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Question:

I am planning to buy "Atlas America" Medical Insurance Plan for my Parents who are visiting USA for tourism purpose . I have few queries mentioned below , could you please clarify them: 1. How the Plan works ? ( I am planning to purchase for $50,000 Policy with $250 Deductible) 2. What is the PPO network this plan supports ? The First Health PPO Network. 3. Can I go to any Hospital/Doctor who are not part of the PPO network ? In that case how the plan works ? Will it be direct billing or I have to submit a claim request ? 4. If I purchase a $50,000 Policy with $250 Deductible for my Parents then $50,000 will be individually for Father and Mother i.e $50,000 will be for my Father and $50,000 will for my Mother , right ? or it is like total for both of them will be $50,000 ? 5. I regularly visit the below Hospital , could you please confirm this Hospital is covered under this plan and there will be direct billing for any Doctor visit or hospitalization billing ? Baptist Medical Center South 14550 Old St. Augustine Road Interstate 95 Exit 335 Jacksonville, Fl 32258 6. I regularly visit the below Urgent Care,could you please confirm this Urgent Care is covered under this plan and there will be direct billing for any Doctor visit or hospitalization billing ? Also could you please let me know the 50$ Copay option is applicable at this Urgent Care facility ? CareSpot Urgent Care 8705 Perimeter Park Blvd #2 Jacksonville, FL 32216 7. Will this plan cover doctor prescribed medicine bills ? over the counter medicine bills ? 8. Could you please explain the Copay option for the Urgent Care ? How Atlas America Insurance is different from Patriot America Plus Insurance in regards to Copay ? Thanks in advance for all your help !!!

Answer:

Please see the answers to your questions below. If you have additional questions please contact our office to speak with a licensed agent. 

1. How the Plan works ? ( I am planning to purchase for $50,000 Policy with $250 Deductible)

Please see Atlas America for details on how the plan works. 

2. What is the PPO network this plan supports ?

The First Health PPO Network.

3. Can I go to any Hospital/Doctor who are not part of the PPO network ? In that case how the plan works ? Will it be direct billing or I have to submit a claim request ?

Yes, you can go in or out of network. Please see the link provided under question 1 for how the plan works. It is up to the provider if they will do direct billing or if they will expect payment from you and for you to file for reimbursement. Most hospitals will directly bill insurance.

4. If I purchase a $50,000 Policy with $250 Deductible for my Parents then $50,000 will be individually for Father and Mother i.e $50,000 will be for my Father and $50,000 will for my Mother , right ? or it is like total for both of them will be $50,000 ?

The policy max is per person as is the deductible.

5. I regularly visit the below Hospital , could you please confirm this Hospital is covered under this plan and there will be direct billing for any Doctor visit or hospitalization billing ?

Please see HCC PPO Network

It is up to the provider if they will do direct billing or if they will expect payment from you and for you to file for reimbursement. Most hospitals will directly bill the insurance.

6. I regularly visit the below Urgent Care,could you please confirm this Urgent Care is covered under this plan and there will be direct billing for any Doctor visit or hospitalization billing ? Also could you please let me know the 50$ Copay option is applicable at this Urgent Care facility ?

Please see HCC PPO Network

The copay is applicable to any US urgent care. It is up to the provider if they will do direct billing or if they will expect payment from you and for you to file for reimbursement.

7. Will this plan cover doctor prescribed medicine bills ? over the counter medicine bills ?

Yes, the plan has coverage for prescribed medication for any covered illness or injury. Over the counter medication is not covered under any plan.

8. Could you please explain the Copay option for the Urgent Care ? How Atlas America Insurance is different from Patriot America Plus Insurance in regards to Copay ?

Atlas America has the $50 urgent care copay and Patriot America Plus does not so with Patriot plans you would pay out of your pocket until you have met the chosen deductible and then the plan will pay it's percentage. 

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DISCLAIMER: Information presented in our Questions and Answers section is generic and was deemed to be accurate at the time of response. Please use the answers as a guide and do not make decisions based on the answers. The answers presented may be outdated and altogether inaccurate currently or not relevant as the details provided such as the insurance terms and conditions, plan benefits, eligibility and coverage may have changed. Insubuy assumes no responsibility for relying on such answers. You should review the latest certificate wording of the insurance policy (available on this website) for the product you are considering for the latest and complete details. If there is any conflict between the answers provided here and the certificate wording, the details of the certificate wording will prevail.

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