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United Healthcare for Indiana Residents



Golden Rule Insurance Company is part of the highly respected United Healthcare family of businesses. United Healthcare currently has over 70 million members nationwide and is rated "A" (Excellent) by A.M. Best. 

 

Golden Rule pioneered the Health Savings Account (formerly known as Medical Savings Account) concept in 1993. These plans combine lower-cost, high deductible health insurance with a tax-advantaged savings account. HSAs are a fast-growing, affordable alternative to traditional health plans and Golden Rule is a market leader.

 

 

Golden Rule Individual Plans

 

Golden Rule offers three flexible health care plans: Copay Plans, High Deductible Plans, and Health Savings Account (HSA) Plans. They also offer water-downed versions of the Copay, High Deductible, and HSA Plans called Saver Plans. In return for more limited benefits, Saver Plans provide significant savings. They may be ideal for people who need coverage for the bigger expenses instead of for routine health care. These Saver Plans can also be combined with Golden Rule's Optional Preventive Care Benefits Package. This add-on is not available for all products, however, so request additional information to find out if this option is available for your needs.


Also available are Short Term MedicalSM and Medicare Supplement Insurance Plans. Golden Rule Insurance Company is a subsidiary of United HealthCare. (Each company is financially responsible for its own insurance products.)

 

 

Copay Select

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Copay Select Plans are more like traditional employer plans with a co-payment for routine healthcare expenses. Individuals who prefer the convenience of copay benefits for routine health care expenses, families with young children who have regularly scheduled doctor visits and adults who want copay benefits for preventive care and prescriptions drugs benefit most from a CoPay Select Plan. Copay Select plan highlights include:

  • Preventative care benefits for adults and children ($35 copay fror the office visit. Lab tests and x-rays are covered at 80%. $300 annual maximum)
  • Unlimited office visits ($35 copay per visit)
  • 80% coinsurance once the dedcutible is met
  • Choice of $3 million or $5 million lifteime maximum benefit per person
  • Prescription drug card benefits
    • Generic drugs - $15 copay
    • Preferred brands - $30 copay*
    • Non-preferred brands - $60 copay*

(*please note there is a $100 calendar year deductible for brand and non-preferred brand drugs)

 

Copay Saver

 

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The Copay Saver plan limits the number of office visits with a $35 copay benefit to 2 per person, per calendar year for a lower monthly premium. Unlike Copay Select, Copay Saver plans do not include a preventative care benefit, but an optional preventative care benefit package is available through Golden Rule for an additional premium. Check out our Copay Select/Saver Comparison Chart to see the benefits broken down by each line item.

 

Health Savings Account Plans

These plans combine lower cost high deductible plans with network discounts and tax advantaged savings accounts. HSA Plans are great for persons interested in more control over how their health care dollars are spent, families interested in one annual deductible and savings on monthly premiums, or high income individuals looking for an additional tax shelter. Golden Rule offers 2 different Health Savings Account plans: HSA 100 and HSA Saver.

 

HSA 100

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HSA 100 provides significantly reduced premium costs by using higher deductibles while covering 100% of medical expenses after the deductible is met. This includes doctor office visit fees, prescription drugs, diagnostic testing, hospitalization, and surgery. There are no copays for doctor visits, but once the calendar year deductible is met the insurance will pay 100% of covered expenses.

 

 

 

HSA Saver

 

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This plan works like HSA 100 with reduced benefits for outpatient care. These limitations include:

  • Outpatient doctor visits are not covered
  • Outpatient precription drugs are not covered (though you do receive discount card)
  • Preventative care visits are not covered (unless optional preventative care package is purchased)
  • Outpatient lab and x-ray charges are only coverd within 14 days of surgery or confinement
  • Outpatient therapy is not covered, including physical, mental, occupational, and speech
  • Emergency room benefit is limited to $250 per person per year (if ER is used and not admitted to the hospital)

High Deductible Health Plans

Insurance agents refer to Golden Rule's High Deductible Plans as catastrophic coverage. They offer lower premiums to individuals and families willing to pay a higher percentage of routine health care expenses. High Deductible plans are great for individuals looking for low cost protection from unexpected illness and accidents and early retirees needing a bridge to Medicare.  

 

Plan 100

Our Rating:

 

 

 

Plan 100 is a Golden Rule top seller and has an easy to understand plan design. The benefits are not complicated with multiple copayment or coinsurance amounts. Plan 100 simply pays all covered expenses after the calendar year deductible is met.

 

 

Saver 80

 

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Saver 80 is Golden Rule's lowest premium plan. Like Saver 100, It provides coverage for hospital confinements, surgical procedures in or out of the hospital, and more costly outpatient care, such as CAT Scans and MRIs. It does not cover smaller medical costs such as office visits, child immunizations, preventive care, and prescription drugs (Discount Card Included).

 

 

Optional Benefits

 

Preventive Care Benefits Package:

Golden Rule offers you the choice of additional coverage for adult and child preventive care services with any of their Preferred Network HSA plans. If elected, this option replaces preventive care benefits otherwise included within the plan. This package waives the deductible and covers 100% of the following expenses:

  • $35 copay on each office visit (primary care, OBGYN, etc.)
  • Doctor office X-ray and labs covered at 100% (deductible waived)
  • Includes child (0-18) immunizations, well-care visits, PSA Testing, Pap Smear, and Mammography
  • Limited to $300 annually on covered expenses (Doesn't apply toward PSA Testing, Pap Smears, and Mammography)
  • Separate benefit on covered expenses for child immunizations, limited to $300 annually

  

Hospital Indemnity Rider:

The optional HSA Hospital Indemnity Rider is designed to help protect against major hospitalization expenses during the early months of coverage while cash accumulates in your savings account.

 

The HSA Hospital Indemnity Rider provides a lump-sum cash benefit on the third day of hospital confinement. This money can be used to help pay your deductible or for any other purpose.

The cash benefit amount depends on your deductible amount and decreases over time (see table).

The optional rider pays once, regardless of the number of hospitalizations, and there are no benefits under this rider if the hospitalization would not have been covered by the medical coverage.

 

Hospital Indemnity Rider Cash Benefit

Month

Single Benefit

Family Benefit

1

$1,500

$3,200

2

$1,400

$2,950

3

$1,250

$2,700

4

$1,150

$2,450

5

$1,050

$2,225

6

$950

$2,000

7

$850

$1,775

8

$750

$1,550

8

$675

$1,325

10

$600

$1,125

11

$525

$925

12

$450

$725

13

$400

$550

14

$350

$400

15

$300

$250

16

- 0 -

- 0 -

One-Time
Premium Amount
For This option

$40

$150

 

 

 

Term Life Benefit:

You may choose an optional decreasing term life insurance benefit for you and your spouse if your spouse is also a covered person under the same Golden Rule health policy. The amount of life insurance protection provided for you and your spouse will depend on the primary insured's attained age at the time of death, as shown in the table.

 

Attained Age of
Primary Insured
at Death

Primary Insured
Benefit Amount

Covered
Spouse Benefit
Amount

49 or less

$30,000

$15,000

50 - 59

$18,000

$9,000

60 - 64

$12,000

$6,000

 
 
 

Rate Information:

Preferred rates without options are available on our instant quote page. These rates do not include optional benefits such as term life. Rates depend on gender, family size, smoking status, zip code, and health status.

 

The premium can be paid via quarterly billing, or a monthly bank draft.  The bank draft will occur on the premium due date each month. The initial premium can be paid with a check, credit card, or bank draft.  This payment will be processed immediately upon receipt.

 

 

 

Networks:

Golden Rule has 3 different networks in Indiana to provide strong network access through out the state. As a member of the United HealthCare group of companies, Golden Rule members have access to United Healthcare's statewide Choice Plus network that includes over 19,000 physicians and 150 hospitals. In December 2007, the Choice Plus network solidified itself as one of Indiana' most comprehensive provider networks after United Healthcare reached an agreement with Advocate Health Care, the largest health care system in Indiana. This agreement provided members access to Advocate Health Care's 10 hospitals and over 1,100 physicians.

 

The Choice Plus network is statewide and available to all Indiana residents while HealthLink and MultiPlan PPO are only available in certain zip codes.  Indiana residents living in zip codes 624-629 are able to choose between the HealthLink or Choice Plus network, and residents living in zip code beginning with 614 are able to choose between the MultiPlan PPO or Choice Plus network. For additional information about the ChoicePlus, HealthLink, or MultiPlan networks or to search for network providers, visit the Golden Rule networks homepage.

 

 

Underwriting:

UnitedHealthcare/Golden Rule has one of the fastest underwriting departments in the industry.  Most applications are approved in less than a week.  However, it could take longer if medical records are requested, so it is best to allow 4 weeks or more if possible.  Certain conditions may be excluded with a temporary rider (usually for one to two years), or an indefinite rider.

 

Golden Rule Insurance Company will typically call you on the phone to verify information on your application. It is standard practice to request a Blood Pressure Inquiry if you are currently being treated for or have recently discontinued treatment for high blood pressure.

 

 

Effective dates:

For injuries, the effective date for a mailed application will be the later of: (a) the requested effective date, if any, shown on the application; or (b) the date upon which the original application is actually received by Golden Rule. For an application sent by any electronic method, the effective date for injuries will be the later of: (a) the requested effective date, if any, shown on the application; or (b) the day after the date upon which the application is actually received by Golden Rule.

 

The effective date for illnesses will be the same as for injuries if you are replacing prior coverage within 62 days of application for this coverage and disclose replacement information on the initial application for insurance.  If replacement information is not disclosed on the initial application for insurance, the effective date for illnesses will be the 15th day after the effective date for injuries.  Illnesses that begin prior to that 15th day will be treated as a preexisting condition and will not be covered until the individual has been a covered person for 12 months.

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