With SmartHealth Advantage Limited Benefit, You Choose The Plan That’s Best For You!

The following insurance benefits are provided under the Group Accidental Death and Dismemberment and Medical Care Insurance policy. It is provided to all active members who are enrolled in the SmartHealth Advantage Limited Benefit programs as an added benefit of your membership and features:
           

SmartHealth Advantage Limited Benefit Plan Insurance Benefits   AdV 100 ADV 200 ADV 500 CHOICE Plan SELECT Plan
Accidental Death & Dismemberment Benefit†:
Pays the beneficiary up to the benefit amount listed for the member's death or less of certain body parts in a covered accident or a portion of that amount for the accidental death of a family member, if this is a family membership, (50% for covered spouse, 60% if there are no dependent children; 20% for covered dependent children, 25% if there is no covered spouse.)
  $25,000 $25,000 $25,000 $10,000 $25,000
Accident Medical/Dental Expense Benefit†:
Pays part of the expenses you are charged by a hospital, doctor or certain other charges, up to a maximum of the amount listed if you are injured in a covered accident. Subject to $100 deductible.
  $2,500
per
occurrence
$2,500
per
occurrence
$5,000
per
occurrence
$5,000
per
occurrence
$5,000
per
occurrence
Accident Disability Benefit†:
If you are under age 70, it pays a monthly benefit for total disability resulting from a covered accident. Benefits are payable for up to 12 months and are subject to a 90 day waiting period.
  $500 per
month
$500 per
month
$500 per
month
$1,000 per
month
$500 per
month
Doctor Visits Benefit†:
If you are under age 65, it pays you the amount listed per visit to a doctor's office to be diagnosed or treated for a covered injury or sickness. You will be paid for up to 5 visits per person and 5 visits per family per year.
  $25 per visit
5 visits per family
per calendar year
$50 per visit
5 visits per family
per calendar year
$50 per visit
5 visits per family
per calendar year
N/A $50 per visit
5 visits per family
per calendar year
Daily Hospital ACCIDENT†:
  N/A N/A N/A $150 N/A
Ambulance Benefit†:
If you are under age 65, it pays the benefit amount for each ambulance transport for up to 3 transports per person per year.
  $100 per
transport
$100 per
transport
$100 per
transport
N/A N/A
Daily Hospital Confinement Benefit†:
If you are under age 65, it pays you the amount listed per day for up to 30 days if you have to be admitted and stay in a hospital to treat you for a covered injury or sickness.
  $100 per day $200 per day $500 per day N/A $50 per day
Intensive Care Unit Benefit†:
If you are under age 65, it pays you the amount listed per day for up to 14 days if you are confined to an intensive care unit in a hospital to treat you for a covered injury or sickness.
  $500 per day $800 per day $1,000 per day N/A N/A
Inpatient / Outpatient Surgery†:
If you are under age 65, it pays benefits according to the surgical schedule as set forth in the description of coverage provided in your membership materials. The maximum amount payable for each surgical procedure is the Point Value of each procedure on the surgical schedule(from 2.0 to 200.0), multiplied by the Unit Value for the plan you choose. The maximum for all procedures in a calendar year is $20,000 per covered person.
  $20-$2,000
per procedure
(Up to $20,000 per year)
$20-$2,000
per procedure
(Up to $20,000 per year)
$40-$4,000
per procedure
(Up to $20,000 per year)
N/A N/A

EMERGENCY ROOM Benefit†:

  N/A N/A $100 (3 Visits) N/A N/A

SmartHealth Advantage Limited Benefit PLUS plan members receive the following group
insurance benefits:

AD Protector Accidental Death Benefit††

 
Member                      
Common Carrier Accidental Death: N/A $1,000,000 N/A $1,000,000   N/A $1,000,000 N/A $1,000,000 N/A $1,000,000
Motor Vehicle/Pedestrian Accidental Death: N/A $100,000 N/A $100,000   N/A $100,000 N/A $100,000 N/A $100,000
All Other Accidents, Accidental Death: N/A $25,000 N/A $25,000   N/A $25,000 N/A $25,000 N/A $25,000
                       
If family plan is selected, the following benefits are provided to spouse and eligible dependents:
Spouse                      
Common Carrier Accidental Death: N/A $250,000 N/A $250,000   N/A $250,000 N/A $250,000 N/A $250,000
Motor Vehicle/Pedestrian Accidental Death: N/A $50,000 N/A $50,000   N/A $50,000 N/A $50,000 N/A $50,000
All Other Accidents, Accidental Death: N/A $10,000 N/A $10,000   N/A $10,000 N/A $10,000 N/A $10,000
Each Child                      

Common Carrier Accidental Death:

N/A $20,000 N/A $20,000   N/A $20,000 N/A $20,000 N/A $20,000
Motor Vehicle/Pedestrian Accidental Death: N/A $5,000 N/A $5,000   N/A $5,000 N/A $5,000 N/A $5,000
All Other Accidents, Accidental Death: N/A $3,000 N/A $3,000   N/A $3,000 N/A $3,000 N/A $3,000
                       
Per Accident Maximum Account N/A $1,000,000 N/A $1,000,000   N/A $1,000,000 N/A $1,000,000 N/A $1,000,000

† All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions and limitations, of the group policy. To obtain more information about this insurance, please call 866-915-1148 and ask to speak to a licensed agent or click on the link above.

All members of the SmartHealth Advantage Limited Benefit Plan are enrolled into the American Advantage Association to be eligible to receive these benefits.  The insurance benefits are underwritten by The United States Life Insurance Company in the City of New York, NAIC # 70106. United States Life is domiciled in the state of New York with a principal place of business of 70 Pine Street NY, NY 10270 and licensed in all states, plus DC, except PR.  These benefits are under Group AD&D & Medical Care Insurance Policy (Form #G-19000) issued to American Advantage Association.  Coverage becomes effective on the date provided in your membership materials.

† THIS IS NOT BASIC HEALTH INSURANCE.  THIS OFFER INCLUDES DISCOUNTS AND/OR SERVICES PLUS ADDED LIMITED BENEFIT INDEMNITY INSURANCE.  NONE OF THESE, INDIVIDUALLY OR IN COMBINATION ARE A SUBSTITUTE FOR BASIC HEALTH COVERAGE, MAJOR MEDICAL INSURANCE OR ANY OTHER MEDICAL EXPENSE REIMBURSEMENT INSURANCE PLAN.

†† All members of the SmartHealth Advantage Limited Benefit Plus Plans are enrolled into the American Advantage Association to be eligible to receive these benefits.  The insurance benefits are underwritten by National Union Fire Insurance Company of Pittsburgh, P.A. NAIC# 012-19445 and subject to the exclusions, limitations, terms and conditions of coverage as set forth in the description of coverage provided in your membership materials and the Group Accident and Sickness Indemnity Insurance Policy (Form No. SRG9115164) issued to American Advantage Association.  Benefits reduce 50% for accidents occurring on or after age 70. Spouse and Children Benefits are available only to members enrolling in a family membership.