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United Security Life – Preferred Value – ILLINOIS
A comparison of the Preferred Value offered by United Security Life is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | Preferred Value Application | Preferred Value Application |
| Brochure | Preferred Value Brochure | Preferred Value Brochure |
| Copay | $30 copay per non-preventive visit, 4 visits per year (Office visit fee only) | $30 copay per non-preventive visit, 4 visits per year (Office visit fee only) |
| Office Visit | $30 copay per non-preventive visit. 4 visits per year. (Office visit fee only) | Benefits reduced by 25% |
| Deductible | Individual: $1,500, Family: $4,500 | Individual: $1,500, Family: $4,500 |
| Coinsurance | 80% | Benefits reduced by 25% |
| Coinsurance Limit | $15,000 | $15,000 |
| Out-of-Pocket Maximum | Preferred Value | Preferred Value |
| Lifetime Maximum | $5,000,000 | $5,000,000 |
| Prescription Drugs | No prescription drug coverage unless an optional prescription drug card is selected | Benefits reduced by 25% |
| Emergency Room | Subject to deductible & coinsurance | Benefits reduced by 25% |
| Adult Preventative Care | Preferred Value | |
| Child Preventative Care | Preferred Value | Preferred Value |
| Lab / X-Ray | Subject to deductible & coinsurance | Benefits reduced by 25% |
| Maternity | Not covered | Not covered |
| Physical Therapy | Benefits reduced by 25% | |
| Skilled Nursing | 10 visits per year up to $200/visit | Benefits reduced by 25% |
| Home Health Care | Preferred Value | Preferred Value |
| Mental Health | Preferred Value | Preferred Value |
| Hospital Care | Subject to deductible & coinsurance | Benefits reduced by 25% |
| Optional Benefits | Enhanced Prescription Drug Card | Enhanced Prescription Drug Card |