How Pre-Med Defender Works

Coverage Options

Pre-Med Defender is a customizable secondary health plan that works seamlessly with a group’s primary health plan to help fill gaps in medical coverage. Pre-Med Defender includes a combined benefit plan that covers both in-patient and out-patient procedures equally. With several plan options to choose from, members can select to have:

LOWER out-of-pocket costs

LOWER deductibles

LOWER co-pays (including prescriptions)

LOWER coinsurance to pay

BENEFIT COVERAGE AMOUNTS

(100% In-Patient and Out-Patient)

Maximum Benefit (Per Coverage Period)

$1,000 - $20,000*/single
$2,000 - $40,000*/family

Deductible (Per Coverage Period)

$0 - $5,000 (max. 2/family)

Percentage of Covered Expenses Policy Pays

Up to 100%

*Benefits vary by carrier.

Unlike other plans, Pre-Med Defender pays 100% of covered in-patient and out-patient procedures!

The Two-Card System for Claims

Primary Major Medical Plan

Pre-Med Defender Supplemental Plan

STEP 1: Members present both ID cards to the provider at the time of service.

STEP 2: Provider will submit claims to both the primary and secondary plan.

STEP 3: Secondary Claims are then paid directly to the provider.

It’s that simple!

Covered Charges

Covered charges are the unpaid portions of charges for medical care, treatment and services that are eligible for reimbursement under and deemed allowable by the policyholder’s primary plan, and which are not excluded from coverage under the policy.

Doctor Office Visits*

Pre-Med Defender plans can provide a co-payment for doctor office and specialist visits when they have been removed from the primary health plan.

“Co-payment” is a specified amount that a Covered Person is responsible for paying. Each time the Covered Expense is incurred before benefits are payable under the policy.

Out-Patient Prescription Drug Programs*

Pre-Med Defender can further assist employer groups who are having financial and underwriting difficulties with their primary health plan by offering a prescription drug carve-out or alternative prescription program.

With many high-deductible health plans, prescription drugs are subject to the out-of-pocket maximums of the health plan and can be very troublesome for employees. By carving out the prescription component of a traditional medical plan, the cost savings can be staggering!

Our Pre-Med Rx programs can provide basic prescription benefits as well as provide a full “managed care” pharmacy solution for long-term health plan cost savings.

View available states.

*Not available in all states