Allstate Health Solutions FAQs: Dental, Accident, Hospital, Cancer and Life Plans
These Allstate Health Solutions FAQs cover dental, accident, hospital, cancer and term life plans. Licensed Vivna agents wrote each answer in plain English. Because plans vary by state, every answer shows where it applies. Call 888-730-6001 anytime for free help.
Vivna Insurance is an independent, licensed agency offering Allstate Health Solutions products. We are not Allstate Health Solutions or its affiliates. Supplemental plans pay benefits on top of health insurance and do not replace it. Plans and availability vary by state.
Allstate Health Solutions Basics
Start here to learn who Allstate Health Solutions is and how its products fit together. Then compare the plans.
β What is Allstate Health Solutions?
Allstate Health Solutions is the marketing name for supplemental and short-term products from the Allstate Corporation.
Three companies underwrite the products: National Health Insurance Company, Integon National Insurance Company and Integon Indemnity Corporation.
π Where this applies: Florida and Texas
β Which Allstate Health Solutions products can I get with an Oscar plan in Florida or Texas?
The Oscar library lists eight Allstate Health Solutions products you can pair with Oscar.
These are Hospital Expense Protection Plus, Cancer, Cancer and Heart/Stroke, and Plan Enhancer. The list also includes Select Dental PPO, Term Life, Term Life Critical Illness and Accident Fixed-Benefit. However, each is a separate policy from Oscar's ACA coverage.
π Where this applies: Florida and Texas
β Who is the insurance company behind Allstate Health Solutions products in Texas?
National Health Insurance Company underwrites the Texas policies for these products.
Also, each underwriting company is responsible for its own products.
π Where this applies: Texas
β Who is the insurance company behind Allstate Health Solutions products in Florida?
It depends on the product you choose.
For example, Integon Indemnity Corporation underwrites the Florida Cancer, Cancer and Heart/Stroke, Plan Enhancer and Accident Fixed-Benefit policies. By contrast, National Health Insurance Company underwrites Hospital Expense Protection Plus and Select Dental PPO in Florida.
π Where this applies: Florida
β Are Allstate Health Solutions supplemental plans the same as Oscar health insurance?
No, Allstate Health Solutions companies underwrite these as separate supplemental policies.
These plans provide limited benefits. Also, they do not replace comprehensive (major medical) coverage like an Oscar ACA plan.
π Where this applies: Florida and Texas
β Do Allstate Health Solutions supplemental plans count as minimum essential coverage?
No, these supplemental plans do not count as minimum essential coverage.
The brochures state they do not satisfy the government's requirements for minimum essential coverage. Instead, the plans aim to sit on top of a major medical plan.
π Where this applies: Florida and Texas
β Can I add an Allstate Health Solutions plan to my Oscar or other ACA plan?
Yes, you can add an Allstate Health Solutions plan to your Oscar or other ACA plan.
The brochures say the plans pay benefits regardless of other medical coverage you have. As a result, these plans can help with deductibles and other out-of-pocket costs an ACA plan leaves behind.
π Where this applies: Florida and Texas
β What can end my Allstate Health Solutions coverage even if it is renewable?
Renewable coverage depends on following plan rules, including dependent eligibility.
Also, coverage can end if the plan stops in your state. In addition, moving to a state that does not offer the plan can end it.
π Where this applies: Florida and Texas
β Where can I read the full details of an Allstate Health Solutions policy?
Your policy and Outline of Coverage list the full benefits, exclusions and limitations.
The brochures are summaries. Also, if the brochure and policy differ, the policy governs.
π Where this applies: Florida and Texas
β Which Allstate Health Solutions plans are guaranteed issue?
Plan Enhancer and Accident Fixed-Benefit have no health questions.
Meanwhile, Cancer and Heart/Stroke is guaranteed issue at $25,000 and $30,000. However, Term Life uses a health questionnaire.
π Where this applies: Florida and Texas
β Which Allstate Health Solutions plans have no waiting period?
Hospital Expense Protection Plus, Accident Fixed-Benefit and Plan Enhancer Accident Medical Expense have no waiting period.
Select Dental PPO also starts on day one. The exception is major care on the original Copay Plan.
π Where this applies: Florida and Texas
β Which Allstate Health Solutions plans pay cash directly to me?
Cancer, Cancer and Heart/Stroke, Accident Fixed-Benefit and Term Life Critical Illness pay cash directly to you.
By contrast, Term Life pays your beneficiary.
π Where this applies: Florida and Texas
β Which Allstate Health Solutions plans can help with my Oscar deductible?
You can use any cash benefit toward a deductible.
In addition, Plan Enhancer's examples show it covering costs after a primary plan's deductible or out-of-pocket limit.
π Where this applies: Florida and Texas
β What are the age limits on Allstate Health Solutions products?
Select Dental PPO is for ages 0 to 64.
Term Life has issue ages of 18 to 64. By contrast, Term Life Critical Illness has issue ages of 18 to 60. Plan Enhancer riders also require a primary age of 18 to 64.
π Where this applies: Florida and Texas
β Until what age can I renew each Allstate Health Solutions product?
Hospital Expense Protection Plus, Select Dental PPO and Plan Enhancer riders renew to age 65.
Meanwhile, Accident Fixed-Benefit renews to age 70. Cancer and Heart/Stroke renews to 75, and Term Life renews to 85.
π Where this applies: Florida and Texas
β Do Allstate Health Solutions plans replace an ACA plan if I cannot afford one?
No, these plans provide limited benefits and are not minimum essential coverage.
So, if cost is the concern, a licensed agent can check whether you qualify for ACA subsidies.
π Where this applies: Florida and Texas
Select Dental PPO
Select Dental PPO covers checkups, fillings and major work. Here you can see what it pays and when.
β What is Allstate Health Solutions Select Dental PPO?
It is a family of dental plans with coinsurance and copay options.
Every plan covers preventive and basic care. You can also add optional vision coverage.
π Where this applies: Florida and Texas
β Who underwrites Select Dental PPO?
National Health Insurance Company underwrites Select Dental PPO in Florida and Texas.
π Where this applies: Florida and Texas
β Who can buy Select Dental PPO?
Individual and family plans are available for ages 0 to 64.
Child-only plans are also available.
π Where this applies: Florida and Texas
β What dental network does Select Dental PPO use?
It uses the Aetna Dental Administrators network, with 89,000 providers nationwide.
To get in-network benefits, show your ID card at each visit.
π Where this applies: Florida and Texas
β How do I find a Select Dental PPO dentist?
To find a Select Dental PPO dentist, contact the carrier for its provider search.
π Where this applies: Florida and Texas
β What Select Dental PPO plans are available?
There are three coinsurance plans and two copay plans.
The coinsurance plans are Value, Plus and Prime. Also, the copay options are Copay Plan and Copay Plan 2.
π Where this applies: Florida and Texas
β Is there a waiting period on Select Dental PPO?
There is mostly no waiting period, since care is covered from day one.
However, the original Copay Plan has a 6-month wait for major services.
π Where this applies: Florida and Texas
β What is the deductible on the Select Dental PPO coinsurance plans?
Value, Plus and Prime all have a $50 individual and $150 family deductible in network.
By contrast, the out-of-network deductible is $100 individual and $300 family.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover cleanings and checkups?
Yes, the coinsurance plans pay 100% in network and 70% out of network for preventive care.
Preventive care includes exams, cleanings and bitewing or full-mouth X-rays.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover fluoride?
Yes, Select Dental PPO covers fluoride for children under 18.
The plan lists fluoride treatments as a preventive service for that age group.
π Where this applies: Florida and Texas
β How much does Select Dental PPO pay for fillings?
Fillings are basic services, and the coinsurance plans pay 60% in network the first year.
From year two, they pay 80% in network. Out of network, they pay 30%, then 50%.
π Where this applies: Florida and Texas
β What counts as basic dental services on Select Dental PPO?
Basic services include fillings, simple extractions, emergency treatment of dental pain and consultations.
Denture adjustments and repairs count as well.
π Where this applies: Florida and Texas
β Does the Select Dental PPO Value plan cover crowns or root canals?
No, the Value plan does not cover major services like crowns or root canals.
Instead, the Plus, Prime and copay plans include major services.
π Where this applies: Florida and Texas
β How much does the Select Dental PPO Plus plan pay for major services?
Plus pays 15% in network and 10% out of network for major services in the first year.
Then, from year two, it pays 25% in network and 15% out of network.
π Where this applies: Florida and Texas
β How much does the Select Dental PPO Prime plan pay for major services?
Prime pays 25% in network and 15% out of network for major services in the first year.
Then, from year two, it pays 50% in network and 30% out of network.
π Where this applies: Florida and Texas
β What counts as major dental services on Select Dental PPO?
Major services include crowns, oral surgery, periodontics, endodontics (root canals), dentures and deep sedation for major work.
π Where this applies: Florida and Texas
β What is the annual maximum on Select Dental PPO?
Value and Plus start at $1,000, rising to $1,500 in year two and $2,000 in year three.
By contrast, Prime starts at $2,000, then rises to $2,500 and $3,000.
π Where this applies: Florida and Texas
β Do Select Dental PPO benefits go up the longer I keep it?
Yes, on the coinsurance plans, benefits improve the longer you keep coverage.
Basic and major coinsurance improve after the first year. Also, annual maximums rise in years two and three.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover braces?
Only the Prime plan covers braces, and only for children under 19.
It pays 15% the first year and 50% from year two, up to a $1,000 orthodontic maximum.
π Where this applies: Florida and Texas
β How does the Select Dental PPO Copay Plan work?
The Copay Plan has no deductible, and you pay $50 per preventive visit.
You also pay $50 per basic or tier 1 major procedure. Tier 2 major procedures cost $250 each. Finally, the annual maximum is $3,000 per person.
π Where this applies: Florida and Texas
β Is there a waiting period on the Select Dental PPO Copay Plan?
Yes, tier 1 and tier 2 major services have a six-month waiting period.
However, preventive and basic services start on day one.
π Where this applies: Florida and Texas
β How does Select Dental PPO Copay Plan 2 work?
Copay Plan 2 charges $0 for preventive care.
Basic care is $100 per procedure in year one and $50 after. Tier 1 major is $125, then $75. Similarly, tier 2 major is $500, then $350.
π Where this applies: Florida and Texas
β Does Select Dental PPO Copay Plan 2 have a waiting period or annual maximum?
No, Copay Plan 2 has no waiting period on any service and no benefit maximum.
π Where this applies: Florida and Texas
β What is the difference between tier 1 and tier 2 major services on Select Dental PPO copay plans?
Tier 1 includes oral surgery, periodontics, composite fillings and deep sedation.
By contrast, tier 2 includes crowns, root canals, bridges and inlays or onlays.
π Where this applies: Florida and Texas
β Is the Select Dental PPO copay charged per visit or per procedure?
Preventive copays apply per visit, while basic and major copays apply per procedure.
π Where this applies: Florida and Texas
β Are any copays waived on the Select Dental PPO copay plans?
Yes, the copay plans waive copays for deep sedation during basic services.
The plans also waive copays for post and core, core buildup and deep sedation tied to major work.
π Where this applies: Florida and Texas
β What happens if I see an out-of-network dentist on a Select Dental PPO copay plan?
Out of network, the plan pays the maximum allowable amount.
You then pay your copay plus any remaining balance. By contrast, in network the plan pays the negotiated rate. As a result, you pay nothing extra beyond your copay.
π Where this applies: Florida and Texas
β How does Select Dental PPO work in Texas?
Texas is a passive network state for Select Dental PPO.
You still get network discounts. However, there are no cost-sharing differences if you use an out-of-network dentist.
π Where this applies: Texas
β Does Select Dental PPO cover dental implants?
No, Select Dental PPO excludes dental implants and implant removal.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover teeth whitening or cosmetic work?
No, the plan excludes teeth bleaching and treatment mainly for cosmetic purposes.
π Where this applies: Florida and Texas
β Will Select Dental PPO replace a tooth I lost before joining?
Not right away, since the plan excludes replacing a tooth missing before your effective date.
That exclusion lasts until you have 24 months of coverage.
π Where this applies: Florida and Texas
β Will Select Dental PPO replace my dentures?
The plan won't replace dentures less than 10 years old unless you've been insured at least 24 months.
It also excludes lost or stolen dentures, except as listed in the benefits.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover crowns for young kids?
For children under 16, the plan covers only stainless steel or plastic crowns.
At those ages, it excludes inlays, onlays, bridges and other crowns.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover anesthesia?
The plan lists deep sedation or general anesthesia for major services as covered.
However, it excludes services by anesthesiologists or anesthetists, and IV sedation.
π Where this applies: Florida and Texas
β Does Select Dental PPO cover dental care abroad?
Select Dental PPO covers only emergency treatment of dental pain abroad.
Otherwise, it excludes care outside the United States, its possessions or Canada.
π Where this applies: Florida and Texas
β Does Select Dental PPO meet the ACA pediatric dental requirement?
No, Select Dental PPO does not meet the ACA pediatric dental coverage level.
Instead, you can buy ACA-standard pediatric dental through your state's Marketplace or an agent.
π Where this applies: Florida and Texas
β Will Select Dental PPO pay for my child's dental care if my Oscar plan has pediatric dental?
No, Select Dental PPO does not pay for the same treatment.
It excludes treatment covered by a medical plan or an ACA-compliant pediatric dental plan.
π Where this applies: Florida and Texas
β Can I add vision coverage to Select Dental PPO?
Yes, you can add AvΔsis vision coverage to any dental plan.
There are two levels. Also, the AvΔsis network has over 98,000 providers.
π Where this applies: Florida and Texas
β What does Select Dental PPO Level 1 vision cover?
Level 1 has a $15 eye exam copay and a $25 lens copay every 24 months.
Frames or contacts get a $130 maximum every 24 months. Progressives also get up to $55.
π Where this applies: Florida and Texas
β What does Select Dental PPO Level 2 vision cover?
Level 2 has a $10 eye exam copay and a $25 lens copay every 12 months.
Frames or contacts get a $200 maximum every 12 months. Progressives also get up to $135.
π Where this applies: Florida and Texas
β What lens extras come with Select Dental PPO vision?
Both vision levels cover polycarbonate lenses.
Level 2 also covers scratch-resistant coating, UV protection and tints. By contrast, Level 1 offers discounts on those. Anti-reflective and light-to-dark tinting are discounted on both levels.
π Where this applies: Florida and Texas
β Can I use an out-of-network eye doctor with Select Dental PPO vision?
Yes, out-of-network vision benefits are available.
However, you get the best value with in-network AvΔsis providers.
π Where this applies: Florida and Texas
β How do I find a Select Dental PPO vision provider?
Contact the carrier to search the AvΔsis vision provider network.
π Where this applies: Florida and Texas
β What does Select Dental PPO vision not cover?
Exclusions include LASIK and other vision surgery, non-prescription lenses, oversize lenses and vision therapy.
Replacing lost or broken eyewear is also excluded, except at normal intervals.
π Where this applies: Florida and Texas
β How long can I keep Select Dental PPO?
Select Dental PPO coverage is renewable to age 65.
You must follow plan rules. Also, the plan must still be offered in your state.
π Where this applies: Florida and Texas
Accident Fixed-Benefit Plan
This plan pays set cash amounts after a covered accident. As a result, you can cover deductibles and bills.
β What is the Allstate Health Solutions Accident Fixed-Benefit plan?
It pays a set cash benefit for each covered injury or service after an accident.
For example, benefits help with hospital stays, fractures, ambulance rides and rehab.
π Where this applies: Florida and Texas
β Who underwrites the Allstate Health Solutions Accident Fixed-Benefit plan?
Integon Indemnity Corporation underwrites the Florida policy.
Meanwhile, National Health Insurance Company underwrites the Texas policy.
π Where this applies: Florida and Texas
β Do I need a LIFE Association membership for the Accident Fixed-Benefit plan in Florida?
Yes, in Florida this plan is only available through a LIFE Association membership.
Also, membership fees apply.
π Where this applies: Florida
β Do I need a LIFE Association membership for the Accident Fixed-Benefit plan in Texas?
The Texas brochure does not mention a LIFE Association membership.
Still, a licensed agent can confirm enrollment details.
π Where this applies: Texas
β What LIFE Association perks come with Accident Fixed-Benefit in Florida?
The brochure lists 24/7 telemedicine, a personal concierge, lab test discounts and public WiFi protection.
It also lists gym discounts and Lifeline Screening. However, these perks are not insurance and may vary by state.
π Where this applies: Florida
β Do I have to answer health questions for Accident Fixed-Benefit?
No, there is no health questionnaire, so coverage is guaranteed.
π Where this applies: Florida and Texas
β Is there a waiting period on Accident Fixed-Benefit?
No, benefits are available as soon as your policy's effective date.
π Where this applies: Florida and Texas
β Is there a network for Accident Fixed-Benefit?
No, you can see any doctor or go to any hospital.
π Where this applies: Florida and Texas
β Who gets the money from Accident Fixed-Benefit?
Accident Fixed-Benefit pays cash directly to you.
You can use it any way you need, such as catching up after missed work.
π Where this applies: Florida and Texas
β Can Accident Fixed-Benefit help with my health plan or auto deductible?
Yes, the brochure says benefits can help pay things like auto and medical deductibles.
That is because the cash goes to you.
π Where this applies: Florida and Texas
β Is there a limit on how many accidents Accident Fixed-Benefit covers?
No, the brochure says there are no annual or lifetime limits, no matter how many accidents you have.
However, per-accident maximums still apply.
π Where this applies: Florida and Texas
β What is the maximum Accident Fixed-Benefit pays per accident?
Treatment and services benefits pay up to $15,000 per covered accident.
Meanwhile, injury, fracture and ambulance benefits pay up to $10,000 per covered accident.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for a hospital stay?
Hospital room and board pays $750 per day, up to 30 days.
In addition, inpatient hospital services pay $750 per day, up to 15 days.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for an ER visit?
It pays $250 per day per covered accident for an ER visit.
The maximum benefit period is one day.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for doctor visits?
It pays $50 per physician visit, procedure or consultation, up to eight.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit pay for outpatient surgery?
Yes, outpatient surgical expenses pay $250 per visit, up to five visits.
π Where this applies: Florida and Texas
β What other treatment does Accident Fixed-Benefit pay for?
Ancillary hospital charges pay $150 each, up to five.
It also pays $100 for medical equipment or braces and $150 for rehabilitation.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit pay for dental or eyeglasses after an accident?
Yes, it pays $200 for dental and $50 for eyeglasses, contact lenses or hearing aids.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for a broken bone?
The amount depends on the bone, with hip, neck or skull fractures paying $2,500.
A pelvis, thigh, lower leg, upper arm, forearm or vertebra fracture pays $1,500. By contrast, a wrist, hand, foot or collarbone fracture pays $1,000.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for broken ribs?
It pays $500 per broken rib.
A sternum fracture pays $1,500. Also, a cheekbone or coccyx fracture pays $300.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit pay for a broken finger or toe?
No, the fracture schedule excludes fingers, thumbs, toes and ankles.
π Where this applies: Florida and Texas
β How much does Accident Fixed-Benefit pay for a dislocation or concussion?
A dislocated hip, knee, wrist, elbow, ankle, shoulder blade, collarbone or jaw pays $500.
Also, a concussion pays $100.
π Where this applies: Florida and Texas
β How soon after an accident must an injury occur for Accident Fixed-Benefit to pay?
The injury must occur within 30 days of the covered accident.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit pay for an ambulance?
Yes, Accident Fixed-Benefit pays for both ground and air ambulance trips.
Ground ambulance pays $200 per trip, up to two trips. By contrast, air ambulance pays $3,000 per trip, up to one trip.
π Where this applies: Florida and Texas
β What does the Accident Fixed-Benefit AD&D benefit pay in Florida?
Florida AD&D benefits pay a percentage of a $50,000 amount.
Loss of both hands, feet or eyes pays 100%. Meanwhile, one hand, one foot, or speech or hearing in both ears pays 50%. Finally, one eye or ear pays 25%.
π Where this applies: Florida
β Does the Florida Accident Fixed-Benefit plan pay an accidental death benefit?
The Florida brochure's AD&D table does not show a separate accidental death amount.
Instead, the table lists loss of limbs, sight, speech and hearing. So, confirm the details with a licensed agent.
π Where this applies: Florida
β What does the Accident Fixed-Benefit AD&D benefit pay in Texas?
In Texas, accidental death pays $50,000, as does loss of both hands, feet or eyes.
Loss of one hand or foot, or speech or hearing in both ears, pays $25,000. Also, loss of one eye or ear pays $12,500.
π Where this applies: Texas
β Does the Texas Accident Fixed-Benefit plan cover my children?
The Texas brochure shows AD&D benefits for dependent children at 50% of the listed amounts.
That said, a licensed agent can explain other family coverage details.
π Where this applies: Texas
β Does Accident Fixed-Benefit cover illness?
No, Accident Fixed-Benefit excludes illness and disease, with a few exceptions.
Even so, the plan makes exceptions for bacterial infection from an accidental cut or wound, botulism and ptomaine poisoning.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover motorcycle accidents?
No, medical benefits do not cover motorcycle accidents under Accident Fixed-Benefit.
The plan excludes injuries from riding or being struck by a 2- or 3-wheeled motor vehicle. It also excludes injuries from riding or being struck by an off-road vehicle.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover car accidents when I was driving without a license?
No, the plan excludes injuries while operating a motor vehicle without a current, valid license.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover accidents while drunk or high?
No, Accident Fixed-Benefit excludes losses while you are legally intoxicated.
It also excludes losses while under drugs not taken on a physician's advice.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover sports injuries?
Accident Fixed-Benefit excludes some sports injuries.
For medical benefits, the plan excludes intercollegiate, semi-pro and pro sports. In addition, it excludes motor racing, rodeo, hang gliding, parachuting and bungee jumping.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover military service injuries?
No, Accident Fixed-Benefit excludes losses while on active duty in any armed forces.
The plan also excludes Reserve or National Guard training beyond 31 days.
π Where this applies: Florida and Texas
β What medical conditions does Accident Fixed-Benefit exclude?
It excludes hernia, appendicitis, heart conditions, pathological fractures and overuse injuries like tennis elbow.
The plan also excludes pregnancy and mental health care unless a covered injury causes them.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover cosmetic surgery after an accident?
Accident Fixed-Benefit covers cosmetic surgery only when the covered injury makes it necessary.
Otherwise, the plan excludes cosmetic, plastic or restorative surgery.
π Where this applies: Florida and Texas
β Does Accident Fixed-Benefit cover flying?
It covers flying only as a fare-paying passenger on a scheduled commercial airline or military transport.
However, the plan excludes flying as a pilot or crew member.
π Where this applies: Florida and Texas
β How long can I keep Accident Fixed-Benefit?
Accident Fixed-Benefit plans auto-renew each year up to age 70.
To renew, you must follow plan rules. The plan must also still be offered in your state.
π Where this applies: Florida and Texas
β Is Accident Fixed-Benefit major medical coverage?
No, Accident Fixed-Benefit provides limited benefits and is not major medical coverage.
It also does not satisfy minimum essential coverage requirements. Instead, it works alongside an Oscar or other ACA plan.
π Where this applies: Florida and Texas
β How is the Florida Accident Fixed-Benefit plan different from the Texas plan?
The Florida and Texas Accident Fixed-Benefit plans have matching benefit schedules.
However, the Florida plan requires LIFE Association membership, and Integon Indemnity underwrites it. By contrast, National Health underwrites the Texas plan, which lists a $50,000 accidental death benefit.
π Where this applies: Florida and Texas
Hospital Expense Protection Plus
This plan pays cash for covered hospital stays. So see how it helps with your share of a hospital bill.
β What is Allstate Health Solutions Hospital Expense Protection Plus?
Hospital Expense Protection Plus is a fixed-benefit plan that pays set dollar amounts.
It pays for hospital stays, ambulances and some emergency and outpatient services. The plan provides limited benefits. Also, it pays in addition to other medical coverage.
π Where this applies: Florida and Texas
β Who underwrites Hospital Expense Protection Plus?
National Health Insurance Company underwrites Hospital Expense Protection Plus in Florida and Texas.
The plan also uses the Allstate Health Solutions marketing name.
π Where this applies: Florida and Texas
β Is Hospital Expense Protection Plus major medical insurance?
No, the brochure says Hospital Expense Protection Plus provides limited benefits.
It pays fixed cash amounts for specific services. However, any costs above those amounts are your responsibility.
π Where this applies: Florida and Texas
β Do I need a LIFE Association membership for Hospital Expense Protection Plus?
The brochure describes Hospital Expense Protection Plus as a LIFE Association member offering.
LIFE memberships provide access to Allstate Health Solutions plans plus other lifestyle benefits. For membership details and fees, ask a licensed agent.
π Where this applies: Florida and Texas
β What is the LIFE Association?
The LIFE Association, Inc. is a not-for-profit, members-only association.
Members get access to Allstate Health Solutions plans. They also get lifestyle benefits like travel savings, ID protection and wellness discounts.
π Where this applies: Florida and Texas
β What extras come with the LIFE Association membership on Hospital Expense Protection Plus?
The brochure lists travel savings, identity theft help and fitness facility discounts.
Identity theft help covers monitoring and recovery. Fitness discounts apply at over 9,000 fitness facilities. However, these lifestyle benefits and discounts are not insurance and may vary by state.
π Where this applies: Florida and Texas
β Does my agent get paid from the LIFE Association membership fee?
Your agent may receive compensation connected with LIFE Association membership fees.
In fact, the brochure discloses that your agent and Allstate Health Solutions may both receive this compensation.
π Where this applies: Florida and Texas
β What plan options does Hospital Expense Protection Plus have?
Hospital Expense Protection Plus offers six plans in two groups.
Base plans A, B and C focus on hospital stays. By contrast, Max plans D, E and F add office visits, lab work and, on some plans, urgent care.
π Where this applies: Florida and Texas
β What is the difference between the Base and Max plans in Hospital Expense Protection Plus?
The Base plans help offset hospital stay costs, while Max plans pay for more services.
Base plans are A, B and C. Max plans D, E and F also pay for office visits, radiology and lab tests. In addition, Plans D and E add urgent care, and Plan F adds ICU and ER benefits.
π Where this applies: Florida and Texas
β How much does Hospital Expense Protection Plus pay for a hospital admission?
Hospital Expense Protection Plus pays a set admission amount once per year, based on your plan.
Plan A pays $1,500, Plan B $3,000 and Plan C $5,000. Meanwhile, Plan D pays $500, Plan E $1,500 and Plan F $3,000.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus pay a daily hospital benefit?
Yes, every plan pays $150 per day for hospital confinement due to sickness or injury.
Plans A, B, D, E and F pay up to 31 days. However, Plan C pays up to 10 days.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover ICU stays?
Only Plan F covers ICU stays, paying $1,000 per day for 1 day of ICU care.
The benefit applies to either sickness or injury. However, Plans A through E do not include an ICU benefit.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus pay for doctor office visits?
Only the Max plans, D, E and F, pay for doctor office visits.
They pay $75 per office visit, up to 2 visits per year. However, Base plans A, B and C do not cover office visits.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover urgent care?
Plans D and E pay $75 per urgent care visit, up to 2 visits per year.
However, Plans A, B, C and F do not include an urgent care benefit.
π Where this applies: Florida and Texas
β What does Hospital Expense Protection Plus pay if I am put in observation instead of admitted?
Every plan pays an observation unit benefit once per year.
Plan A pays $750, Plan B $1,500 and Plan C $2,500. Meanwhile, Plan D pays $250, Plan E $750 and Plan F $1,500.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover ambulance rides?
Yes, every Hospital Expense Protection Plus plan pays for ground and air ambulance rides.
Ground ambulance pays $250 per trip, and air ambulance pays $25,000 per trip. However, each benefit covers only 1 trip per year.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus pay for emergency room visits?
Only Plan F pays for emergency room visits, at $250 per visit.
It covers up to 4 ER visits per year. However, Plans A through E do not include an emergency room benefit.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover lab work and X-rays?
Plans D, E and F pay $50 per radiology test and $50 per lab test.
Each benefit covers up to 2 tests per year. However, Base plans A, B and C do not include these benefits.
π Where this applies: Florida and Texas
β Is there a waiting period on Hospital Expense Protection Plus?
No, Hospital Expense Protection Plus has no waiting periods, so benefits start on day one.
However, the pre-existing condition exclusion still applies for the first 12 months.
π Where this applies: Florida and Texas
β Do I have to use a network with Hospital Expense Protection Plus?
No, Hospital Expense Protection Plus has no network restrictions.
As a result, you can choose your hospital or provider.
π Where this applies: Florida and Texas
β Will Hospital Expense Protection Plus pay if I also have an Oscar plan?
Yes, Hospital Expense Protection Plus pays benefits in addition to any other medical coverage.
In fact, the plan pays the fixed amounts on top of what your ACA plan covers.
π Where this applies: Florida and Texas
β What happens if my hospital bill is more than Hospital Expense Protection Plus pays?
You are responsible for any costs above the benefit amount.
That's because the plan pays only the fixed dollar amount listed for each covered service.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover pre-existing conditions?
Not right away, because the plan has a 12-month pre-existing condition exclusion.
It excludes claims tied to a pre-existing condition for the first 12 months after your effective date. Also, the look-back is the 1 year before coverage starts.
π Where this applies: Florida and Texas
β What counts as a pre-existing condition on Hospital Expense Protection Plus?
A pre-existing condition looks back at the year before your effective date.
It includes a condition you got advice, care, tests or prescriptions for in that year. Also, it includes a condition with symptoms in that year that should have led to care.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover pregnancy or childbirth?
No, Hospital Expense Protection Plus excludes pregnancy and childbirth, except complications of pregnancy.
Also, a pregnancy that exists the day before your effective date counts as a pre-existing condition.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover mental health or substance abuse?
No, Hospital Expense Protection Plus lists mental illness and substance abuse as exclusions.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover prescriptions?
No, Hospital Expense Protection Plus excludes outpatient prescription drugs.
It also excludes herbal products, vitamins, supplements and similar items.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover dental, vision or hearing care?
No, Hospital Expense Protection Plus excludes dental treatment, routine eye exams and routine hearing exams.
It also excludes glasses, contacts, cochlear implants and hearing devices.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover preventive care?
No, the plan excludes preventive services unless the benefits section lists them.
Instead, your Oscar or other ACA plan covers preventive care.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover weight-loss surgery?
No, the plan excludes gastric bypass and other surgery for weight control or obesity.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover transplants or kidney dialysis?
No, the plan excludes transplants, organ donation and end stage renal disease.
π Where this applies: Florida and Texas
β Are injuries from risky sports covered by Hospital Expense Protection Plus?
No, Hospital Expense Protection Plus excludes injuries from hazardous activities.
Examples include skydiving, bungee jumping, rodeo, motor racing and rock climbing. The plan also excludes intercollegiate and paid contact sports.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover injuries while drunk or high?
No, the plan excludes injuries while legally intoxicated or under the influence of illegal or non-prescribed drugs.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover care outside the U.S.?
Only in Canada, since the plan excludes care outside the United States, its possessions or Canada.
π Where this applies: Florida and Texas
β What other conditions does Hospital Expense Protection Plus exclude?
Hospital Expense Protection Plus excludes several other conditions and treatments.
Examples include allergy shots and testing (except emergency allergic reactions), chronic pain disorders and foot conditions like bunions. The plan also excludes cosmetic surgery, sleep disorders and varicose vein treatment.
π Where this applies: Florida and Texas
β Does Hospital Expense Protection Plus cover experimental treatment or clinical trials?
No, the plan excludes experimental or investigational services and care received during a clinical trial.
π Where this applies: Florida and Texas
β How long can I keep Hospital Expense Protection Plus?
You can keep it until age 65, since it is guaranteed renewable.
However, the certificate states some reasons coverage can end earlier. Also, the plan renews automatically.
π Where this applies: Florida and Texas
β Is Hospital Expense Protection Plus different in Florida and Texas?
The Hospital Expense Protection Plus brochure is the same for Florida and Texas.
In addition, National Health Insurance Company underwrites it in both states.
π Where this applies: Florida and Texas
Plan Enhancer
Plan Enhancer adds cash benefits on top of a health plan. In addition, these answers explain how claims work.
β What is Allstate Health Solutions Plan Enhancer?
Plan Enhancer is a build-your-own supplemental plan.
It starts with Accident Medical Expense coverage. Then you can add a Cancer and Heart/Stroke rider and a Sickness Hospitalization rider where available.
π Where this applies: Florida and Texas
β Who underwrites Plan Enhancer?
National Health Insurance Company underwrites Plan Enhancer in Texas.
Meanwhile, Integon Indemnity Corporation underwrites it in Florida.
π Where this applies: Florida and Texas
β Do I have to answer health questions for Plan Enhancer?
No, Plan Enhancer is guaranteed issue, so there is no health questionnaire.
In fact, the base plan and both riders have guaranteed acceptance.
π Where this applies: Florida and Texas
β What benefit levels does Plan Enhancer offer?
Plan Enhancer benefit levels range from $2,500 to $35,000.
However, some plan combinations are not available at every level. So check availability with your agent.
π Where this applies: Florida and Texas
β Can I buy the Plan Enhancer riders by themselves?
No, the Cancer and Heart/Stroke and Sickness Hospitalization riders cannot be bought on their own.
However, you can buy Accident Medical Expense by itself.
π Where this applies: Florida and Texas
β What does Plan Enhancer Accident Medical Expense cover?
It pays covered accident-related medical expenses up to your chosen benefit amount, with no deductible.
The plan also includes ground ambulance, medical equipment and accidental death and dismemberment benefits.
π Where this applies: Florida and Texas
β How much does Plan Enhancer pay for an ambulance or medical equipment after an accident?
Accident Medical Expense includes a $900 ground ambulance benefit and a $200 durable medical equipment benefit.
However, availability and benefits vary by state.
π Where this applies: Florida and Texas
β Is there a deductible or waiting period on Plan Enhancer Accident Medical Expense?
No, Plan Enhancer Accident Medical Expense has no deductible and no waiting period.
It also has no network restrictions.
π Where this applies: Florida and Texas
β Who can buy Plan Enhancer Accident Medical Expense?
Applicants must be 74 or younger to buy Accident Medical Expense.
Plus, the carrier guarantees acceptance.
π Where this applies: Florida and Texas
β Can you give an example of how Plan Enhancer Accident Medical Expense works?
In the brochure example, a broken hand costs $4,500 and the primary plan has a $3,000 deductible.
A $5,000 Accident Medical Expense plan pays $4,500. As a result, you have $1,500 left after the deductible for other costs.
π Where this applies: Florida and Texas
β Does Plan Enhancer Accident Medical Expense cover illness?
No, it does not pay for sickness unless the sickness directly results from a covered accidental injury.
π Where this applies: Florida and Texas
β What does the Plan Enhancer Cancer and Heart/Stroke rider pay?
It pays lump-sum cash for a covered first-ever cancer diagnosis and a covered heart attack or stroke.
The percentage paid varies by condition. However, the rider does not cover NSTEMI heart attacks.
π Where this applies: Florida and Texas
β What is the waiting period on the Plan Enhancer Cancer and Heart/Stroke rider?
There is a 90-day waiting period for cancer and a 30-day waiting period for heart/stroke.
A pre-existing condition limitation also applies.
π Where this applies: Florida and Texas
β Who is eligible for the Plan Enhancer Cancer and Heart/Stroke rider?
The primary policyholder must be 18 to 64.
You can also cover dependents from birth to age 25. Plus, there are no health questions.
π Where this applies: Florida and Texas
β Can you give an example of the Plan Enhancer Cancer and Heart/Stroke rider?
In the brochure, cancer treatment costs $14,019 and the primary plan pays $9,019.
A $5,000 rider covers the rest, so you pay $0 out of pocket.
π Where this applies: Florida and Texas
β How do pre-existing conditions work on the Plan Enhancer Cancer and Heart/Stroke rider?
Pre-existing conditions have a look-back of 24 months before your effective date.
The rider does not pay for a related diagnosis in its first 12 months. In addition, it never pays for diseases diagnosed before coverage started.
π Where this applies: Florida and Texas
β What does the Plan Enhancer Sickness Hospitalization rider pay?
It pays a lump sum on the first covered day of a hospital admission for sickness.
There is no deductible. However, the stay must last more than 24 hours.
π Where this applies: Florida and Texas
β How often can the Plan Enhancer Sickness Hospitalization rider pay?
It pays one benefit per year per person, and two benefits per year per family.
π Where this applies: Florida and Texas
β Is there a waiting period on the Plan Enhancer Sickness Hospitalization rider?
Yes, the Sickness Hospitalization rider has a 30-day waiting period.
Also, it does not cover pre-existing conditions until you have been insured under the rider for 12 months.
π Where this applies: Florida and Texas
β Can you give an example of the Plan Enhancer Sickness Hospitalization rider?
In the brochure, a pneumonia stay costs $9,300 and the primary plan pays $4,300.
A $5,000 rider covers the rest, so you pay $0 out of pocket.
π Where this applies: Florida and Texas
β Who is eligible for the Plan Enhancer Sickness Hospitalization rider?
The primary policyholder must be 18 to 64.
You can also cover dependents from birth to age 25. Plus, the carrier guarantees acceptance.
π Where this applies: Florida and Texas
β Does the Plan Enhancer Sickness Hospitalization rider cover having a baby?
No, the rider excludes maternity, pregnancy (including complications), infertility and routine newborn care.
Also, a pregnancy that exists before your effective date counts as a pre-existing condition.
π Where this applies: Florida and Texas
β What hospital stays does the Plan Enhancer Sickness Hospitalization rider exclude?
Exclusions include behavioral health or substance abuse stays, ER-only visits, rehab or custodial stays and weight-loss treatment.
This rider also excludes stays caused by an accident.
π Where this applies: Florida and Texas
β Does Plan Enhancer pay if I have an Oscar or other ACA plan?
Yes, Plan Enhancer pays cash benefits regardless of other medical coverage.
For example, the brochure shows it covering costs left after a primary plan pays.
π Where this applies: Florida and Texas
β Does Plan Enhancer Accident Medical Expense cover prescriptions?
No, it excludes all prescription and over-the-counter products, drugs and medicines.
π Where this applies: Florida and Texas
β What injuries does Plan Enhancer Accident Medical Expense not cover?
Exclusions include tendonitis, bursitis, carpal tunnel and other overuse injuries.
The plan also excludes hernia and heat exhaustion.
π Where this applies: Florida and Texas
β Does Plan Enhancer cover accidents from risky sports or jobs?
No, it excludes hazardous activities like skydiving, racing, climbing, extreme sports and intercollegiate sports.
It also excludes paid activities like taxi or delivery driving and pro sports.
π Where this applies: Florida and Texas
β Does Plan Enhancer cover accidents while drinking or using drugs?
No, it excludes accidents tied to voluntary alcohol or controlled substance use.
However, the exclusion does not apply to drugs taken as your doctor advised.
π Where this applies: Florida and Texas
β Does Plan Enhancer Accident Medical Expense cover alternative treatments?
No, it excludes massage therapy, acupuncture, biofeedback, aromatherapy and similar holistic therapies.
π Where this applies: Florida and Texas
β Does Plan Enhancer cover care outside the U.S.?
Plan Enhancer covers care outside the U.S. only in Canada.
Otherwise, it excludes treatment outside the United States, its possessions or Canada.
π Where this applies: Florida and Texas
β How long can I keep Plan Enhancer?
Accident Medical Expense is renewable to age 75.
By contrast, the Cancer and Heart/Stroke and Sickness Hospitalization riders are renewable to age 65.
π Where this applies: Florida and Texas
β Is Plan Enhancer a Medicare supplement?
No, the brochure states Plan Enhancer is not a Medicare supplement insurance plan.
π Where this applies: Florida and Texas
Cancer, Heart Attack and Stroke Plans
These plans pay cash after a covered diagnosis. For that reason, they can help with costs health insurance leaves behind.
β What is the Allstate Health Solutions Cancer plan?
It pays a lump-sum cash benefit after a first-time cancer diagnosis.
You can use the money for anything, from medical bills to rent or groceries. However, the plan provides limited benefits.
π Where this applies: Florida and Texas
β Who underwrites the Allstate Health Solutions Cancer plan?
National Health Insurance Company underwrites the Cancer plan in Texas.
By contrast, Integon Indemnity Corporation underwrites it in Florida.
π Where this applies: Florida and Texas
β How much does the Allstate Health Solutions Cancer plan pay?
A first-ever cancer diagnosis pays 100% of the benefit level you choose.
You can choose $5,000, $10,000, $15,000, $25,000, $30,000, $50,000 or $75,000.
π Where this applies: Florida and Texas
β How does the Allstate Health Solutions Cancer plan pay out?
It pays a lump sum directly to you after a covered first-time diagnosis.
Also, the payment does not depend on your actual bills.
π Where this applies: Florida and Texas
β Can you give an example of how the Allstate Health Solutions Cancer plan works?
In the brochure example, a person with a $50,000 level gets a colon cancer diagnosis.
Medical bills total $14,019. As a result, the person keeps the remaining $35,981 for any need, like a mortgage.
π Where this applies: Florida and Texas
β What counts as cancer under the Allstate Health Solutions Cancer plan?
It is a malignant tumor or blood cancer that needs specific treatment.
The treatment must be radiation, chemo, immunotherapy or full removal of an internal organ. Also, metastatic cancer with no recommended therapy counts.
π Where this applies: Florida and Texas
β Does the Allstate Health Solutions Cancer plan cover skin cancer?
The Cancer plan does not cover noninvasive skin cancers.
That means the cancer definition excludes basal cell carcinoma, squamous cell carcinoma and melanoma in situ.
π Where this applies: Florida and Texas
β What other conditions are not covered as cancer by the Allstate Health Solutions Cancer plan?
The plan does not cover cervical carcinoma in situ or premalignant conditions.
Premalignant conditions include myelodysplastic disorders, leukoplakia and hyperplasia. Also, the plan excludes an incidental finding after surgery unless further chemo, radiation or immunotherapy is recommended.
π Where this applies: Florida and Texas
β Does the Allstate Health Solutions Cancer plan pay for a second cancer?
The plan pays for a first-time cancer diagnosis.
However, it excludes any disease diagnosed before your effective date.
π Where this applies: Florida and Texas
β Is there a waiting period on the Allstate Health Solutions Cancer plan?
Yes, in most states the Cancer plan has a 90-day waiting period.
However, waiting periods vary by state. Where no waiting period applies, the plan reduces benefit payments for a limited time.
π Where this applies: Florida and Texas
β What is the Allstate Health Solutions Cancer plan waiting period in Texas?
In Texas, a 90-day waiting period applies to Cancer plan benefits.
π Where this applies: Texas
β What is the Allstate Health Solutions Cancer plan waiting period in Florida?
The brochure does not state the Florida waiting period for the Cancer plan.
It says most states use 90 days, and waiting periods vary by state. So ask a licensed agent to confirm the Florida terms.
π Where this applies: Florida
β What happens if I am diagnosed with cancer during the waiting period?
The plan pays no benefit for a cancer diagnosed during the waiting period.
Instead, coverage for that person ends, and the plan refunds the premium paid for that person.
π Where this applies: Florida and Texas
β Can I get the Allstate Health Solutions Cancer plan if I have had cancer before?
Yes, you can, but some limits apply to past diagnoses.
However, the plan will not pay for any disease diagnosed at any time before your effective date.
π Where this applies: Florida and Texas
β How does the pre-existing condition rule work on the Allstate Health Solutions Cancer plan?
The Cancer plan looks back at the 24 months before your effective date.
Also, the plan won't pay a cancer tied to a pre-existing condition and diagnosed in the first 12 months.
π Where this applies: Florida and Texas
β Can I cover my family on the Allstate Health Solutions Cancer plan?
Yes, the Cancer plan offers both individual and family plans.
The plan pays benefits per covered person. Also, you pay one rate for any number of children.
π Where this applies: Florida and Texas
β Can I see any doctor with the Allstate Health Solutions Cancer plan?
Yes, the Cancer plan has no network restrictions, so you can see any doctor or hospital.
π Where this applies: Florida and Texas
β Does the Allstate Health Solutions Cancer plan pay if I already have an Oscar plan?
Yes, the Cancer plan pays benefits regardless of other coverage you have.
For example, the cash can help with your ACA plan's deductible or everyday bills.
π Where this applies: Florida and Texas
β What does the Allstate Health Solutions Cancer plan exclude?
The plan excludes conditions that do not meet its cancer definition.
It also excludes suicide or attempted suicide and self-inflicted sickness or injury. In addition, the plan does not pay amounts above the maximum benefit.
π Where this applies: Florida and Texas
β Is the Allstate Health Solutions Cancer plan major medical coverage?
No, the Cancer plan provides extra benefits for a first-time cancer diagnosis.
However, it is not comprehensive coverage and is not minimum essential coverage.
π Where this applies: Florida and Texas
β How long can I keep the Allstate Health Solutions Cancer plan?
The Cancer plan is renewable to age 75 or 85, depending on the state.
However, you must follow plan rules, and the plan must still be available where you live.
π Where this applies: Florida and Texas
β What is the Allstate Health Solutions Cancer and Heart/Stroke plan?
It pays lump-sum cash after a covered cancer diagnosis, heart attack or stroke.
Bypass surgery and angioplasty also pay partial benefits. However, the plan provides limited benefits.
π Where this applies: Florida and Texas
β Who underwrites the Allstate Health Solutions Cancer and Heart/Stroke plan?
National Health Insurance Company underwrites the Cancer and Heart/Stroke plan in Texas.
Meanwhile, Integon Indemnity Corporation underwrites it in Florida.
π Where this applies: Florida and Texas
β What benefit amounts does the Cancer and Heart/Stroke plan offer?
The Cancer and Heart/Stroke plan offers four benefit levels.
Both the $25,000 and $30,000 levels are guaranteed issue. By contrast, the $50,000 and $75,000 levels are standard issue.
π Where this applies: Florida and Texas
β Do I have to answer health questions for the Cancer and Heart/Stroke plan?
The brochure calls the $25,000 and $30,000 levels guaranteed issue.
However, the $50,000 and $75,000 levels are standard issue. So ask a licensed agent what the higher levels require.
π Where this applies: Florida and Texas
β How much does the Cancer and Heart/Stroke plan pay for each condition?
A first-ever cancer, heart attack or stroke pays 100% of your benefit.
By contrast, coronary bypass pays 25%, and coronary angioplasty pays 10%.
π Where this applies: Florida and Texas
β Can the Cancer and Heart/Stroke plan pay more than once?
Yes, the plan can pay more than once after partial payouts.
After a partial payout, the plan keeps paying for other covered conditions. Finally, it stops once it pays 100% of your benefit.
π Where this applies: Florida and Texas
β Can you give an example of how the Cancer and Heart/Stroke plan works?
In the brochure example, someone with a $50,000 level gets colon cancer.
The bills total $14,019, and the plan pays $50,000. As a result, the person has $35,981 left for anything, like a car payment.
π Where this applies: Florida and Texas
β What counts as a heart attack under the Cancer and Heart/Stroke plan?
It must be a myocardial infarction diagnosed with heart biomarker tests and new EKG changes.
However, the plan does not cover cardiac arrest not caused by a heart attack.
π Where this applies: Florida and Texas
β Does the Cancer and Heart/Stroke plan cover an NSTEMI heart attack?
No, the plan does not cover non-ST elevation myocardial infarctions (NSTEMI).
π Where this applies: Florida and Texas
β What heart conditions does the Cancer and Heart/Stroke plan cover?
It covers coronary artery disease or cardiac arrhythmia that results in a heart attack or bypass.
The plan also covers coronary artery disease resulting in angioplasty.
π Where this applies: Florida and Texas
β Does the Cancer and Heart/Stroke plan cover a mini-stroke (TIA)?
No, the plan does not count a transient ischemic attack (TIA) as a stroke.
Transient global amnesia does not count either. Instead, a covered stroke needs imaging showing new brain tissue damage.
π Where this applies: Florida and Texas
β What else does not count as a stroke on the Cancer and Heart/Stroke plan?
The plan excludes brain injury from external trauma.
It also excludes brain damage from infection, vasculitis, encephalopathy or inflammatory disease. In addition, the plan excludes vestibular ischemic disorders.
π Where this applies: Florida and Texas
β What counts as cancer under the Cancer and Heart/Stroke plan?
Covered cancer is a malignant tumor or blood cancer needing radiation, chemo, immunotherapy or organ removal.
However, the plan does not cover noninvasive skin cancers, melanoma in situ or cervical carcinoma in situ.
π Where this applies: Florida and Texas
β Is there a waiting period on the Cancer and Heart/Stroke plan?
Yes, in most states it is 90 days for cancer and 30 days for heart/stroke.
However, waiting periods vary by state. Where none applies, the plan reduces benefits for a limited time.
π Where this applies: Florida and Texas
β What are the Cancer and Heart/Stroke waiting periods in Texas?
In Texas, cancer benefits have a 90-day waiting period.
Also, heart/stroke benefits have a 30-day waiting period.
π Where this applies: Texas
β What are the Cancer and Heart/Stroke waiting periods in Florida?
The brochure does not list Florida's waiting periods separately.
It says most states use 90 days for cancer and 30 for heart/stroke. So confirm the Florida terms with a licensed agent.
π Where this applies: Florida
β What happens if I have a heart attack during the Cancer and Heart/Stroke waiting period?
The plan pays no benefit for a disease first diagnosed in the waiting period.
Instead, coverage for that person ends, and the plan refunds their premium.
π Where this applies: Florida and Texas
β Does the Cancer and Heart/Stroke plan cover pre-existing conditions?
Not at first, because the plan has a 24-month look-back before your effective date.
The plan does not pay a related diagnosis in the first 12 months. Also, it never pays for anything diagnosed before coverage.
π Where this applies: Florida and Texas
β Can I cover my kids on the Cancer and Heart/Stroke plan?
Yes, the Cancer and Heart/Stroke plan offers individual and family plans.
The plan pays benefits per covered person. Also, one rate covers any number of children.
π Where this applies: Florida and Texas
β Does the Cancer and Heart/Stroke plan have a network?
No, you can see any doctor or go to any hospital.
π Where this applies: Florida and Texas
β Does the Cancer and Heart/Stroke plan work with my Oscar plan?
Yes, the plan pays in addition to any other coverage you have.
However, it is not major medical and is not minimum essential coverage.
π Where this applies: Florida and Texas
β How long can I keep the Cancer and Heart/Stroke plan?
The Cancer and Heart/Stroke plan is renewable to age 75.
However, you must follow plan rules, and the plan must still be available in your state.
π Where this applies: Florida and Texas
β What is the difference between the Allstate Health Solutions Cancer plan and the Cancer and Heart/Stroke plan?
The Cancer plan pays only for a first-time cancer, with levels from $5,000 to $75,000.
By contrast, Cancer and Heart/Stroke also pays for heart attack, stroke, bypass and angioplasty. Its levels range from $25,000 to $75,000.
π Where this applies: Florida and Texas
Term Life and Term Life Critical Illness
Term life protects your family for a set number of years. Also, one version adds a critical illness benefit.
β What is Allstate Health Solutions Term Life insurance?
It is term life coverage that pays a cash benefit to your beneficiary if you die.
Your beneficiary can use the money any way they need. For example, it can go toward a mortgage or college tuition.
π Where this applies: Florida and Texas
β Who underwrites Allstate Health Solutions Term Life?
Allstate Health Solutions is the marketing name for three underwriters.
They are National Health Insurance Company, Integon National Insurance Company and Integon Indemnity Corporation. However, the brochure does not say which one issues each state's policy.
π Where this applies: Florida and Texas
β How much coverage can I get with Allstate Health Solutions Term Life?
You can choose $20,000, $25,000, $30,000, $50,000, $75,000, $100,000, $125,000 or $150,000 in coverage.
π Where this applies: Florida and Texas
β Who can buy Allstate Health Solutions Term Life?
Allstate Health Solutions issues Term Life policies for ages 18 to 64.
π Where this applies: Florida and Texas
β Do I need a medical exam for Allstate Health Solutions Term Life?
No, Allstate Health Solutions Term Life does not require a medical exam.
Instead, you complete a health history questionnaire. The product is still medically underwritten.
π Where this applies: Florida and Texas
β How long is the term on Allstate Health Solutions Term Life?
The policy has a 10-year term with a five-year rate guarantee.
π Where this applies: Florida and Texas
β Does Allstate Health Solutions Term Life renew?
Yes, Allstate Health Solutions Term Life auto-renews through age 85.
Coverage lasts until the earlier of death or the first renewal after your 85th birthday.
π Where this applies: Florida and Texas
β Can rates change on Allstate Health Solutions Term Life?
Rates are guaranteed for the first five years of the policy.
After that, Allstate Health Solutions can change premium rates with appropriate notice.
π Where this applies: Florida and Texas
β Can I cover my spouse or kids on Allstate Health Solutions Term Life?
You can cover yourself and your spouse only.
However, there is no dependent coverage and no child-only policy.
π Where this applies: Florida and Texas
β Does Allstate Health Solutions Term Life pay for suicide?
Not for suicide in the first two years after the effective date or reinstatement.
Instead, the policy limits benefits to the premium paid.
π Where this applies: Florida and Texas
β Does Allstate Health Solutions Term Life cover death in a private plane?
Only partly, since death from other air travel is limited to the premium paid.
However, the limit does not apply to a paying passenger on a scheduled airline.
π Where this applies: Florida and Texas
β Does Allstate Health Solutions Term Life cover death from war?
Certain war-related deaths are excluded, and benefits are then limited to premiums paid.
This mainly applies outside the home area or in civilian units serving with the U.S. military.
π Where this applies: Florida and Texas
β How do I get more information on an Allstate Health Solutions Term Life policy?
Contact the carrier for more details on an Allstate Health Solutions Term Life policy.
Your Outline of Coverage and policy also have the full details.
π Where this applies: Florida and Texas
β What is Allstate Health Solutions Term Life Critical Illness?
It combines term life with a critical illness benefit.
The policy pays your family if you die. It also pays you if you are diagnosed with a covered condition.
π Where this applies: Texas
β Where is Allstate Health Solutions Term Life Critical Illness sold?
The brochure is marked for use in Texas only.
Ask a licensed agent about availability in other states.
π Where this applies: Texas
β Who underwrites Allstate Health Solutions Term Life Critical Illness?
National Health Insurance Company underwrites the policy in Texas.
π Where this applies: Texas
β Who can buy Term Life Critical Illness?
Plans are issued for ages 18 to 60, for you and/or a spouse.
π Where this applies: Texas
β What benefit amounts does Term Life Critical Illness offer?
Term life benefits are $25,000, $30,000, $50,000, $75,000, $100,000, $125,000 or $150,000.
The critical illness benefit equals the term life benefit and is payable to age 85.
π Where this applies: Texas
β Which illnesses pay the full Term Life Critical Illness benefit?
Full benefits apply to invasive cancer, heart attack, stroke, kidney failure, coma, blindness, deafness and major organ transplant.
Paralysis, loss of limb and major burns also pay in full.
π Where this applies: Texas
β Which conditions pay a partial Term Life Critical Illness benefit?
It pays 25% for coronary artery bypass graft, noninvasive cancer, advanced Alzheimer's disease and heart valve surgery.
π Where this applies: Texas
β Can Term Life Critical Illness pay more than once?
Yes, Term Life Critical Illness can pay more than once.
For example, after a 25% partial payment, 75% of the critical illness benefit remains. As a result, multiple payouts are possible.
π Where this applies: Texas
β What happens to my life insurance if Term Life Critical Illness pays a claim?
Your total benefits are reduced by the amount paid.
In addition, your monthly premium goes down while the policy stays active.
π Where this applies: Texas
β How long does Term Life Critical Illness keep paying?
The policy pays benefits until the term ends or the benefits are fully paid.
π Where this applies: Texas
β Does Term Life Critical Illness have deductibles or copays?
No, there are no deductibles, coinsurance, copays or preauthorization.
Also, you can visit any doctor or hospital.
π Where this applies: Texas
β Is there a waiting period on Term Life Critical Illness?
Yes, cancer has a 90-day waiting period.
Other covered critical illnesses have a 30-day waiting period. However, waiting periods may vary by state.
π Where this applies: Texas
β What happens if I am diagnosed during the Term Life Critical Illness waiting period?
No critical illness benefit is paid if you are diagnosed during the waiting period.
Instead, the critical illness rider ends. Then the premium paid for that rider is refunded.
π Where this applies: Texas
β Does Term Life Critical Illness cover an NSTEMI heart attack?
No, Term Life Critical Illness does not cover non-ST elevation myocardial infarctions (NSTEMI).
π Where this applies: Texas
β Does Term Life Critical Illness cover pre-existing conditions?
Pre-existing conditions are not covered for the first 12 months of continuous coverage.
The look-back is the 12 months before your effective date. After that, conditions specifically excluded stay excluded.
π Where this applies: Texas
β Will Term Life Critical Illness pay for an illness I already had?
No, the policy does not cover a critical condition diagnosed before your effective date.
It also excludes a qualifying procedure done before your effective date.
π Where this applies: Texas
β What is a Special Exception Rider on Term Life Critical Illness?
It is a rider that excludes a specific condition, treatment, body part or system.
As a result, the policy does not cover anything that rider excludes.
π Where this applies: Texas
β What does Term Life Critical Illness exclude?
Exclusions include mental illness, substance abuse and injuries while driving over the legal alcohol limit.
The policy also excludes felonies, illegal acts, self-inflicted harm and hazardous activities like skydiving.
π Where this applies: Texas
β Does Term Life Critical Illness cover procedures done outside the U.S.?
No, it excludes procedures performed outside the United States or its territories.
π Where this applies: Texas
β What happens if I do not send records for a Term Life Critical Illness claim?
The claim can be denied if requested records or information are not given within 30 days.
However, it can be reopened once the information arrives, but not after 365 days.
π Where this applies: Texas
β What life insurance exclusions apply to Term Life Critical Illness?
Suicide in the first two years limits the benefit to premiums paid.
Certain war-related deaths also limit the benefit to premiums paid. Similarly, non-scheduled air travel deaths are limited to premiums paid.
π Where this applies: Texas
β How long can I keep Term Life Critical Illness?
Term life coverage is renewable to the earlier of death or the first renewal after your 85th birthday.
Also, rates are guaranteed for the first five years.
π Where this applies: Texas
β Does Term Life Critical Illness replace my Oscar health plan?
No, it provides extra benefits for a critical illness or death.
It is not major medical. Also, it does not meet minimum essential coverage rules.
π Where this applies: Texas
π More Supplemental Coverage Guides
These answers cover each Allstate Health Solutions plan. When you want more depth, these guides from our licensed agents explain how supplemental coverage works. Then, if a question comes up, call 888-730-6001 anytime.
π Supplemental Coverage Guides
𧩠More Supplemental FAQ Libraries
π Questions About Allstate Health Solutions Plans?
These answers cover the most common questions, but every family is different. Therefore, our licensed agents compare Allstate Health Solutions and other supplemental plans for free.
Best of all, our help costs you nothing. Request a free quote online, or call 888-730-6001 to speak with an agent today. You can also reach us through our contact page.
- π 888-730-6001
- βοΈ memberservices@vivna.net
- π Deerfield Beach, Florida
Official resources: the Allstate Health Solutions website, HealthCare.gov, and the National Association of Insurance Commissioners.
Vivna Insurance is an independent, licensed agency offering Allstate Health Solutions products. We are not Allstate Health Solutions or its affiliates. Supplemental plans pay benefits on top of health insurance and do not replace it. Plans and availability vary by state.