The Catastrophic Care Plan may be right for you if you want a health plan that can
help you maintain your good health and provide benefits and financial protection
“just in case” you have a serious illness or injury. This is an alternative
to more expensive comprehensive coverage.
The plan features an annual maximum copayment of $3,000
per member and $6,000 for family coverage. Once you pay
the annual maximum copayment amount for eligible expenses,
including the deductible, the plan pays 100 percent of HMSA’s
eligible charges for covered services, up to a lifetime maximum
amount of $5 million.
HMSA’s Catastrophic Care Plan is medically underwritten and your application
is subject to approval. This means that the professional medical underwriters at
HMSA and its business associate, Medwise Partners, Inc. (MPI), will review your
medical history to determine if you will be offered plan coverage. During the medical
underwriting process, HMSA or MPI may request additional information, medical records,
and lab tests needed to complete the review.
Upon approval, you will be notified of your plan’s
effective date and be billed for your first month’s dues. Because this
is a medically underwritten plan and subject to approval, we strongly
encourage you to keep any existing health care coverage until your
Catastrophic Care Plan coverage is confirmed.