March 12, 2010

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Time Short Term – HealthSaver Limited-Benefit – VIRGINIA

A comparison of the HealthSaver Limited-Benefit offered by Time Short Term is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Network See Provider See Provider
Application HealthSaver Limited-Benefit Application HealthSaver Limited-Benefit Application
Brochure HealthSaver Limited-Benefit Brochure HealthSaver Limited-Benefit Brochure
Copay N/A N/A
Office Visit Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details. Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Deductible $2,500 $2,500
Coinsurance HealthSaver Limited-Benefit HealthSaver Limited-Benefit
Coinsurance Limit HealthSaver Limited-Benefit HealthSaver Limited-Benefit
Out-of-Pocket Maximum HealthSaver Limited-Benefit HealthSaver Limited-Benefit
Lifetime Maximum $100,000 $100,000
Prescription Drugs Not covered Not covered
Emergency Room $150 access fee per visit (waived if admitted), then subject to deductible and coinsurance $150 access fee per visit (waived if admitted), then subject to deductible and coinsurance
Adult Preventative Care Not covered Not covered
Child Preventative Care Not covered Not covered
Lab / X-Ray Covered (subject to deductible and coinsurance) Covered (subject to deductible and coinsurance)
Maternity Not covered Not covered
Physical Therapy HealthSaver Limited-Benefit HealthSaver Limited-Benefit
Skilled Nursing HealthSaver Limited-Benefit HealthSaver Limited-Benefit
Home Health Care Not covered Not covered
Mental Health Not covered Not covered
Hospital Care
  • Hospital Room: Inpatient services covered subject to deductible and coinsurance. Access fee applies. Specific policy provisions vary by state, refer to brochure and your policy contract for more details.
  • Intensive Care: Inpatient services covered subject to deductible and coinsurance. Access fee applies. Specific policy provisions vary by state, refer to brochure and your policy contract for more details.
  • Surgery: Inpatient and Outpatient services covered subject to deductible and coinsurance. Access fees and maximum benefit limitations apply. See brochure for more details.
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  • Hospital Room: Inpatient services covered subject to deductible and coinsurance. Access fee applies. Specific policy provisions vary by state, refer to brochure and your policy contract for more details.
  • Intensive Care: Inpatient services covered subject to deductible and coinsurance. Access fee applies. Specific policy provisions vary by state, refer to brochure and your policy contract for more details.
  • Surgery: Inpatient and Outpatient services covered subject to deductible and coinsurance. Access fees and maximum benefit limitations apply. See brochure for more details.
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    Optional Benefits HealthSaver Limited-Benefit HealthSaver Limited-Benefit