctor Office Visit in 2002 was relatively low. It was only $77!
Therefore, the most important areas to cover are: Hospital Confinement Surgical Expenses Emergency Room Charges
Guaranteed renewable individual policies, not collectively renewable Issue age pricing, not attained age pricing No Pre-authorization Top industry ratings & claim paying abilities No associations or association dues Use anywhere in the USA Local Home Office and Agent support No Lifetime Maximums Freedom of choice Choosing a Healthcare Insurance Policy Important things to consider!
It’s YOUR health! YOU choose your health care providers. WHO? WHAT? WHEN? WHERE? These are questions that YOU answer! With United American, you are in control of your health care — no gate keepers, no primary care physicians, no pre-certification, no worries about using out-of-network providers which could run up huge co-payment obligations. UA’s Freedom of Choice That’s our way… the United American way!
United American’s GOOD SENSE PLAN Finally, an Affordable Health Insurance Policy that m akes good sense!
GSP Specified Benefit Hospital and Surgical Expense Coverage for Individuals & Families DRB* Maximum $400 Issue Ages 0-63** *Daily Hospital Room Benefit **Ages 0-60 in CA Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.
GSP Eligible Hospital and Surgical Expenses Daily Room Benefit $400 per/day up to $292,000 Benefits are payable for as long as two years for each covered injury or sickness beginning with the first day of hospital confinement. Benefits renew for each new covered injury or sickness. Intensive Care Benefit $800 per/day up to $72,000 Two times the Daily Room Benefit is payable in lieu of Daily Room Benefit for up to 90 days of confinement in an intensive care unit of a hospital for each injury or sickness. Benefits renew for each new covered injury or sickness. Surgical Expense Benefit up to $7,500 Benefits are payable for surgical operations due to each injury or sickness per schedule (up to $7,500). Benefits renew for each new covered injury or sickness. Assistant Surgeon’s Benefit up to $1,500 20% of the surgical benefit payable. Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.
GSP Eligible Hospital and Surgical Expenses Administration of Anesthetic Benefit up to $1,875 Benefits are payable for administration of anesthetic up to 25% of the surgical benefit payable. Benefits renew for each new covered injury or sickness. Radiotherapy Benefit up to $7,500 Benefits are payable in lieu of other policy benefits for radiotherapy treatment IN or OUT of hospital for each injury or sickness. Benefits renew for each new covered injury or sickness. Registered Nurse Benefit up to $15,300 Benefits are payable for full-time private duty services of a Registered Nurse (R.N.) up to $85.00 per 8-hour shift for 2 shifts per day for up to 90 days for each injury or sickness. Benefits renew for each new covered injury or sickness. Ambulance Benefit up to $150 Benefits are payable for ambulance expense for each injury or sickness. Benefits renew for each new covered injury or sickness. Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.
GSP Eligible Hospital and Surgical Expenses In-Hospital Medical Expense Benefit up to $2,000 Benefits are payable for expenses incurred up to $35 per visit, one visit each day, up to $2,000 for doctor’s visit for each injury or sickness not requiring surgery. Benefits renew for each new covered injury or sickness. Miscellaneous Hospital Expense up to $25,000 Benefits are payable for miscellaneous hospital expense (less $500 deductible) at the rate of 80% of the expense incurred, other than room charges or physician fees, up to $25,000 (plus $500 if the maximum is reached) for each injury or sickness. This benefit is payable during a hospital confinement or when surgery is performed in a hospital on an outpatient basis. Benefits renew for each new covered injury or sickness. Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.
GSP Eligible Hospital and Surgical Expenses Outpatient Hospital Benefit up to $200 Benefits are payable for treatment at a hospital for any one covered injury or sickness not requiring confinement as a resident patient. (Except when a larger benefit would result from miscellaneous hospital expense benefit because of surgery performed in the hospital on an outpatient basis.) Benefits renew for each new covered injury or sickness. Additional benefits available in most states Males over 50 — yearly prostate cancer screening Females over 35 — yearly mammogram Breast reconstructive surgery All insureds — diabetic equipment, supplies and training Guaranteed renewable Individually owned policy Issue age pricing Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.
GSP Eligible Hospital and Surgical Expenses Accidental Death Benefit The premiums paid for an Insured’s coverage will be refunded if the Insured’s death results from accidental bodily injury. Example: $200 a month premium x 12 months x 5 years = $12,000 Refunded Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions. LIMITATIONS AND EXCLUSIONS We will not pay benefits under this policy for: 1.Normal pregnancy (including childbirth); or 2.Rest cure, custodial care or functional nervous or mental disorders; or 3.Any Hospital Stay or other service for which You or a Family Member do not incur a charge; or 4.Any loss covered by any Worker’s Compensation or Employers’ Liability Law; or 5.Any Hospital Stay or other service that is not medically necessary; or 6.Any expense incurred in excess of the usual, customary and regular charges for any service or materials in the geographic area where furnished; or 7.Charges incurred for professional radiological or pathological interpretation; or 8.Rehabilitative care services received at a facility not meeting the definition of a Hospital.
Additional Benefits paid under Policy Form UA-250 Plans/benefits may vary by state.
Additional Benefits paid under Policy Form CILS Plans/benefits may vary by state. See application/brochure for Limitations & Exclusions
Additional Benefits paid under Policy Form CANB This is a cancer only policy. Plans/benefits may vary by state.
Additional Benefits paid under Policy Form SMXC Plans/benefits may vary by state.
Additional Benefits paid under Policy Form SSXC Plans/benefits may vary by state.
Additional Benefits paid under Policy Form HMXC Plans/benefits may vary by state.
UA Partners ® Program Dental Vision Hearing Aid Chiropractic Prescription Drug 24-Hour Nurse HelpLine Travel Assist Our optional discount service program includes:
Nationwide discount health services program with savings for: Chiropractic Dental Eye Care Hearing Aids Prescriptions Mail Order Pharmacy Up to 40% Up to 50% Up to 20% Up to 30% Save More $$ UA Partners ® Program
Provider Network Program UA Partners members and their families have access to negotiated rates with over 300,000 physicians, and over 4,100 hospitals across the country through a network of providers. These network programs are offered by Competitive Health, which was founded in 1996 and is one of the leading administrators of discount medical health benefits in the nation.
How does the Provider Network Program work? Member calls 1-800 for nearest provider and makes an appointment Member presents the UA Partners with PPO ID card to physician’s office Member presents the Provider Letter to the provider at the first appointment Physician’s office calls toll-free number and enters UA Partners member ID number, physician’s tax ID number and CPT-4 code The repriced amount is calculated in seconds Provider collects repriced amount from patient
Why United American? Providing quality health protection since 1947 Top ratings with A.M. Best & S&P Fast policy issue (4-6 weeks) Local office Personal support (always deal with a live person, either Home Office staff or Agent) Individual qualification (not a group plan) Guaranteed renewable policies Issue age pricing No Lifetime Maximums on GSP No associations or association dues Freedom of Choice Use anywhere in the U.S. and outside UA Partners to help drive down the cost of Health Care Services