Flagship plan
Health Saver Plus III
A traditional indemnity health insurance plan with the freedom and the cost savings that go with it, placed by Mike Garvey across Pennsylvania, Delaware, Maryland, Indiana, Kentucky, Kansas and Missouri.
Chapter 01
What an indemnity plan pays, and what it does not
Health Saver Plus III offers all the freedom and cost savings of a traditional indemnity health insurance plan. Because it pays as a fee-for-service plan rather than through a negotiated network, benefits are paid at the Usual, Customary and Reasonable rate, and the plan's deductible applies before benefits pay out. On an outpatient basis, benefits are paid toward physician visits, radiology, X-ray, EKG, labs and injections, brand name and generic prescriptions, emergency room visits and urgent care center visits.
Maximum Covered Benefits per covered person per calendar year come in three published tiers: $250,000, $500,000 and $1,000,000. The majority of Pro Health Plans policyholders have chosen $500,000 per covered person per calendar year.
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The MultiPlan and PHCS network is an option, not a leash
Health Saver Plus III adds the MultiPlan/PHCS PPO Network: more than 900,000 healthcare providers, doctors, specialists and hospitals nationwide, at no additional cost. No referrals are needed. Any doctor nationwide is available to you.
Using the network is optional, not required. Policyholders can see any doctor or hospital without a penalty for going outside it, because the network exists to lower what you pay, not to restrict where you go.
Chapter 03
What rides along at no extra cost
ScriptSave, a no-cost prescription savings card, is accepted at more than 62,000 chain and independent retail pharmacies under group number 2242. Health Saver Plus III reimburses $15 per daily generic prescription and $30 per brand name prescription.
Teladoc puts U.S. board-certified physicians on the phone or online anytime, anywhere, available 24 hours a day, 7 days a week, 365 days a year, by phone, online or through a mobile app. Karis360 adds a dedicated Healthcare Navigator, the Karis Surgery Saver and the Karis Bill Negotiator, plus a concierge phone service for questions about the plan itself.
Renewal and limits, in plain words
Health Saver Plus III carries a $5,000,000 lifetime maximum per policy and is guaranteed renewable until age 65.
Preventive care benefits and daily emergency ambulance cover, ground and air, are included in every policy alongside the outpatient benefits above.
Pro Health Plans. Pro Health Plans is owned and operated by a group of licensed, independent insurance agents who have met the financial and ethical standards set by New Era - Philadelphia American Life Insurance Company. Pro Health Plans has also completed the licensing standards set by each state in which we engage the insurance business. Call (610) 529-1106.
This page summarizes Health Saver Plus III. The policy itself, and its stated exclusions, governs what is and is not covered.