Detailed Description of Premier Health’s Benefit Enhancements
for 2017–2018 Policy Year

  • Increased maximum coverage for all three plan options:
    • Secure: $1 Million → $2 Million
    • Optima: $3 Million → $4 Million
    • UltraCare: $5 Million → $8 Million
  • Outpatient Prescriptions
    • Secure: $3,000 → $5,000 per policy year
    • Optima: $6,000 → $15,000 per policy year
  • Wellness
    • If used every 12 months:
      • Secure: $150
      • Optima: $250
      • UltraCare: $350
    • If used every 24 months, same benefit limits as before will apply:
      • Secure: $500
      • Optima: $750
      • UltraCare: $1,000
    • 12 month waiting period waived if insured transfers from another Insurer through which they had coverage for 12 months prior to transferring
  • Organ Transplant and Services
    • Removed 3 organ limit
  • Congenital Disorders:
    • Changed coverage limitation for ages 18 and over as follows:
      • Secure: $500,000 → 100%
      • Optima: $1 Million → 100%
  • Outpatient Physician/Specialist Visits
    • Secure: Max 30 Visits → Unlimited
    • Optima: Max 40 Visits → Unlimited
  • Home Health Care Services
    • Secure: 30 days/policy year → 100% up to the benefit max

New Benefit Added

  • Prophylactic Surgery (aka cancer risk reduction surgery; 12 month waiting period applies)
    • Secure: Up to $20,000 lifetime
    • Optima: Up to $25,000 lifetime
    • UltraCare: Up to $30,000 lifetime