Insurance FAQs

Medical

No matter which Healthgram medical option you elect, all preventive care is covered at 100% in-network and you will have no lifetime maximums or pre-existing limitations.

Coverage Levels

You also have the choice of whom, in addition to yourself, you want to cover under medical benefits. You will have the choice of covering just yourself, you and a spouse, you and your children, or your entire family.

Healthcare Terms

• Coinsurance: The percentage of allowed charges for covered services that you are required to pay. For example, your benefits plan may cover 90% of the charges for a covered hospitalization, leaving you responsible for the other 10%. This 10% is known as the coinsurance.

• Copayment (Copay): A flat dollar amount you must pay for a covered service. For example, you may have to pay a copay for each covered visit to a primacy care doctor. Copays will now accumulate towards your out-of-pocket maximum.

• Deductible: The amount you pay each year before your benefits plan shares in the cost of certain services. The deductible may not apply to all services. For example, preventive is always covered innetwork and no deductible will be required before your preventive services are paid.

• Out-of-Pocket Limit: The most you will pay during the plan year (excluding payroll deductions). Once you pay this amount of your pocket during the year, your benefits plan usually pays 100% of the covered services.