Your plan
Schedule of Benefits · Amerus Summit Health Plans

AMERUS PHCS

A real deal $0 deductible. Straightforward coverage for the people who matter most. Flat copays at the doctor's office, and a 40 / 60 split on the big stuff you can read on one page.
$0
Individual deductible $0 family
Out-of-pocket max$4,000 individual
$8,000 family
The split on the big stuffYou pay 40%
the plan pays 60%

As seen on

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At the point of care

What you'll actually pay
when you use it.

no deductible to chew through first.
$50
Primary care
  • Office visitsA flat copay, per visit
  • The same copay every timeNo deductible to meet first
$75
Specialists
  • Specialist visitsA flat copay, per visit
  • No coinsurance at the visitYou pay the copay, not a percentage of the bill
$75
Urgent care
  • Walk-in urgent careNot an emergency, but it can't wait
  • The same flat copayWhatever the visit costs
$50
Basic labs
  • Basic laboratory workA flat copay for basic labs
  • Bigger lab work differsIt runs on the 40 / 60 split below
flat copays. no deductible. read it in a minute.
Before you enroll

The team checks your doctor, your hospital and your pharmacy by name before you enroll, so you know exactly where you stand before anything is signed.

Some benefits on this plan carry day or service limits, listed in the next section. Ask the team how the plan counts visits, days and services before you receive care.

High-cost services

The big stuff is a 40 / 60 split.

No deductible first. You pay 40% of the bill, the plan pays 60%, and your share of covered services stops at $4,000 for the year, $8,000 for a family. Each service below carries its yearly limit, printed right where you can read it.

Inpatient hospital stay
40%
Up to 5 days
Outpatient facilitySame-day procedures and facility care
40%
2 services a year
Emergency roomA flat $500 copay first, then the 40% share
$500 + 40%
2 visits a year
LaboratoryBasic labs are the flat $50 copay, above
40%
3 services a year
X-ray
40%
3 services a year
MRI and CT imaging
40%
2 services a year

Covered services, subject to plan terms, limitations, exclusions and authorization requirements. Limits are counted by the plan, so confirm how visits, days and services are counted before you receive care.

Prescriptions

Your drugs run on a
discount card.

ask us what yours would cost.
How the card works

Generic, preferred and non-preferred medications all run through a discount card. You show the card at a participating pharmacy and pay the discounted price for the prescription.

A discount card is a discount program, not an insured prescription benefit. Bring your prescription list to the first call and the team will tell you what each one would actually cost.

Monthly rates

Straightforward pricing,
No-surprises coverage.

four rates. pick your household.
Individual $482.95 per month
Individual + spouse $737.08 per month
Individual + children $756.01 per month
Family $960.42 per month
Before you enroll

Rates are quoted monthly and are separate from copays and the 40% share. Ask the team for the all-in monthly figure for your household before anything is signed. Rates remain subject to eligibility, underwriting, plan changes and final approval.

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You call, we answer. Call the team →
What happens next

Three steps, and the plan is yours.

1Call the team

One call, (817) 205-6257. Ask anything, no pressure.

2Enroll in about 15 minutes

The team walks you through it, right on the phone.

3You're covered

And never on your own. The team sticks with you after you enroll, for every question, every claim, every step.

Quick answers

Asked all the time.

Can I keep my doctor?

The team checks your doctor, your hospital and your pharmacy by name before you enroll, so you know exactly where you stand before anything is signed.

When does coverage start?

Fast. But start dates come with real deadlines, and they vary. The sooner you call, the sooner you're covered.

What does the $0 deductible mean?

There is nothing to pay down before the plan starts working. Copays and the 40% share apply from day one, and $4,000 individual, $8,000 family is the out-of-pocket maximum for covered services. Day and service limits apply to some benefits, and they are printed on this page.

ready when you are

Questions about the Amerus PHCS plan?
The team picks up.