This plan uses Preferred Provider Network (PPO). The plan pays 80 or 90 percent of the negotiated amount for covered medical expenses. For example- if you have a $10,000 bill, and network benefit may bring that down to $4000 and 80% will be paid by the plan ($3200) and you pay $800.
The plan will pay based off a schedule of benefits. Schedule of Benefits is a list of covered medical services. Next to each item on the list is a dollar amount (maximum benefit). The plan pays only to the listed maximum benefit. For example, your plan pays $1,900 a day for a hospital room. If the total hospital charge is $5,000 per day, the plan will pay $1,900. If the hospital charges $10,000 per day, the plan still only pays $1,900.
The INF Elite & INF Premier provides coverage for Pre-Existing Conditions as defined in the plan as per policy limitations, exclusions, and maximums. These Plans may cover physician visits, labs, in-patient, out-patient, and specialist care.There is a 12 month look-back period for pre-existing conditions under these plans.
Diplomat America Plan offer Acute-onset Pre-Existing conditions cover for visitors of all ages. These plans are relatively in-expesive to purchase. There is no guarantee that a typical condition will be covered. The Acute-Onset plans by nature may only cover emergency, in-patient hospitalizations related to pre-existing conditions in certain conditions. Coverage will end as soon as the patient is discharged from the hospital. Pre-Existing episodes must meet certain guidelines to be eligible for benefits to be paid out.