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Thread: Patriot America vs Patriot America Plus Clarifications

  1. #1
    Join Date
    May 2005
    Posts
    2,621

    Default Patriot America vs Patriot America Plus Clarifications

    Hello,

    I have looked at your site insubuy.com - and found Patriot America & Patriot America PLUS as 2 plans that fit the need - However, I have few clarifications and questions before I decide to buy from here then from India. Parents ages 65 & 63 and visiting for about 3 months from India.

    (1) What is the difference between the two (PA and PA Plus)?

    (2) PA Plus indicates that it covers "Acute onset of pre-existing conditions to policy max for age <70" what does that mean ?
    I wanted to know with some specifics & also any references where claim was settled successfully

    (3) I am in 94583 zip code -- is there any Insubuy agent locally who I can work with ?

    (4) What are the hospitals in 94583 zip code that accepts PA plans as cashless (direct billing) policies and is there a way to verify ?
    what documents are needed under emergency or otherwise for claiming the benefits ?

    Regards,

  2. #2
    Join Date
    May 2011
    Location
    Plano, TX
    Posts
    3,435

    Default

    (1) What is the difference between the two (PA and PA Plus) ?

    The difference between the Patriot America and Patriot America Plus plans is simply the acute onset of a pre-existing condition coverage.

    Everything else about the plan is identical


    (2) PA Plus indicates that it covers "Acute onset of pre existing conditions to policy max for age <70" what does that mean ?
    I wanted to know with some specifics & also any references where claim was settled successfully

    The acute onset of a pre-existing condition definition is as follows :

    ** Acute Onset of a Pre-existing Condition – a sudden and unexpected outbreak or recurrence of a pre-existing condition(s) which occurs spontaneously and without advance warning either in the form of a physician’s recommendations or symptoms, is short of duration, is rapidly progressive and requires urgent care. The acute onset of a pre-existing condition (s) must occur after the effective date of the policy, Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A pre-existing condition that is a chronic or congenital condition or that gradually become worse over time will not be considered an acute onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs treatment existent or necessary prior to the effective date of coverage. **

    You can also view a very informative FAQ on the acute onset of a pre-existing condition that may assist with answering any additional question about this coverage. This link will also provide examples of such cases.

    Acute onset FAQ: https://www.insubuy.com/visitor-insu...ng-conditions/



    (3) I am in 94583 zipcode -- is there any Insubuy agent locally who I can work with ?

    Unfortunately, the only Insubuy office is located in Plano, TX, but we are more than happy to arrange a call with a licensed agent to discuss plan options and answer any questions.

    (4) What are the hospitals in 94583 zipcode that accepts PA plans as cashless (direct billing) policies and is there a way to verify ?
    what documents are needed under emergency or otherwise for claiming the benefits ?

    You can perform a provider search using the following link: https://www.insubuy.com/img-first-health-ppo-network/

    It is best to travel with a copy of the ID Card as this will provide all needed information for claims purposes for yourself and the provider if it is ever needed.

    If you have any other questions please feel free to call out office and speak with a licensed agent.
    Thanks & Regards

    Toll Free: (866) INSU- BUY
    Local: (972) 985-4400
    Fax: (972) 767-4470
    Website: https://www.insubuy.com

  3. #3
    Join Date
    May 2005
    Posts
    2,621

    Default

    Thank you for your response.

    What is the process of claim ? Lets say if there is a need for immediate medical attention (emergency or otherwise)

    There is a medical hospital - San Ramon Regional Medical center -- which is listed in the IMG First Health ppo network -

    We walk into the hospital and provide the Insurance ID card - and they will accept that as medical policy / coverage and settle any claim directly ?

    Regards,

  4. #4
    Join Date
    May 2011
    Location
    Plano, TX
    Posts
    3,435

    Default

    Hello,

    Please see the answers to your email listed below.

    What is the process of claim ? Lets say if there is a need for immediate medical attention (emergency or otherwise)

    Please see the following information about the claims process and how to file a claim.
    Claims Procedure: https://www.insubuy.com/internationa...urance-claims/



    There is a medical hospital - San Ramon Regional Medical center -- which is listed in the IMG First Health ppo network –

    As previously mentioned you can perform a provider search using the following link.
    PPO Network Search: https://www.insubuy.com/img-first-health-ppo-network/


    We walk into the hospital and provide the Insurance ID card - and they will accept that as medical policy / coverage and settle any claim directly ?

    Hospitals will always bill directly to the insurance that is standard procedure simply because of the amounts that are charged related to visiting one.
    Thanks & Regards

    Toll Free: (866) INSU- BUY
    Local: (972) 985-4400
    Fax: (972) 767-4470
    Website: https://www.insubuy.com

  5. #5
    Join Date
    May 2005
    Posts
    2,621

    Default

    Thank you very much for details.

    Are there any data/stats available for PA Plus / IMG as how many claims they received and how many claims they successfully settled? If not for entire PA Plus / IMG, do you have details for those that purchased thru Insubuy.com?

    Your responses are much appreciated and will help decide which policy to buy

    Regards,

  6. #6
    Join Date
    May 2011
    Location
    Plano, TX
    Posts
    3,435

    Default

    Hello,

    No, that information is not available for any plan.
    Thanks & Regards

    Toll Free: (866) INSU- BUY
    Local: (972) 985-4400
    Fax: (972) 767-4470
    Website: https://www.insubuy.com

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