MEDMAX
Four numbers to remember and you're set.
The framework
Four numbers you need to remember.
just four numbers.
- Preventive careAnnual wellness, screenings, vaccines
- TeladocUnlimited virtual visits, 24/7
- Primary careAfter deductible
- SpecialistsNo referral needed
- Urgent careWalk-ins covered
- ER visitsAccident or sickness
- Outpatient surgeryUp to 3 per year
- Ambulance ridesEmergency transport
- Inpatient hospitalAdmission & stay
- Inpatient surgeryPre-cert required
- Surgical servicesAnesthesia included
How deductibles work
For everything that's not free, you meet your deductible first.
Then your copay.
And everything's covered after that.
In-network benefits
What's covered, in plain English.
Office & everyday care
Surgery & emergencies
Specialty & therapy
Worth knowing
A few things to keep in mind.
-
1
Pre-certification
Some services need pre-cert (inpatient stays, advanced imaging, infusions, surgery). Skip it and you can lose up to 50% of allowed charges, or get fully denied.
-
2
True emergencies are exempt
Severe injury or life-threatening symptoms? Go to the closest ER. No out-of-network penalty, no denial. 48-hour grace period if you're admitted.
-
3
Maternity has a 12-month waiting period
After that, most prenatal, delivery, and postnatal care is fully covered. Vaginal delivery $250 copay, C-section $500. Genetic testing only if medically necessary.
-
4
Elective surgery isn't covered
This plan focuses on medically necessary care. Considering elective procedures? Ask Perry about pairing this with supplemental coverage.
For your records
The full schedule of benefits, in writing.
Every limit, every copay, every preventive service the plan covers. Bring it to your doctor's office. Send it to your accountant. Keep it on hand.
Do your research
Before you sign, look us up.
ready when you are
Think MedMax $750 fits? Let's make it official.
Call the team: (817) 205-6257 · thehealthyinsurancedude.com