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World
Value Advantage plans at a glance:
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Features
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Value
Advantage 70
|
Value
Advantage 50
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| Lifetime
Maximum |
|
Choice
of $1 million or optional $5 million |
|
|
Choice
of $1 million or optional $5 million |
|
| Deductibles |
|
Choice
of $1,100, $1,500, $2,500, $5,000, $7,500,
$10,000.
Out-of-PPO deductible is three times PPO deductible. |
|
|
Choice
of $1,100, $1,500, $2,500, $5,000, $7,500,
$10,000.
Out-of-PPO deductible is three times PPO deductible. |
|
Coinsurance
*
World pays/you pay |
|
In-PPO:
70%/30% to $10,000
Out-of-PPO: 50%/50% to $10,000 |
|
|
In-PPO:
50%/50% to $10,000
Out-of-PPO: 30%/70% to $10,000 |
|
Out-of-Pocket
Max
Your maximum payment
for eligible charges after deductible.
Copayments for optional physician
office visits, drugs, access fees
and emergency room are not included
in maximum. |
|
In-PPO:
$3,000
Out-of-PPO: $5,000 plus charges above usual
and customary. |
|
|
In-PPO:
$5,000
Out-of-PPO: $7,000 plus charges above usual
and customary. |
|
| Inpatient
Hospital |
|
Subject
to deductible and coinsurance after a $500
access fee per admission (maximum of four
per covered person/per calendar year).
See Benefit Increase option #3
below. |
|
|
Subject
to deductible and coinsurance after a $500
access fee per admission (maximum of four
per covered person/per calendar year).
See Benefit Increase option #3
below. |
|
Outpatient
Medical
*Not applicable to chemo
and dialysis
|
|
Subject
to deductible and coinsurance after a $250
access fee per admission (maximum of 4 per
covered person/per calendar year)*.
See Benefit Increase option #3
below. |
|
|
Subject
to deductible and coinsurance after a $500
access fee per admission (maximum of four
per covered person/per calendar year).
See Benefit Increase option #3
below. |
|
| Emergency
Room |
|
Subject
to deductible and coinsurance after a $250
additional copayment. Waived if patient is
admitted directly into hospital as inpatient. |
|
|
Subject
to deductible and coinsurance after a $250
additional copayment. Waived if patient is
admitted directly into hospital as inpatient. |
|
Foreign
Travel Emergency
Emergency care that begins during
first 60
days outside U.S. |
|
Subject
to deductible and coinsurance; $100,000 lifetime
maximum. |
|
|
Subject
to deductible and coinsurance; $100,000 lifetime
maximum. |
|
| Physician
Office Visits |
|
Not
covered. Discounts may be available
at PPO providers.
Diagnostic lab and x-ray subject to deductible
and coinsurance.
See Benefit Increase option #1
below. |
|
|
Not
covered. Discounts may be available
at PPO providers.
Diagnostic lab and x-ray subject to deductible
and coinsurance.
See Benefit Increase option #1
below. |
|
Prescription
Drugs
|
|
|
|
|
|
Optional:
Benefit Increase Options
- Physician
Office Visits: This option provides a $40 copay
for PPO physician office visits. Out-of-PPO visits
are still subject to the deductible and coinsurance.
- Prescription
Drugs: After a separate $500 Rx deductible per
year, this option will provide a maximum benefit of
$2,500 per person, per calendar year:
- Generic
- $10, plus 20% of remaining charge
- Brand
Name (formulary) - $25, plus 50% of remaining
charge
- Brand
Name (non-formulary) - $35, plus 50% of remaining
charge
State variations apply.
- Inpatient
and Outpatient: Waives the $500 Inpatient Access
Fee and $250 Outpatient Access Fee
.
|
Coverage
Synopsis:
Value
Advantage Plan
This
plan covers 50% or 70% of your first $10,000 in covered
expenses, then 100% of covered expenses up to $1,000,000.
Routine doctors visits and outpatient prescription drugs
are not covered, although you may add optional benefits
which will give you a $40 copay for doctor visits.
The
prescription drug rider comes with a $500 annual deductible,
after which generic drugs would come with a copay of $10
(plus 20% of the remaining cost of the drug); $25 for brand
name (plus 50% of the cost of the drug), or $35 for non-formulary
drugs (plus 50% of the cost of the drug). Emergency
room visits are covered with a $250 access fee, which is
waived if you are admitted into the hospital, at which time
your coverage would be subject to your deductible and coinsurance.
Foreign
travel is also covered for 60 days, with a $100,000 lifetime
limit.
See
the WorldCARE
Advantage Series – Product Comparison chart
to see how this plan compares with the HD Advantage plan.
Optional
Riders:
Maximum
Benefit Option
Your
Value Advantage policy/certificate's lifetime coverage
maximum is $1 million per covered person. The Maximum
Benefit Option increases the lifetime maximum to $5 million.
It also increases the per-organ transplant maximum from
$500,000 to $1,000,000 at nationwide Centers of Excellence,
facilities that specialize in specific types of transplants
and can provide you with quality care on a cost efficient
basis.
Term
Life Benefit Option
The
Term Life Benefit Rider provides you and/or your spouse
with annually renewable term life insurance coverage in
benefit amounts of $10,000, $25,000 or $50,000. Plus,
you also have the option of converting your term-life policy
to a World whole life policy. (Note:
Not available in Georgia, Ohio and Oklahoma.)
Outpatient
Accident Benefit Option
With
the Outpatient Accident Benefit Rider, your plan pays 100
percent of expenses for a covered injury, not to exceed
the amount you choose ($500, $1,000, $1,500, $2,000, $2,500,
$3,000 or $5,000) per calendar year for treatment of injuries
on an outpatient basis, with no deductible or coinsurance.
Additional benefits are subject to your deductible and coinsurance.
(Note: Not all levels are available in all states)
Expenses
covered under this rider include:
-
Services, supplies, and physician's care;
-
X-ray and laboratory tests; and
- Treatment
or services received in a hospital emergency room,
urgent care center, physician's office, or ambulatory
surgical center or facility.
|
|
Rates:
This
plan comes with an initial 12 month rate guarantee.
Preferred
rates without riders are available on our instant
quote page. The quoted rates are for the $2
million maximum benefit, and do not include optional benefits
such as term life, supplemental accident, maternity, and
Rx riders.
Please
contact us for rates on the
optional benefits. Rates depend on gender, smoking
status, zip code, and health status.
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.
The
following chart shows when you can expect payment to be
deducted from your credit card:
| |
|
App
Effective Date
|
Credit
Card Charged
|
|
1st
of the month
|
1st
of month
|
|
2nd
- 5th of month
|
5th
of month
|
|
6th
- 10th of month
|
10th
of month
|
|
11th
- 15th of month
|
15th
of month
|
|
16th
- 20th of month
|
20th
of month
|
|
21th
- 28th of month
|
25th
of month
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PPO
Network:
World
Insurance Company recently signed an agreement with Great-West
Healthcare, a division of Great-West Life & Annuity
Insurance Company. Great-West Healthcare operates
a substantial multi-state (national) healthcare network
that includes more than 4,200 hospitals and 530,000 providers.
It provides network and other services to more than 2 million
people.
Find
a Doctor
Underwriting:
Underwriting
of your application with World normally takes two to four
weeks, though if medical records are ordered it could take
longer. World's underwriting seems fairly lenient,
and often accept applicants who may have been turned down
by other companies.
It is
standard practice for them to request a Blood Pressure Inquiry
if you are currently being treated for or have recently
discontinued treatment for high blood pressure. Certain
conditions may be waivered with a temporary rider (usually
for one to twos years), or an indefinite rider.
Effective
dates:
The
earliest your coverage can go into effect is ten days after
you have signed your application. You may request
an effective date any time between 10 and 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 World Insurance
that your coverage has been approved and is in force.
About
World Insurance:
World
Insurance was founded in 1903 in Omaha, Nebraska,
as the World Accident Association. The company began
hiring agents in 1925 and became World Insurance Company
in 1929. The first general agency was established
in Colorado in 1938. In 1943, World mutualized and
was authorized to sell life insurance as well as accident
and sickness policies.
By the
late 1950s, World was licensed in 45 states with 500 agents
nationwide. The company's product portfolio included
a wide variety of individual hospital, life and disability
policies.
Today,
World is licensed in 46 states and the District of Columbia.
More than 11,200 general agents and agents represent the
company.
World
Insurance has been assigned a rating of A-
(Excellent) from the A.M.
Best Company, an independent insurance rating organization.
HSA
for America is an independent authorized
World agent.
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