Sickness & Accident, Hospital/Surgery for Individuals, Families, and Groups

No Deductible or Co-pays
Use and Hospital or Doctor
Hospital benefit to $1,000 per day
Intensive Care to $4,000 per day
Surgery benefit to $20,000
Anesthesiologist benefit to $4,000
Benefits paid directly to YOU
Issue ages 0 to 64

Medical Benefits Schedule

Hospital Benefits
Benefit Description Deductible Classic Silver Gold Platinum
Daily Hospital confinement from the 1st day up to 1 year due to sickness or injury
None
$250
$500
$750
$1000
Daily intensive care INCLUDES hospital confinement benefit up to 30 days
None
$1000
$2000
$3000
$4000
Surgical Benefits
Pays scheduled amount for surgury due to sickness or injury
None
$5000
10000
15000
$20000
Pays schedule expenses for administration of anethesia during a covered surgery
None
$1000
$2000
$3000
$4000
Emergency Benefits
Pays expenses incurred for emergency treatment due to an injury
None
$62.50
$125
$187.50
$250
Pays expenses incurred for ambulance services due to sickness or injury
None
$125
$250
$375
$500

 

Issue Age Unisex Rates

Age
Monthly
Monthly
Monthly
Monthly
Classic
Silver
Gold
Platinum
Child
$10
$20
$30
$40
19-39
$20
$40
$60
$80
40-49
$25
$50
$75

$100

50-59
$37.50
$75
$112.50
$150
60-64
$45
$90
$135
$180

Add $15.00 Monthly administration fee per certificate.
VBA Membership is required. Membership starts at $5.00

Coverage may vary or may not be available in all states, see an agent for more details.

The Following Benefits are included with this selection of coverage

  • The Dividend Club: Value Benefits of America (VBA) members will earn Dividends (paid quarterly to you on Merchandise, Services, Travel & Entertainment when you shop from our Online Mall and make a purchase. Choose from retailers like these, just to name a few, and get the dividends: Walmart.com, Target.com, BestBuy.com, CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com, BrooksBrothers.com, Brookstone.com, Buy.com, EddieBauer.com, LizClairborne.com, FOA.com, FOSSIL.com, HotelDiscounts.com, Jcrew.com, etc.
  • Car Rental Services: Provides discounts at Alamo, National, Hertz, and Avis.
  • Rewards Network: America's Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off every meal plus up to 15% off your hotel room rate.
  • Refund Sweepers: Free Merchandise, Bargains, Online Coupons, Rebates, Sweepstakes & more.

Frequently Asked Questions

Do Rates go up due to Age increase? No

Who is eligible for coverage? Any eligible individuals under the age 65 and their dependants who are VBA Members.

Who are eligible dependents? Your spouse under age 65 and your dependant children under the age of 19 or under the age of 25 if they are a full time student.

What are the medical requirements to enroll in the plan? Simply answer a few "yes/no" questions on the application form. There is no medical exam required. Issuance of a Certificate of Insurance or payment of benefits may depend upon the answers given in the application and the truthfulness thereof.

Do I have to pay deductibles and co-pays under this plan? No, this plan is designed to pay the first dollar of covered expenses for the member and all the member's enrolled dependants up to the limits of the plan option selected.

When does coverage begin? Coverage will begin on the first of the month following approcal of the applicaiton and receipt of the first modal premium.

Can I use any doctor or hospital? Yes, you may use any doctor or hospital of your choice.

Are pre-existing conditions covered? After your policy has been in effect for more than 12 months, pre-existing conditions are covered.

What is a pre-existing condition? Any condition you have now or had within a 12 month period prior to the effective date of coverage for each insured person.

 

For VBA Members

Exclusions and Limitations

Pre-Existing conditions provisions for medical care benefits

PRE-EXISTING CONDITION means an injury or sickness for which a person: incurred charges received medical treatment consulted a physician, or took prescribed drugs within 12 monthhs before he became insured under a given benefit section of the group policy. In spite of any other provision of the group policy: No benefits will be paid under a benefit section for charges incurred for a pre-existing condition until:

  1. the person has not: incurred charges received medical treatment consulted a physician, or taken prescribed drugs for such a condition, or any complication of it, for 12 continuous months, while insured; or
  2. the person stays insured under such benefit section for 12 continuous months.

General Exclusions
No medical care benefits will be paid by the group policy for charges incurred for treatment which:

  1. is given after a person's insurance ends, regardless of when the injury or sickness occurred. However, medical care benefits may be provided in the Benefits After Insurance Ends provision of a given benefit seciton.
  2. is not essential for the necessay care or treatment of the injury or sickness involved.

    NECESSAY CARE OR TREATMENT means that a treatment, service, supply, or medicine: is appropriate and essential for the diagnosis or treatment of the person's symptoms; is within the scope, duration or intensity of that level of care which is needed to provide safe, adequate and appropriate diagnosis or treatment; is furnished within the framework of generally accepted methos of medical treatment; involves only the use of any drugs or substances formally approved by the United States Food and Drug Administration.

    A treatment, service, supply, or medicine will not be considered NECESSARY CARE OR TREATMENT if it is: par of a treatment plan that is determined to be an Experimental Procedure or for research purposes; or provided primarily as a convenience to the patient, the patient's family or the provider of care.

    EXPERIMENTAL PROCEDURE means any medical procedure, equipment, treatment or course of treatment, or drugs or medicines that are: limited to research; not proven in an objective manner to have therapeutic value or benefit; restricted to use by medical facilities capable of carrying out scientific studies; of questionable medical effectiveness; or would be considered inappropriate medical treatment.

    To determine whether a procedure is experimental, United States Life will consider, among other things, commissioned studies, opinions and references to or by the American Medical Association, the Fedral Food and Drug Administration, the Department of Health and Homan Services, the National Institues of Health, the Council of Medical Specialty Societies and any other association or program or agency that has the authority to review or regulate medical testing or treatment.
  3. would be given free of charge if the person was not insured.

    However, medical care benfits will be paid for covered charges incurred by a state for medical assistance to an insured person under Title XIX of the Social Security Act of 1965.
  4. results from a war or an act of war.
  5. results from intentionally self-inflicted injury.
  6. Is given by a person's spouse or his spouse's parents, children, grandparents, grandchildren, sisters, brothers, aunts, uncles, nieces or nephews.

The policy described on this page provides limited benefits only, which are less than the minimum standards for benefits for major medical expenses coverage as prescribed by the insurance regulatory authority of your state.

Be sure to review your certificate completely when you receive it.

 

 

   

 
Designed by: ComFix Computer Services