The WellPremium Medical Enhanced line of plans includes the WellPremium benefit coverage. The WellPremium benefit is designed to help cover your “everyday” needs such as doctors visits, labs and x-rays and even urgent care, while the Medical Enhanced plans are designed to help cover surgeries and hospitalization.
The WellPremium plan is designed to help cover your “everyday” type of needs, from bumps and bruises to broken bones, for a 0-dollar deductible. After the deductible is met, there is a usually a copay or coinsurance for covered services. This plan has a $0 deductible and 0 coinsurance, and covers doctor visits, urgent care, labs, radiology, and images for an associated copay. The WellPremium plan is guarantee issues and has no preexisting conditions.
The Medical Enhanced plans are designed to cover many of your needs inside a facility. The plan helps cover hospitalization, in and outpatient surgery, emergency room, dialysis and chemotherapy at 80/20 coinsurance. The plan pays 80% and the member pays 20% of the claim after the deductible is has been met. There are three different plan options that members can choose, the Medical Enhanced 10.0, Medical Enhanced 5.0, and Medical Enhanced 2.5. The different numbers refer to the three different deductibles, out of pocket and annual maximums that are included in each plan. The plans do have a 12-month preexisting condition clause and do require preauthorization for coverages such as hospitalization, in and outpatient surgery, dialysis and chemotherapy. There is no preauthorization required for the emergency room.