Welcome to our Frequently Asked Questions Page
Please select a benefit would you like to learn more about.
| Discount Dental & Vision Plans | Life Insurance | Final Expense |
| Medicare Advantage | Medicare | Medicare Supplements (Medigap) |
Discount Plans FAQ
There are no deductibles, annual limitations or health restrictions and you are able to use the plan immediately.
No, this is not an insurance plan. Our discount plans provide you with discounted prices on a wide range of health care services and products; you will pay for services at the discounted price at the time services are received.
Yes, one of the wonderful features of our discount plans is that your entire household can receive the discounts, even children living at a college!
You can add dependents on your plan at no additional cost to you.
Yes, your membership can be used at any participating provider in the United States except where the Pruim Health Programs or any of its benefits are not available.
You may go to the provider of your choice; however, you will only receive a discount by going to a participating provider.
No. Another great feature of the discount plan is your ability to select any provider from the network. You can change providers at any time and household members can select their own providers.
The providers will recognize the name of the network with which they participate, so when you call, it is important to use the name of the correct network.
Yes, just contact customer service and let them know what day is best for you.
You would need to contact Customer Service and provide your First Name, Last Name and Phone number. We will verify your information and get a new packet sent out for you at no additional cost.
Yes. You can cancel your plan a any time; there are no contracts involved. If you cancel your membership within 30 days of the effective date, you will receive a full refund of all periodic charges. The processing fee is non-refundable except in AR, MD and TN.
To cancel you must, verbally or in writing, notify Prium Health at 280 South Ronald Reagan Blvd Suite 140, Longwood FL 32750 or 1-877-954-4502.
Life Insurance FAQ
One of the most important reasons to purchase life insurance is to ensure your your family have the financial needs when you are no longer around to help. Life insurance can be very helpful in aiding your survivors pay bills and debts after your death, as well as for funeral expenses. It may also be used as part of an overall financial strategy to accumulate wealth and distribution.
A life insurance policy is a contractual arrangement between you and the life insurance company. You are considered the policyholder and get to determine the amount of life insurance coverage required and pays the life insurance company a premium to keep the policy in force. You get to name a beneficiary (the person who will receive the life insurance benefits) as well.
You may choose to pay the premium weekly, monthly, quarterly, semi-annually, annually or all at once and lay that out in the policy. The premium must be paid according to the terms of the policy to keep the life insurance policy active.
Should the policyholder die while a life insurance policy is in force, then the life insurance company will pay out the death benefits specified in the policy. Whole life policies may also have an accrued cash value that can be paid out as well. Death proceeds are paid as a lump sum to the named beneficiary as stipulated in the policy.
There are two basic types of life insurance; Term Life and Whole Life (Permanent). Although there are many options on the market, just know that they are all variations of the basic two designed to meet specific needs of their clients. It really depends on your needs.
If you think you would be struggling to purchasing life insurance then term life insurance will most likely be the best option. You’ll get the most protection and value for your dollar.
If you’d like to have life insurance and with the option of having an extra retirement vehicle investment, then whole life insurance will most likely be the best option for you.
The amount of life insurance you need depends on your goals, your family, and the expenses you want your family to be able to cover once you are no longer there to support them.
Things to consider when deciding on how much is right for you, consider the following:
- Are you simply trying to make your final expenses are taken care of after you pass? (Funeral service, casket, debts, etc)
- Do you have a wife and/or dependants? Add your family’s cost of living, your personal and household debt and the projected costs of your children’s education as a starting point to determine the amount of coverage you need.
- Do you want your life insurance policy to accrue value and work for you as an investment vehicle? If so, there are several different types of permanent life insurance to choose from.
Yes. You may purchase a rider to add a child or children to your policies with a variety of term and permanent life policies.
Many policies contain a provision where an insured person may collect a significant portion of his or her policy’s death benefit while still alive. The money can be used to pay for uncovered medical expenses, take care of any urgent matters or simply do certain things for your family or friends while you still can. It’s important to note that the amount withdrawn from the policy is subtracted from the death benefit payments your beneficiaries receive, along with an interest charge for early payment of benefits.
Premium rates for life insurance are typically based on several factors.
- Physical condition: Age, gender, height, and weight
- Health status: Any conditions you may have. This also includes whether or not you use tobacco or nicotine
- Occupation and hobbies: Taking into account if you participate in high-risk activities for work of play.
Most life insurance companies will ask for a medical exam as a risk assessment.
We highly recommend that you meet with a licensed agent for a professional assessment to determine the right policy for your needs.
Final Expense FAQ
Final expense insurance (also know as funeral insurance or burial insurance) is a policy with a smaller payout, usually paid out to a beneficiary to help cover funeral, cremation and/or burial costs as well as any debt.
Final expense insurance does not require an exam and allows for some imperfections in a person’s health without causing additional costs. Also the payout is much smaller since it is mainly just to cover any immediate expense after death such as funeral services.
This will depend on the type of funeral service you anticipate having. If you think the services will be modest with simple services, you will want to opt for a smaller policy. If you expect to have a much larger service that will cost much more, you’ll want a larger policy to make sure all expenses are covered. Larger policies have a larger monthly premium but give more money to the beneficiaries when the policy is paid out.
Medicare Advantage FAQ
Medicare Advantage plans (also known as Medicare Part C) are part of the original Medicare program and designed by congress give Medicare beneficiaries a lower-premium option. They get their benefits from a private insurance company instead of original Medicare. To enroll in a Medicare Advantage Plan you must first be enrolled in the original Medicare Part A and Part B.
The plans typically provide Part A (hospital), Part B (medical) and typically Part D (drug) coverage. Medicare Advantage plans are part of the federal Medicare program and can be purchased from private insurers for additional coverage. There are various types of Medicare Advantage plans, such as HMO, PPO and Private Fee-for-Service plans.
In exchange for lower premiums that Medicare Advantage plans offer, you must adhere to certain rules. If you’re willing to follow the rules, you can find a plan with attractive low premiums.
Here are some of the rules for Medicare Advantage:
- Be enrolled in both Medicare Part A & B
- Pass a health question asking about being diagnosed with End-Stage Renal Disease (kidney failure)
- Get prior authorization for certain procedures or receiving a referral from your primary care physician being seeing a specialist.
- Use doctors and hospitals in a network. Some plans do not cover anything out of network except emergencies and you may have some high expenditures outside of the network.
With a Medicare Advantage plan, you may have to pay a deductible, but will normally have fixed copays for routine doctor’s office visits. There are yearly limits on your out-of-pocket health care costs with these plans, after which you pay nothing for the remainder of the year.
No. Once enrolled in a Medicare Advantage Plan, your insurance company will get involved with the administrative processes to implement your Medicare benefits; you do not lose your Original Medicare. You can return to your Original Medicare Part A and Part B coverage during next the Annual Election Period (AEP) if you wish to leave a current Medicare Advantage plan.
Medicare Advantage Plans must cover all of the services that Original Medicare covers with the exception of hospice care, however, Original Medicare will still cover hospice care even if you’re in a Medicare Advantage Plan. Coverage with Medicare Advantage Plans also includes emergency and urgently needed care.
The plan may opt not to cover the costs of services that aren’t medically necessary under Medicare. It’s imperative to check with your provider before you get the service if you’re not sure whether a service will be covered for you.
Medicare Advantage Plans may also cover dental, vision, hearing and/or wellness programs. Most include Medicare prescription drug coverage (Part D).
If you need a service that the plan refuses and deems as not necessary, you may have to pay the costs out-of-pocket in full. You do however, have the right to appeal the decision.
To make sure that a Medicare Advantage plan will be right for your needs, be sure to ask for a written advance coverage decision so that you know if your needs will be covered. You can get your plan’s contact information from a Personalized Search (under General Search), or search by plan name.
These plans were created to give you more affordable Medicare benefits. Here are some common reasons people choose to get a Medicare Advantage plan are:
- Many plans have lower monthly premiums (Keep in mind you’ll stay pay your Medicare Plan B premium)
- You pay for medical services as you use them. This would be in the form of copays and coinsurance
- Your medical benefits and Part D drug benefits are rolled into one plan
- Some plans may include benefits not covered by other plans like limited vision coverage. You may still have copayments, restrictions and limitations.
We understand that some sometimes an FAQ on our website will not be enough information for everybody’s individual needs. If you are still wondering if Medicare Advantage is right for you, allow for one of our licensed agents give you professional assistance.
Medicare Supplement FAQ (Medigap)
Medicare supplement plans (also known as Medigap) are private insurance plans that fill in some or all of the gaps left behind by original Medicare Parts A & B. These plans and Original Medicare work in tandem. Medicare pays will pay it’s share and then your supplement plan pays afterwards. You will need to present both your Medicare supplement ID and Medicare cards to your healthcare provider when receiving care.
There are ten standardized Medicare supplement plans A-N. There is one variation of Plan C and two variations of Plan F. View our chart here to better understand what each plan covers.
While Medicare Supplement policies supplement the costs related to your “Original Medicare” (the catch-all term used to describe Medicare Part A and B) benefits, Medicare Advantage Plans actually provide you with Part A and Part B benefits (by way of private companies that contract with and are approved by Medicare).
Note: If you already have a Medicare Advantage Plan, which also is known as Medicare Part C, you won’t be able to get a Medicare Supplement plan. And if you have a Medicare Supplement plan and you’d like to move into a Medicare Advantage Plan, you probably should drop the Medicare Supplement plan, as it won’t pay out if you buy a Medicare Advantage Plan.
Take a look at our 2017 Medicare Supplement Insurance (Medigap) Benefits Guide.
As long as you bought your policy after 1992, a company can’t drop you unless you fail to pay your premium, you are found to have been untruthful on your application, or the company becomes bankrupt or insolvent.
If you bought your policy before 1992 and your insurance company decides against renewing your Medicare Supplement policy for one reason or another, you will qualify for “guaranteed issue rights” and be allowed to buy another one.
Medigap policies generally do not cover the following health services and supplies:
- Prescription drugs
- Dental care
- Hearing aids
- Eye examinations
- Private-duty nursing
- Long-term care (care in a nursing home)
LIFE INSURANCE
MEDICARE SUPPLEMENTS
DENTAL & VISION