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Simply put, it is a Comprehensive Major Medical policy, which provides an optional side fund (savings account).
The Major Medical policy: Covers each insured person up to $3 million lifetime. All medical expenses relating to sickness or injury incurred in the hospital or doctor’s office are covered. Drugs are included. Maternity is covered like any sickness after 18 months. It is an “open network” with 95% of Minnesota’s doctors and hospitals signed up as providers. There are three calendar year deductible options for single applicants - $1,100.00, $1,800.00 and $2,600.00, each paying either 100% after the deductible is met, or 80% after the deductible is met with a maximum out-of-pocket exposure of 2X the deductible amount. Optional preventive is covered 100%. One option is subject to the deductible, the other one is not. There are three calendar year deductible options for family applicants - $2,200.00, $3600.00 and $5,150.00 each paying either 100% after the deductible is met, or 80% after the deductible is met with a maximum out-of-pocket exposure of 2X the deductible amount or $5,200.00, whichever is less. Premiums for the health policy are tax-deductible for self-employed individuals. The Health Savings Account (HSA): Insureds may deposit up to 100% of their annual deductible amount each year into the HSA. It is tax-deductible (Federal) for all people as soon as it is deposited. Money from this account may be spent on “qualified expenses’ (See page 4 of the guide.) At the end of each calendar year unspent cash is retained in the account for the following year, at which time another deposit may be made up to an amount equal to the policy’s deductible. There is no limit to the amount of money accumulated in the HSA. The only limit applies to the annual deposit, which may not exceed the annual deductible amount. When the insureds provider submits a bill to Blue Cross the provider is reimbursed from the HSA and that amount is applied toward the annual deductible. When the deductible is met, expenses are paid from the policy. Certain eligible expenses, such as dental, eyeware, daycare, etal, do not qualify as medical expenses. Although they will be paid from the HSA, they do not count toward the deductible. How to apply : The Health Policy. Complete the Application for an Individual Health Contract for AwareCare/HSA Application. Remit one month’s premium check payable to Blue Cross with your application. If you want to pay renewal premiums monthly, please complete a Pay-O-Matic form and include a voided check. It normally takes 30 days to process an application. Please make sure all questions are answered and all details required are provided. If information is missing or unclear on an application it will be returned to you. That will add 2 or more weeks to the processing time. Approximately two weeks after you have submitted your completed application, Blue Cross underwriting will send you Physician Authorization Forms to sign and forward to doctors or clinics, which the underwriter will specify for the release of your medical history. Upon receipt of this medical information underwriting will issue your coverage or decline it. If declined, your premium deposit will be returned. You may then apply for coverage through Minnesota Comprehensive Health Association (MCHA), which is a State managed pool for people who are unable to get health coverage through usual channels. If issued, your contract will not cover pre-existing health conditions for one year. These conditions are defined as those diagnosed, treated or known to you during the six months prior to the issuance of your new policy. State law requires time an insured has been covered by another in-force policy immediately preceding the issuance of the new policy be deducted from this waiting period. Therefore, if you have been covered continuous until the new policy is effective, the waiting period for coverage of pre-existing conditions is erased entirely. The Health Savings Account. Apply for the HSA and remit with the health app. Make no HSA deposit until your health policy has been issued, after which you may make a deposit payable to MII Life. The amount of deposit you may make is limited to no more than 1X your calendar-year policy deductible. Your initial deposit is limited to no more than the prorated calendar year deductible. Example:
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