Limited Fixed Indemnity Plan
Legion Limited Medical
Underwritten by: AXIS Insurance Company
A limited medical health benefit indemnity plan that can pay you a fixed benefit payment amount of money when you incur costs due to specific covered losses, due to accident or sickness, or services with doctors and hospitals. That money can help you deal with those doctor and hospital expenses or other related ones. Your Legion Limited Medical coverage is a benefit of association membership.
What is included?
Hospital Stays Benefits
This plan includes a hospital stays benefit - which means you will receive a set amount when you are confined in a hospital. The benefits are paid directly to you or your designee.
Doctor Visits Benefits
This plan includes a doctor visit benefit - which means you will receive a set amount if you have to visit the doctor. The benefits are paid directly to you or your designee.
A telemedicine solution that solves the three biggest issues in healthcare: Access, Cost, and Quality:
How it works
Just call 1-800-Teladoc and provide your Teladoc account information.
Karis360 takes the hassle out of healthcare by helping members with questions about insurance claims, medical billing, and where to go for care:
Who is it for?
Legion Limited Medical is ideal for people who are looking for:
This is a brief summary of Legion Limited Medical Plan. Benefits are subject to the policy limitations and exclusions. Refer to the policy, certificate, and riders for complete details.
|Inpatient Daily||$500 per day x 30 days|
|ICU (5 days)||$500 per day x 5 days|
|Inpatient Surgery||$500 per day x 2 days|
|Office Visits||$100 per day x 3 days|
|Wellness Visit Benefits||$50 per day x 1 day|
|Wellness Visit Baby Benefits||$50 per day x 1 day|
|ER Sickness||$100 per day x 2 days|
|Outpatient Surgery||$500 per day x 1 day|
|Diagnostic, X-ray and Laboratory|
|Class 1: Laboratory-Blood work, CMP, Lipid Panel, ECG, Pap/PSA, urinalysis and all other laboratory tests|
Maximum number of days for laboratory tests including blood work, comprehensive metabolic panel, lipid panel, all other lab per Plan Year
|$50 per day x 2 days|
|Class II: Radiology, Ultrasound, Mammogram, Sonogram, Angiogram||$50 per day x 2 days|
|Class III: Imaging CT, PET||None|
|Class IV: Other Diagnostic tests- Endoscopy, Bronchoscopy, Colonoscopy without Biopsy, MRI||$50 per day x 1 days|
Exclusions and Limitations
Benefits in connection with a Pre-existing Conditions occurring within the first twelve (12) months of coverage are not payable. “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the six (6) month period before the Covered Person’s coverage became effective under this Policy. This Pre-Existing Condition Limitation shall not apply after the end of the Limitation Period shown in the Schedule of Benefits, commencing on the Insured Person’s Coverage Effective Date.
In addition to any benefit or coverage specific exclusion, benefits will not be paid for any loss which directly or indirectly, in whole or in part, is caused by or results from any of the following unless coverage is specifically provided for by name in the Description of Benefits section of the insurance certificate:
In addition, benefits will not be paid for services or treatment rendered by any person who is:
No. You can begin using your non-insurance benefits as soon as your payment is accepted and approved.
There are no waiting periods for benefits. You can begin accessing your insurance benefits once your payment is accepted and approved. However, Pre-existing Conditions are not covered for twelve (12) months after your membership’s Effective Date.
If you submit your application today, you can select your plan to be effective as early as 12:01am tomorrow. All coverage is subject to approval of your application and receipt of your first payment. Please refer to the plan limitations and exclusions for details.
If for any reason you are not satisfied with your coverage and you have not filed a claim, you can cancel within 30 days of the date of the Welcome letter and we will refund any premium paid and your Limited Medical coverage will be null and void.
Members under this plan may choose to be treated within or outside of the MultiPlan Network.MultiPlan has almost 800,000 healthcare providers under contract, an estimated 57 millionconsumers accessing the network products, and 40 million claims processed through the networks each year, giving them more of the experience and resources healthcare payers and providers need to face today’s unprecedented cost and competitive pressures. As part of your Membership plan, an arrangement has been negotiated between the Association and MultiPlan to treat individuals within the MultiPlan Network for a reduced fee over the customary fees of non-Network Providers.
After you complete your purchase and your payment is approved, your fulfillment package, ID card, association documents, insurance certificate and any other plan documents are available to you online under your Customer Login. A copy of your Welcome letter and ID cards will arrive by mail within 7-10 business days after payment is received and approved. If you are unable to access, you can request a copy of your certificate by calling 877.353.0962.
Fixed-indemnity insurance plans offer a cash benefit payout in case you suffer from specific illnesses or injuries covered by your policy. It is not major medical insurance, it does not include all ten of the essential health benefits of the Affordable Care Act (Obamacare) and if you do not have Obamacare, you may be subject to an additional tax.
An insurance policy feature that provides coverage without a deductible. Typically, first dollar coverage exists all the way up to the full amount on the policy.
Sometimes a provider will not submit the claim on your behalf. If this occurs, you can submit the claim yourself by followingthese steps:
For claims and questions about your benefits, please call WEB-TPA at: 1-855-457-8178
For policies purchased on or before July 1st 2018:
Administrative Concepts Inc.
994 Old Eagle School Rd., Ste. 1005
Wayne, PA 19087
EDI Payor ID: 22384
For claims and questions about your benefits, please call Administrative Concepts Inc. at: 1-877-301-5421
Preferred Provider (PPO) Network Access
First Health Network
Customer Service and Billing
For customer service or billing questions please contact us at:
For simple transactions such as a payment error where you payment information needs to be updated or if you want a refund inside the “free-look period” which is 10 days in most states, this can be done in the member portal @ www.AgileHealthInsurance.com/customers
For other payment errors where you need to process a payment, you need to call Agile at (877) 353-0962 to process the payment.
Other refund requests will have to be escalated, please call (877) 353-0962 for other requests and they will be addressed on a case by case basis in accordance with each individual insurance company’s policy.
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Short Term Medical Insurance
Limited Fixed Indemnity Plans
HealthInsurance.com, LLC is a licensed insurance agency. CA License #0D10265. It is not a government agency, insurer, or medical provider.
This advertisement is for Short-Term Medical, Indemnity, and Affordable Care Act (ACA) products.
Individuals can enroll in ACA plans outside designated enrollment periods only if specific conditions are met. Individuals can enroll in a Short Term Medical or Indemnity product if not met. Short-term and limited-benefit medical insurance are not part of the Affordable Care Act (Obamacare). They may not cover pre-existing conditions or all ten essential benefits. Limited Benefit Medical Indemnity Insurance is designed to provide additional benefits to supplement major medical insurance and may not be available in some states without proof of major medical insurance.
If you provide your contact information, a licensed insurance agent may contact you to help you enroll in a Short Term Medical, Indemnity, or ACA product from one of the carriers we represent. Enrollment is not obligated and depends on the plan’s contract renewal. We may direct you to our partner websites for additional assistance. It is essential to carefully review all policies before making a decision.