SmartHealth Diamond 250

Membership in the SmartHealth Diamond Limited Benefit Plans includes a Medical Discount Program with the following discount and service features:

Patient Advocacy:
Our personal Patient Advocates are dedicated to help you locate healthcare providers and specialists AND help you eliminate many of the hassles typically encountered when dealing with the healthcare system. Not Available in California.

Physician Program:
Savings: 5% to 50%. Our network of physicians includes General Practitioners, as well as specialists representing over 130 specialties. The specialists include Anesthesiologists, Cardiologists, Chiropractors, Dermatologists, Endocrinologists, Gynecologists, Neurologists, Oncologists, Pediatricians, Psychiatrists, Surgeons, and more.

Hospital Program: (Not Available in California)
If you know that you or a loved one requires a hospital stay, we’ll work with you to find the hospital that offers the greatest savings based on the hospital privileges provided to your physician. Savings of 5% to 25% are typical and in some cases, hospitals have agreed to package rates for certain procedures making savings of 5% to 40% possible. State Disclosure - New Hampshire: Members must secure payment with a major credit card or health insurance plan, if any. Cases in excess of $2,000 may require a bank wire transfer of funds or certified funds prior to a referral being issued. In some states members will be required to make a minimum $1,000 deposit to the hospital for each day scheduled for in-patient hospital services. (Deposit will be applied against total bill).

Dental:
Savings: 5% to 30%. Current members and their family can save an average of 5%-30% off of area dental procedures* when performed by a participating Dental Network dentist. With a network of tens of 1,000’s of credentialed dentists, chances are you’re sure to find a participating dentist regardless of where you live or work. Current members will save on routine dental services, such as cleaning, x-rays and fillings as well as crowns, root canals, dentures, oral surgery, orthodontics, periodontics and cosmetic dentistry where available. Savings are received immediately at the time of service. * Savings are based upon a comparison of national average negotiated network provider discounts. Actual savings will vary based upon procedure, geographic location, and the dentist’s dental discount.

Vision:
This program offers the nation’s largest discount vision care vision network with more than 30,000 eye MDs, optometrists, opticians, optical outlets and 13,000 locations nationwide. It is the only national network that includes Ophthalmologists who discount all of their services on medical and surgical procedures, including cosmetic surgery and LASIK. Members also receive substantial discounts on all contact lenses, frames, lenses and designer sunglasses, in addition to providing one FREE eye exam annually per membership for prescription glasses.

Prescription Drug Program:
Save an average of 23% off brand name drugs and an average of 55% off generic drugs. There are more than 55,000 participating pharmacies nationwide. You pay the discounted price at the time the prescription is filled. There are no claim forms to complete or different co-pays to remember. Pharmacy Web Tools will allow you to locate participating pharmacies anywhere in the country, get retail pharmacy drug pricing, and identity equivalent alternative drugs. Discounts are also available through mail order.

Nurseline:
Current members have 24-hour access to a Registered Nurse to answer any questions on family health issues, in English and Spanish. When you need help determining whether or not you or a family member needs to see a doctor, or when no one else is available to give you medical advice, our professional nurses are there to help.

Chiropractic Care:
5% to 50%. The chiropractic network consists of thousands of chiropractors who have been carefully screened to make sure that he or she meets high standards, and will allow you to enjoy unlimited use of his/her services with no hassles.

Hearing:
Members receive a free hearing exam, hearing aid cleanings and adjustments as well as a 15% discount off normal retail prices on Beltone hearing aids at any of the 1,800 Beltone Independent locations.

TelaDoc™:
TelaDocTM is a network of state licensed primary care physicians who, diagnose individual medical problems via the telephone, recommend treatment, and prescribe medication (when appropriate) over the telephone 24 hours a day, 365 days a year. You can access this service wherever you happen to be: your home, office, hotel room, or vacation campsite. Simply make a phone call and, in most cases, speak to a doctor within 30 – 40 minutes. TelaDoc does not issue prescriptions for DEA controlled substances. Consultations not provided for children under 12 years old. Not available to residents or in the states of South Carolina and Oklahoma.

Travel Assistance:
When you're traveling, the unexpected can occur. Emergencies do happen, but help is now only a phone call away. 24 hour toll-free emergency service that can help you access emergency assistance when traveling 100 or more miles away from home. Travel Assistance service is there when a crisis strikes.

CONTACT911™:
A disaster could strike anywhere, anytime, making communication the critical component of any emergency plan. CONTACT 911™ is the tool you need to stay connected when it matters the most, so you can adapt your plan to the circumstances at hand. Plan includes 6 person contact list and 20 minutes per month. Unused minutes roll over to the next month.

The following limited benefit insurance is provided under the Group Accidental Death and Dismemberment and Medical Care Insurance Policy and is an added benefit of membership featuring:

Accident Medical / Dental Expense Benefit:
Pays up to $1,000 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 a $100 deductible

Accidental Death & Dismemberment Benefit:
Pays the beneficiary up to $2,500 for the member's death in a covered accident or a portion of that amount for the accidental death of a family member, if this is a family membership, or loss of certain body parts (50% for covered spouse, 20% for covered dependant children).

Accident Disability Benefit:
Pays a $250 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.

Doctor Visits Benefit:
Pays you $50 per visit to a doctor's office to be diagnosed or treated for a covered accident (or sickness). You will be paid for yup to 5 visits per person and 5 visits per family per year.

Daily Hospital Confinement Benefit:
Pays you $250 per day for up to 180 days if you have to be admitted and stay in a hospital to treat you for a covered accident or sickness.

ICU:
Pays you $250 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 accident or sickness.

Inpatient / Outpatient Surgery from $50 to $5,000 per producer:
Pays benefits according to the surgical schedule as set forth in the description of coverage provided in your membership materials.

Ambulance Benefit:
Pays $100 for each ambulance transport for up to 3 transports per person per year.

*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 1-866-915-1153 and ask to speak to a licensed agent or click on the link above. All members of the Smarthealth Diamond 250 Program 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, a member company of American International Group, Inc¹, NAIC # 70106. United States Life is domiciled in the state of New York with a principal place of business of 830 Third Avenue NY, NY 10022-6565 and licensed in all states, plus DC, except PR. These benefits are under Group AD&D & Medical Care Insurance Policy (Form #G-19001) issued to the American Advantage Association. Dr. Office Visits, Daily Hospital, ICU, Surgery coverage is not provided for loss due to a pre-existing condition for 12 months from the Covered Person’s effective membership date and coverage is not provided for members over the age of 64.* Accident Disability coverage is not provided for members over the age of 69.

¹The underwriting risks, financial obligations and support functions associated with the products issued by The United States Life Insurance Company in the City of New York are its responsibility. The United States Life Insurance Company in the City of New York is responsible for its own financial condition and contractual obligations.

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.