Nationwide Health Net FB Plans

NATIONWIDE PPO CHOICE SAVER SELECT (HSA Qualified)

HSA-qualified plans offer lower deductibles and tax benefits that traditional copay plans don't.  They are amongst the most popular plans offered by Nationwide Life Insurance Company in California.  These plans currently are usually the lowest premiums of any individual or family HSA plans in the state.  They also have several additional benefits not included in other HSA plans.

The PPO Choice Saver Select plan is designed to provide you with economic incentives for using designated health care providers (PPO network).  It provides coverage for major hospital, medical, and surgical expenses incurred as a result of a covered accident or sickness.  Coverage is provided for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services and out-of-hospital care, subject to any deductibles or other limitations which may be set forth in the policy.

Note: Nationwide plans are now being underwritten by Health Net

PPO Choice Saver Select at a Glance:

View the PPO Choice Saver Select brochure  for complete details

1. Benefits reduced to 0% if pre-authorization is not obtained.
2. Benefits reduced to 0% for confinements in a Non-PPO Hospital where a PPO Hospital is reasonably available, the Covered Person’s condition has been stabilized and can safely be transferred to a PPO Hospital.
3. Combined lifetime maximum of $5,000 for “Inpatient” and “Outpatient” services.
4. PPO and Non-PPO combined maximum is 20 visits per calendar year with a maximum payable of $600 while utilizing a PPO provider ($300 while utilizing a Non-PPO provider).  The calendar year maximum amount payable for PPO and Non-PPO combined is $600.
5. The maximum combined for Non-PPO MRI’s, CT Scans and PET Scans is $500 per day.
6. Calendar year maximum payable of $500 while utilizing a PPO provider ($300 while utilizing a Non-PPO provider).  The calendar year maximum amount payable for PPO and Non-PPO Covered Charges combined is $500.
7.Must use a United Resource Network hospital or doctor or benefit is reduced to 0%.  *Service mark used under license from the California Farm Bureau Federation.

This information is presented only as a very brief overview of some of the benefits of this plan, and is intended only for general education.  The amount of benefits provided depends on the plan selected. Premium will vary with the type of benefits selected.  These plans contain exclusions from and limitations of coverage.  Please see the product brochure for more complete information, as well as information about terms of renew ability, preexisting conditions, out-of-network penalties, and notification requirements.  Plans are subject to health underwriting.  To be considered for reimbursement, expenses must qualify as covered expenses.  Expenses are also subject to reasonable and customary limits, unless you use a network, and all other policy provisions, including determinations of medical necessity.

Coverage Synopsis:

PPO CHOICE SAVER SELECT - After you have met your deductible, this plan pays 100% of all covered expenses, up to $5 million per person.

This plan qualifies as HSA-eligible.  Combining a Health Savings Account with any Choice Saver Select plan allows you to make tax-deductible contributions, pay medical expenses with pre-tax dollars, and earn tax-deferred interest.  This account works much like an IRA, except you may use your tax-free savings for qualified medical expenses your health plan does not cover, such as your deductible, contact lenses, or most types of alternative medicine (see the HSA qualified medical expenses page).  If you do not use these funds, they are always yours and continue to grow tax-deferred.

This plan includes many benefits not typically included by other companies offering HSA plans.  These include:

• Routine maternity expenses are covered the same as any other covered services (only available with the $3,600 and $4,800 deductible options)
• Provides $5,000 Term Life on primary insured and $2500 on Spouse
• Provides $5,000 Accidental Death and Dismemberment on primary insured and $2,500 on Spouse
• Mental Health is covered at 100% after the deductible.  Limited to 20 visits and $600 per year, and $5,000 lifetime.
• Preventative care is covered at 100%, $250 per person, with NO DEDUCTIBLE
• Membership with the California Farm Bureau, offering discounts with NAPA, Kelly-Moore Paints, Dodge, Hertz, LensCrafters, and other participating vendors

Rates:

The rates are guaranteed not to go up for 12 months, although your monthly premium could change if you move to a different age rate bracket during the 12-month period. 

The premium can be paid via quarterly, semi-annual, or annual billing, or a monthly bank draft or credit card.  The bank draft will occur on the premium due date each month.  The initial premium can be paid with a check or credit card.

To qualify for the Nationwide health plan in California, you must either already be a Farm Bureau member, or you must pay the annual membership dues along with your application.  The dues for this membership average approximately $70 per year, but vary by county and occupation status.  To find your exact yearly dues, see the chart below.  Your dues are payable in one yearly installment when you apply for a Nationwide health plan.  The one page application is included as page 4 of the Nationwide application.  If you are rejected for the Nationwide health plan, you may cancel your Farm Bureau membership and receive a full refund.

PPO Network:

Nationwide plans are underwritten by Health Net Insurance.  Health Net has an excellent network of health care providers throughout the state.  The large list of doctors and hospitals can be viewed at their online network listings.  Please select the PPO – Individual Plans option.

Underwriting:

Nationwide programs are very popular in California, but their approval process is fairly slow.  Underwriting of your application can take as little two to three weeks, but if medical records are ordered it is not unusual for the process to take over a month. 

It is standard practice to request a Blood Pressure Inquiry or medical records for all applicants who are currently being treated for or who have recently discontinued treatment for high blood pressure.  Certain conditions may be waivered with a temporary rider (usually for one to two years), or an indefinite rider.

Effective dates:

All Nationwide policies begin the first of the month.  The earliest your coverage can go into effect is the first of the month after your signed application has been received by our office.  You may request an effective date any time as far out as 60 days after you sign your application.

Please note, if you are requesting an effective date of less than 21 days from the time you complete the application, you may not receive notification of your approval until after your effective date.  If you have claims during this period, they will be eligible for coverage if submitted after you have been approved.  Also note that you will be billed starting on your requested effective date, even if you have not yet been notified that you have been approved.  This is very good for someone who does not have any present coverage and would like for their benefits to begin right away.  For those who are already covered, it is suggested that you maintain your current coverage in force until you have received notice from either HSA for America or directly from Nationwide that your coverage has been approved and is in force.

HSA Administrator:

Your health savings account is totally separate from your health insurance, and you may use any approved bank or trustee as your HSA administrator.  We recommend that you choose one from our HSA administrator page, where you can compare rates and features. 

About Nationwide:

Nationwide plans are underwritten by Health Net Insurance.  Health Net Insurance is among the nation's largest publicly traded managed health care companies. The company's HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.5 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE programs.

Health Net is an early adopter of the National Committee for Quality Assurance (NCQA) new quality plus standards for assessing how health plans measure the quality and efficiency of care provided by physicians and hospitals in their networks.

Health Net has been assigned a rating of B++ (Very Good) from the A.M. Best Company, an independent insurance rating organization.

HSA for America is an independent authorized Health Net agent.  CA License #: 0E39302

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