Quantum PPO and SureCare Short-Term FAQs: Two Plans Compared Side by Side
These answers cover Quantum PPO and SureCare, two short-term plans we often compare. Companion Life insures Quantum PPO, while Pan-American Life insures SureCare. Because rules change by state, every answer shows where it applies. Call 888-730-6001 anytime for free help.
Vivna Insurance is an independent, licensed agency offering Companion Life and Pan-American Life products. We are not either insurer or their affiliates. Short-term plans are not ACA coverage and may not cover pre-existing conditions. Plans and availability vary by state.
Quantum PPO Basics, Costs and Eligibility
Start here to learn how Quantum PPO works, who can buy it and what it costs. Then see what it covers.
β What is the Companion Life Quantum PPO short-term plan?
Quantum PPO is short-term medical insurance underwritten by Companion Life Insurance Company.
It gives temporary coverage for everyday care and also helps limit financial risk. Plus, members get access to the Cigna Healthcare PPO network.
π Where this applies: Every state where Quantum PPO is sold
β Who is the insurance company behind the Quantum PPO short-term plan?
Companion Life Insurance Company, based in Columbia, South Carolina, underwrites Quantum PPO.
In fact, Companion Life has specialized in insurance benefits for more than 40 years.
π Where this applies: Every state where Quantum PPO is sold
β Is the Quantum PPO short-term plan a Cigna insurance plan?
No, Quantum PPO is not a Cigna plan; Companion Life underwrites the insurance.
Instead, the plan gives you access to the Cigna Healthcare PPO network for lower in-network costs.
π Where this applies: Every state where Quantum PPO is sold
β Is a Companion Life Quantum PPO plan the same as an ACA or Obamacare plan?
No, Quantum PPO is short-term, limited-duration insurance, not comprehensive coverage.
Because of that, it does not have to meet most ACA requirements. It also does not count as minimum essential coverage.
π Where this applies: Every state where Quantum PPO is sold
β What plan options does Companion Life Quantum PPO offer?
Quantum PPO comes in two designs: Quantum PPO High Deductible (HD) and Quantum PPO Copay.
Both use the Cigna Healthcare PPO network. They also pay reduced benefits out of network.
π Where this applies: Every state where Quantum PPO is sold
β Does a Quantum PPO plan have lifetime or annual limits?
Yes, every Quantum PPO option has a total coverage maximum per coverage period.
Many services also have their own dollar or visit limits. So, review the certificate for every limit.
π Where this applies: Every state where Quantum PPO is sold
β What happens when my Quantum PPO short-term plan ends?
Your Quantum PPO coverage stops at the expiration date.
After that, you might have to wait for an open enrollment period to get other coverage. So, line up your next plan before it ends.
π Where this applies: Every state where Quantum PPO is sold
β What deductibles are available on the Quantum PPO Copay plan?
The Copay plan offers a $2,500, $5,000 or $10,000 deductible per person.
In addition, the family deductible is 2 times the plan deductible.
π Where this applies: Every state where Quantum PPO is sold
β What deductibles are available on the Quantum PPO High Deductible plan?
The High Deductible plan lists a $5,000 or $10,000 deductible per person.
Also, the family deductible is 3 times the plan deductible. However, options can vary by state.
π Where this applies: Every state where Quantum PPO is sold
β Is there a separate deductible for out-of-network care on Quantum PPO?
Yes, out-of-network care has a deductible equal to 2 times your plan deductible.
π Where this applies: Every state where Quantum PPO is sold
β What coinsurance does the Quantum PPO plan pay?
In network, the HD plan pays 70% or 100% after the deductible.
By contrast, the Copay plan pays 80% or 100%. However, the 100% level comes only with the $10,000 deductible.
π Where this applies: Every state where Quantum PPO is sold
β What is the out-of-pocket maximum on a Quantum PPO plan?
The in-network out-of-pocket maximum is $10,000 per person.
It includes your deductible, coinsurance and copays (medical copays on the Copay plan). Plus, the family maximum is $25,000, including deductibles.
π Where this applies: Every state where Quantum PPO is sold
β Is there an out-of-pocket maximum for out-of-network care on Quantum PPO?
No, out-of-network care on Quantum PPO has no out-of-pocket maximum.
Also, the plan pays 60% after the out-of-network deductible.
π Where this applies: Every state where Quantum PPO is sold
β What is the total coverage maximum on a Quantum PPO plan?
In network, you can choose a $500,000 or $1,000,000 maximum per coverage period.
However, out-of-network benefits have a $250,000 cap.
π Where this applies: Every state where Quantum PPO is sold
β What is the Quantum PPO coverage maximum in Indiana?
Because of Indiana regulations, the Quantum PPO total coverage maximum there is $2,000,000.
π Where this applies: Indiana
β Are Quantum PPO benefits per person or per family?
Quantum PPO benefits are per covered person unless stated otherwise.
However, family deductibles and the $25,000 family out-of-pocket maximum are the main family-level amounts.
π Where this applies: Every state where Quantum PPO is sold
β Is there a waiting period on a Quantum PPO plan?
Yes, the plan does not cover sicknesses that start in the first 3 days.
It also does not cover cancer that starts in the first 30 days. After that, the plan covers the condition like any other.
π Where this applies: Every state where Quantum PPO is sold
β Which surgeries have a 3-month wait on Quantum PPO?
Quantum PPO has a 3-month wait on several surgeries and conditions.
These include tonsil and adenoid removal, gallbladder removal, hernia repair, sinus or deviated septum surgery and ear tube procedures. Hysterectomy (unless for cancer) and joint, neck and spine muscle disorders also wait. However, emergencies are exempt.
π Where this applies: Every state where Quantum PPO is sold
β Who can apply for a Companion Life Quantum PPO plan?
Applicants and spouses age 18 to 64 and 11 months can apply, plus dependent children.
However, everyone must answer No to all health questions on the application.
π Where this applies: Every state where Quantum PPO is sold
β Can I be turned down for a Quantum PPO plan because of my health?
Yes, you must answer No to every health question on the application to qualify.
π Where this applies: Every state where Quantum PPO is sold
β Do I have to join an association to get a Quantum PPO plan?
In most states, yes, you need to join an association to get Quantum PPO.
The plan is offered to members of Communicating for America, Inc. (CA), an association for self-employed and rural Americans. However, CA is not affiliated with Companion Life.
π Where this applies: Every Quantum PPO state except Missouri, North Carolina and Oklahoma
β Is Quantum PPO an individual plan in some states?
Yes, in Missouri, North Carolina and Oklahoma, Quantum PPO is an individual plan from Companion Life.
Telemedicine and other perks are provided separately from the insurance.
π Where this applies: Missouri, North Carolina and Oklahoma
β Who counts as a dependent on a Quantum PPO plan?
Dependents include your spouse or domestic partner and unmarried children under 26.
Stepchildren, foster and adopted children also qualify. Grandchildren under your legal guardianship who depend on you qualify as well.
π Where this applies: Florida, Arizona, Ohio and 10 more states
β How long can a Quantum PPO plan last?
Quantum PPO plan length depends on your state.
However, company materials note one policy lasts no more than 364 days. A licensed agent can also confirm the terms available where you live.
π Where this applies: Every state where Quantum PPO is sold
β What if I move to another state during my Quantum PPO plan?
If the plan isn't sold in your new state, a new policy can't be issued when yours expires.
π Where this applies: Every state where Quantum PPO is sold
β Can I cancel a Quantum PPO plan and get a refund?
Yes, you can cancel for a refund within the 10-day free look period.
First, send a written cancellation request within 10 days of receipt. Then, coverage is cancelled back to the effective date and your premium is returned.
π Where this applies: Every state where Quantum PPO is sold
β When does Quantum PPO coverage end?
Quantum PPO coverage ends on the earliest of several listed events.
These include the expiration date, the group policy ending, or unpaid premium after the grace period. Coverage also ends on entering full-time military duty or a finding of fraud.
π Where this applies: Every state where Quantum PPO is sold
β When does a dependent's Quantum PPO coverage end?
A dependent's coverage ends when yours ends or when they stop being an eligible dependent.
π Where this applies: Every state where Quantum PPO is sold
β What happens to my Quantum PPO plan if I join the military?
Your coverage ends when you enter full-time active duty.
After that, send written notice, and the unused premium is refunded on a prorated basis.
π Where this applies: Every state where Quantum PPO is sold
SureCare Basics, Costs and Eligibility
SureCare is the Pan-American Life short-term plan. Here you can see who can buy it and how it works.
β What is the SureCare short-term medical plan?
SureCare is short-term medical insurance from Pan-American Life Insurance Company.
It helps pay medical bills during a temporary gap in coverage. Plus, it has no network, so you can see any provider.
π Where this applies: Every state where SureCare is sold
β Who is the insurance company behind SureCare short-term plans?
Pan-American Life Insurance Company underwrites SureCare through its Pan-American Accident & Health division.
AM Best rates the company A (Excellent). In addition, Fitch rates it A (Strong) with a stable outlook.
π Where this applies: Every state where SureCare is sold
β Is a SureCare short-term plan the same as an ACA plan?
No, SureCare is short-term, limited-duration insurance with limited benefits, not an ACA plan.
It is not major medical coverage. Also, it does not count as minimum essential coverage.
π Where this applies: Every state where SureCare is sold
β Can I use a subsidy on a Pan-American Life SureCare plan?
No, federal financial help is not available on short-term plans like SureCare.
However, many people qualify for help on HealthCare.gov plans. So it is worth comparing both before you choose.
π Where this applies: Every state where SureCare is sold
β Is SureCare a group or individual policy?
In most states, SureCare is a group short-term policy for association members.
However, it is an individual plan in Kansas, Missouri, North Carolina and Oklahoma.
π Where this applies: Every state where SureCare is sold
β Who is a SureCare short-term plan a good fit for?
SureCare plan materials target families of all types and women 40+ who want stronger wellness benefits.
They also highlight Spanish-speaking clients who want bilingual support.
π Where this applies: Every state where SureCare is sold
β Is SureCare available in Spanish?
Yes, many SureCare materials and support services are available in Spanish.
For example, there is a Spanish brochure.
π Where this applies: Every state where SureCare is sold
β What happens when my SureCare plan ends?
Your SureCare coverage stops at the end of the coverage period.
After that, you might have to wait for an open enrollment period to get other coverage.
π Where this applies: Every state where SureCare is sold
β What deductibles are available on SureCare?
SureCare lets you choose a $2,500, $5,000 or $10,000 deductible.
Also, the family deductible maximum is 3 times the individual deductible.
π Where this applies: Every state where SureCare is sold
β What is the coinsurance on a SureCare plan?
You pay 20% or 50% of covered expenses after the deductible, depending on the plan you choose.
π Where this applies: Every state where SureCare is sold
β What is the coinsurance maximum on SureCare?
The SureCare coinsurance maximum is $5,000 or $10,000.
After you reach it, the plan pays covered expenses at 100%. However, deductibles, copays and amounts above allowed charges don't count toward it.
π Where this applies: Every state where SureCare is sold
β What is the total coverage maximum on SureCare?
You can choose a $250,000 or $1,000,000 total coverage maximum on SureCare.
π Where this applies: Every state where SureCare is sold
β How soon can SureCare coverage start?
SureCare offers next-day effective dates for injuries.
However, sickness and cancer have short waiting periods.
π Where this applies: Every state where SureCare is sold
β Is there a waiting period on a SureCare plan?
Yes, sicknesses must begin more than 5 days after your SureCare effective date.
Also, cancer must begin more than 30 days after it.
π Where this applies: Every state where SureCare is sold
β Which surgeries have a 6-month wait on SureCare?
SureCare does not cover certain surgeries in the first 6 months of coverage.
These include hysterectomy (unless for cancer), tonsil or adenoid removal, and sinus or deviated septum surgery. Ear tube procedures and hernia repair also have the 6-month wait.
π Where this applies: Every state where SureCare is sold
β Who can apply for a Pan-American Life SureCare plan?
Applicants and spouses up to age 65 can apply, plus dependent children at least 6 months old.
Also, everyone must answer No to all health questions on the application.
π Where this applies: Every state where SureCare is sold
β Can I be turned down for SureCare because of my health?
Yes, you must answer No to every health question on the application to qualify.
π Where this applies: Every state where SureCare is sold
β Do I have to join an association to get SureCare?
In most states, yes, because SureCare is offered to members of Communicating for America, Inc.
You can also join the association without buying insurance.
π Where this applies: Every SureCare state except Kansas, Missouri, North Carolina and Oklahoma
β Is SureCare an individual plan in some states?
Yes, SureCare is an individual plan in Kansas, Missouri, North Carolina and Oklahoma.
In those states, telemedicine and other perks come separately from the insurance.
π Where this applies: Kansas, Missouri, North Carolina and Oklahoma
β Can I add my baby to a SureCare plan?
Dependent children must be at least 6 months old to be eligible for SureCare.
π Where this applies: Every state where SureCare is sold
β How long can I keep a SureCare short-term plan?
SureCare offers up to 3 years of coverage in 13 states.
A licensed agent can confirm whether your state is included.
π Where this applies: Every state where SureCare is sold
β Can I cancel a SureCare plan and get a refund?
Yes, you can cancel SureCare within 10 days of receiving it for a refund.
First, send a written cancellation request. Then the carrier cancels coverage back to the effective date. Plus, you get back the premium and the application fee.
π Where this applies: Every state where SureCare is sold
β Can I cancel SureCare later in the term?
Yes, SureCare coverage ends on the date you ask in writing to end it.
π Where this applies: Every state where SureCare is sold
β When does SureCare coverage end?
SureCare ends with the coverage period, or sooner if premium is unpaid after the grace period.
It also ends when you reach the overall maximum benefit. In addition, it ends if the group policy ends.
π Where this applies: Every state where SureCare is sold
β What happens to SureCare when I turn 65?
SureCare coverage ends on the first day of the month you or your spouse turn 65.
It also ends on the first day of the month either of you becomes Medicare eligible.
π Where this applies: Every state where SureCare is sold
β When does a dependent's SureCare coverage end?
Your child's SureCare coverage ends at age 26 or on marriage.
For a spouse, coverage ends after a divorce. Also, the certificate explains extensions of the age limit.
π Where this applies: Every state where SureCare is sold
β What happens to SureCare if I join the military?
SureCare coverage ends when you enter the armed forces, except reserve duty under 30 days.
With written notice, you get a pro rata refund of unused premium.
π Where this applies: Every state where SureCare is sold
β What extra perks come with SureCare?
SureCare's non-insurance perks include free 24/7 telemedicine, asynchronous visits, hearing and audiology discounts and a prescription discount card.
However, Pan-American Life does not provide these perks.
π Where this applies: Every state where SureCare is sold
Quantum PPO vs. SureCare
These answers put the two plans side by side. As a result, you can match a plan to the care you expect.
β What is the main difference between Quantum PPO and SureCare short-term plans?
Quantum PPO uses the Cigna PPO network, while SureCare has no network at all.
Companion Life's Quantum PPO pays lower benefits out of network. By contrast, SureCare from Pan-American Life has one benefit level for any provider.
π Where this applies: Every state where both plans are sold
β Which plan lets me see any doctor, Quantum PPO or SureCare?
SureCare has no network restrictions, so you can see any provider.
Quantum PPO also pays out of network. However, it comes with a higher deductible, 60% coinsurance and a $250,000 cap.
π Where this applies: Every state where both plans are sold
β How do doctor visit copays compare on Quantum PPO and SureCare?
SureCare has unlimited $30 visits for primary, specialist and urgent care.
By contrast, the Quantum Copay plan charges $30 or $60 for 3 combined visits. Quantum HD visits go to the deductible instead.
π Where this applies: Every state where both plans are sold
β How do ER and hospital costs compare on Quantum PPO and SureCare?
SureCare has no ER or hospital copays, while Quantum has a $250 ER copay.
The Quantum HD plan also adds a $500 hospital copay. Then both plans apply the deductible and coinsurance.
π Where this applies: Every state where both plans are sold
β How do deductibles compare on Quantum PPO and SureCare?
SureCare offers $2,500, $5,000 or $10,000 deductibles.
The Quantum Copay plan offers the same amounts. By contrast, Quantum HD lists $5,000 or $10,000. Family deductibles are 3 times on SureCare and Quantum HD, but 2 times on Quantum Copay.
π Where this applies: Every state where both plans are sold
β How do out-of-pocket limits compare on Quantum PPO and SureCare?
Quantum caps in-network costs at $10,000 per person, including the deductible.
By contrast, SureCare's $5,000 or $10,000 coinsurance maximum comes on top of the deductible and copays.
π Where this applies: Every state where both plans are sold
β How do coverage maximums compare on Quantum PPO and SureCare?
Both Quantum PPO and SureCare offer coverage maximums up to $1,000,000.
In addition, Quantum offers $500,000, while SureCare offers $250,000.
π Where this applies: Every state where both plans are sold
β Which covers prescriptions better, Quantum PPO or SureCare?
The Quantum Copay plan has drug copays of $10, $30 and $75, up to $1,000 or $2,000.
By contrast, Quantum HD offers discounts only. SureCare excludes outpatient drugs but includes a discount card.
π Where this applies: Every state where both plans are sold
β How does preventive care compare on Quantum PPO and SureCare?
Quantum covers one in-network preventive visit up to $250.
By contrast, SureCare covers an adult exam for a $50 copay, then 100%. SureCare also waives the deductible for mammograms, Pap smears and prostate screening.
π Where this applies: Every state where both plans are sold
β How do childhood vaccines compare on Quantum PPO and SureCare?
Both Quantum PPO and SureCare skip the deductible for childhood immunizations.
In addition, SureCare pays them at 50% or 80%.
π Where this applies: Every state where both plans are sold
β How does mental health coverage compare on Quantum PPO and SureCare?
Quantum covers mental disorders in network after the deductible and coinsurance.
By contrast, SureCare limits mental health and substance use care to $100 a day. It allows 30 inpatient and 10 outpatient days.
π Where this applies: Every state where both plans are sold
β How does therapy coverage compare on Quantum PPO and SureCare?
Both Quantum PPO and SureCare cap PT, OT and speech therapy at 20 visits.
However, Quantum pays $50 per day, while SureCare pays up to $100 per day.
π Where this applies: Every state where both plans are sold
β How does ambulance coverage compare on Quantum PPO and SureCare?
Quantum pays up to $1,000 for ground and $2,500 for air ambulance.
By contrast, SureCare pays up to $1,000 for ground or air.
π Where this applies: Every state where both plans are sold
β How do transplant and home health benefits compare on Quantum PPO and SureCare?
Quantum covers in-network transplants after the deductible and coinsurance, plus up to 40 home health visits.
By contrast, SureCare caps transplants at $50,000 and home health at 30 visits.
π Where this applies: Every state where both plans are sold
β How do waiting periods compare on Quantum PPO and SureCare?
Quantum has a 3-day sickness wait, while SureCare has a 5-day wait.
Both plans have a 30-day cancer wait. However, certain surgeries wait 3 months on Quantum and 6 months on SureCare.
π Where this applies: Every state where both plans are sold
β Do Quantum PPO and SureCare treat preexisting conditions the same way?
Mostly, since both plans use a 24-month lookback that includes symptoms.
However, Quantum has some state differences. Both also have a limited preexisting allowance in the certificate.
π Where this applies: Every state where both plans are sold
β How does eligibility compare on Quantum PPO and SureCare?
Quantum covers applicants and spouses 18 to 64 and 11 months, plus children.
By contrast, SureCare covers people up to 65, with children at least 6 months old. Both require No answers to all health questions.
π Where this applies: Every state where both plans are sold
β Which plan covers care abroad, Quantum PPO or SureCare?
Quantum covers immediate medical attention while traveling abroad, after the deductible and coinsurance.
By contrast, SureCare excludes care outside the U.S., Canada or its possessions unless specifically covered.
π Where this applies: Every state where both plans are sold
β Do Quantum PPO and SureCare have an accident benefit?
Quantum includes a supplemental accident benefit up to the deductible amount for care within 72 hours.
Meanwhile, SureCare offers next-day effective dates for injuries.
π Where this applies: Every state where both plans are sold
β How do pre-authorization rules compare on Quantum PPO and SureCare?
Quantum reduces eligible expenses by $1,000 if care is not pre-authorized.
Meanwhile, SureCare asks you to report emergency admissions within 48 hours or the next working day.
π Where this applies: Every state where both plans are sold
β How long can I keep Quantum PPO compared with SureCare?
Quantum PPO coverage length varies by state.
Meanwhile, SureCare offers up to 3 years of coverage in 13 states. A licensed agent can confirm options in your state.
π Where this applies: Every state where both plans are sold
β Do Quantum PPO and SureCare both have a free look period?
Yes, both give you 10 days to cancel in writing for a full refund.
SureCare also refunds the application fee.
π Where this applies: Every state where both plans are sold
β Do Quantum PPO and SureCare both include telemedicine?
Yes, both include free, unlimited 24/7 telemedicine as a non-insurance benefit.
In addition, SureCare adds asynchronous visits and a prescription discount card.
π Where this applies: Every state where both plans are sold
β Do Quantum PPO and SureCare both require association membership?
In most states, yes, both require membership through Communicating for America.
However, each plan is an individual plan in a few states, and those states differ by plan.
π Where this applies: Every state where both plans are sold
β How do Quantum PPO and SureCare compare with an ACA plan?
Both are short-term plans that use health questions and can deny coverage.
By contrast, ACA plans guarantee coverage, cover preexisting conditions and maternity, and offer subsidies. However, you can buy short-term coverage any time of year.
π Where this applies: Every state where both plans are sold
β When can I enroll in Quantum PPO or SureCare compared with an ACA plan?
You can buy short-term plans 12 months a year.
By contrast, ACA plans require open enrollment or a qualifying life event.
π Where this applies: Every state where both plans are sold
What Quantum PPO Covers
Quantum PPO pays for hospital, ER, doctor and drug costs in set ways. So see what each benefit pays.
β How much does a doctor visit cost on the Quantum PPO Copay plan?
A primary doctor visit is a $30 copay on the Quantum PPO Copay plan.
Specialist or urgent care visits are a $60 copay. However, copays apply to 3 combined office visits per coverage period.
π Where this applies: Every state where Quantum PPO is sold
β What happens after my 3 copay visits on the Quantum PPO Copay plan?
Additional primary, specialist and urgent care visits then go to the deductible and coinsurance.
π Where this applies: Every state where Quantum PPO is sold
β How are doctor visits covered on the Quantum PPO High Deductible plan?
On the HD plan, office visits go to the deductible and coinsurance.
Still, seeing Cigna PPO network doctors helps lower what you pay.
π Where this applies: Every state where Quantum PPO is sold
β How much is urgent care on a Quantum PPO plan?
On the Copay plan, urgent care is a $60 copay within the 3-visit combined limit.
By contrast, urgent care on the HD plan goes to the deductible and coinsurance.
π Where this applies: Every state where Quantum PPO is sold
β Are out-of-network doctor visits covered on Quantum PPO?
Yes, Quantum PPO covers out-of-network doctor visits, but at the lower out-of-network level.
Visits go to the out-of-network deductible, and then the plan pays 60%.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover phone or online doctor visits?
The plan excludes telephone and internet consultations unless expressly provided.
However, members do get free 24/7 telemedicine as a non-insurance membership benefit.
π Where this applies: Every state where Quantum PPO is sold
β How does emergency room coverage work on Quantum PPO?
Every Quantum option has a $250 ER copay, in or out of network.
After that, the deductible and coinsurance apply.
π Where this applies: Every state where Quantum PPO is sold
β What do I pay for a hospital stay on a Quantum PPO plan?
On the HD plan, a hospital stay has a $500 copay, then the deductible and coinsurance.
By contrast, a stay on the Copay plan goes straight to the deductible and coinsurance.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover outpatient surgery?
Yes, it covers outpatient surgical facility charges after the deductible and coinsurance, in or out of network.
π Where this applies: Every state where Quantum PPO is sold
β Does a Quantum PPO plan cover ambulance rides?
Yes, ground ambulance pays up to $1,000 and air ambulance pays up to $2,500.
However, both are subject to the deductible and coinsurance.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover organ transplants?
Yes, Quantum PPO covers in-network organ transplants, subject to the deductible and coinsurance.
However, the plan does not cover out-of-network organ and tissue transplants.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover home health care?
Yes, Quantum PPO covers home health care after the deductible and coinsurance, up to 40 visits.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover physical, occupational or speech therapy?
Yes, Quantum PPO covers physical, occupational and speech therapy, with limits.
After the deductible and coinsurance, therapy pays $50 per day. Also, all three therapies share a 20-visit maximum.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover prosthetics and orthotics?
Yes, Quantum PPO covers in-network prosthetics and orthotics up to $2,500 after the deductible and coinsurance.
However, the plan does not cover them out of network.
π Where this applies: Every state where Quantum PPO is sold
β What is the Quantum PPO supplemental accident benefit?
This benefit pays 100% of expenses from an accidental injury treated within 72 hours of the accident.
However, the most it pays is your plan deductible amount.
π Where this applies: Every state where Quantum PPO is sold
β Am I covered on a Quantum PPO plan when I travel outside the U.S.?
Yes, Quantum PPO covers you abroad if you need immediate medical attention.
That care goes to the deductible and coinsurance. However, the plan excludes other care received in a foreign country unless expressly provided.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO require pre-authorization?
Yes, Quantum PPO requires pre-authorization for certain care.
If eligible expenses are not pre-authorized, the plan reduces the benefit by $1,000.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover mental health care?
Yes, Quantum PPO covers in-network mental health care.
Mental disorder treatment goes to the deductible and coinsurance. However, the plan does not cover it out of network.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover substance abuse treatment?
Yes, Quantum PPO covers in-network substance abuse treatment, with limits.
Inpatient care pays $100 per day for up to 31 days per coverage period. Meanwhile, outpatient care pays $50 per visit for up to 10 visits.
π Where this applies: Every state where Quantum PPO is sold
β Does a Quantum PPO plan cover a preventive checkup?
Yes, Quantum PPO covers one in-network preventive visit per coverage period, up to $250.
However, the plan does not cover out-of-network preventive care.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover mammograms and OB-GYN exams?
Yes, Quantum PPO covers mammograms and OB-GYN exams in network.
The annual OB-GYN exam, mammogram and ovarian cancer monitoring go to the deductible and coinsurance. However, the plan does not cover them out of network.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover colorectal and prostate cancer screening?
Yes, Quantum PPO covers colorectal and prostate cancer screenings in network.
These screenings go to the deductible and coinsurance.
π Where this applies: Every state where Quantum PPO is sold
β Are childhood immunizations covered on Quantum PPO?
Yes, and childhood immunizations on Quantum PPO are not subject to the deductible.
π Where this applies: Every state where Quantum PPO is sold
β Does the Quantum PPO Copay plan cover prescriptions?
Yes, the Copay plan covers prescriptions at in-network pharmacies.
Generics are a $10 copay, preferred drugs $30 and non-preferred drugs $75. However, the plan does not cover out-of-network prescriptions.
π Where this applies: Every state where Quantum PPO is sold
β Do I have to meet the deductible before Quantum PPO drug copays apply?
On some Quantum plans, in-network drug copays apply with no deductible.
π Where this applies: Every state where Quantum PPO is sold
β Does the Quantum PPO High Deductible plan cover prescriptions?
The HD plan gives prescription discounts only and does not have drug copays.
π Where this applies: Every state where Quantum PPO is sold
β Is there a limit on Quantum PPO prescription benefits?
Yes, drug benefits are capped at $1,000 for coverage periods of 6 months or less.
For periods over 6 months, however, the cap is $2,000.
π Where this applies: Every state where Quantum PPO is sold
β How can I check if my medicine is on the Quantum PPO drug list?
Agents can check a drug against the Cigna Rx Drug List.
Cigna pharmacy members can also use the Price a Prescription tool for lower-priced options.
π Where this applies: Every state where Quantum PPO is sold
β What network does the Quantum PPO plan use?
Quantum PPO uses the Cigna Healthcare PPO network.
Cigna reports more than 1 million providers and 6,200 in-network hospitals. The network also reaches urban, suburban and rural areas nationwide.
π Where this applies: Every state where Quantum PPO is sold
β How much can I save using Cigna PPO doctors on Quantum PPO?
Cigna's paid-claims analysis shows members paid an average of 58.6% less.
However, actual savings vary by care used, plan design and location.
π Where this applies: Every state where Quantum PPO is sold
β How do I find a Cigna PPO doctor for my Quantum PPO plan?
Visit Cigna's online provider directory and click the orange PICK button.
Then, under Medical, choose the PPO/Choice Fund PPO network. For help, contact the carrier.
π Where this applies: Every state where Quantum PPO is sold
β Can I see doctors outside the Cigna network on Quantum PPO?
Yes, you can see doctors outside the Cigna network, but at a lower benefit level.
Out of network, you face a double deductible, 60% coinsurance, no out-of-pocket maximum and a $250,000 cap. Also, the plan does not cover preventive care, prescriptions or mental health out of network.
π Where this applies: Every state where Quantum PPO is sold
β What online tools do Quantum PPO members get?
Members get personalized information on the myCigna member website.
Tools include provider search, health resources and videos. Pharmacy members can also see plan coverage, claim history and drug prices.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO come with free telemedicine?
Yes, Quantum PPO includes free telemedicine as a non-insurance benefit.
Members get free, unlimited telemedicine doctor consultations 24/7, including dermatology.
π Where this applies: Every state where Quantum PPO is sold
β What other perks come with a Quantum PPO plan?
Non-insurance benefits include hearing and audiology discounts and durable medical equipment discounts.
Members can also reach health liaisons who advocate for them.
π Where this applies: Every state where Quantum PPO is sold
What SureCare Covers
SureCare lets you see any doctor and uses simple copays. In addition, these answers explain its hospital benefits.
β Does SureCare have a provider network?
No, SureCare is an All Provider Access plan with no network restrictions.
Instead, you choose any provider. Plus, one benefit level applies to all of them.
π Where this applies: Every state where SureCare is sold
β How does SureCare pay doctors and hospitals?
SureCare uses reference-based pricing tied to Medicare allowable amounts.
For facilities, it pays up to 150% of Medicare. By contrast, it pays up to 125% for professional services and supplies.
π Where this applies: Every state where SureCare is sold
β What if a provider balance bills me on a SureCare plan?
Tell the plan's claim administrator if a provider balance bills you.
Then, for unexpected charges on covered benefits you don't owe, the administrator can resolve the balance bill.
π Where this applies: Every state where SureCare is sold
β Are SureCare benefits limited to usual and customary charges?
Yes, SureCare limits all benefits to usual, reasonable and customary fees.
So the plan does not cover amounts above the maximum allowable expense.
π Where this applies: Every state where SureCare is sold
β How much is a doctor visit on a SureCare plan?
Primary care, specialist and urgent care visits are each a $30 copay on SureCare.
Also, the deductible does not apply. Then the plan pays the visit at 100% after the copay.
π Where this applies: Every state where SureCare is sold
β Is there a limit on SureCare doctor office visits?
No, SureCare offers unlimited doctor office visits at the $30 copay.
π Where this applies: Every state where SureCare is sold
β Are tests during a SureCare office visit covered by the copay?
No, other services or tests during the visit go to the deductible and coinsurance.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover lab work, X-rays and MRIs?
Yes, SureCare covers diagnostic radiology, ultrasound and lab tests, including MRI, CT and PET scans.
However, it does not cover psychometric, intelligence, behavioral or educational testing.
π Where this applies: Every state where SureCare is sold
β Does SureCare include telemedicine?
Yes, SureCare includes telemedicine as a non-insurance benefit.
You get free, unlimited 24/7 telemedicine visits. In addition, it includes asynchronous questionnaire visits that a provider reviews.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover an annual physical for adults?
Yes, SureCare adults get one preventive exam per year for a $50 copay.
Also, the deductible does not apply. Then the plan covers the exam at 100% after the copay.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover well-child visits?
Yes, SureCare covers well-child visits from birth through age 16.
Visits go to the deductible, then 20% or 50% coinsurance. They include history, exam, developmental assessment and routine tests.
π Where this applies: Every state where SureCare is sold
β Are children's vaccines covered on SureCare?
Yes, SureCare covers children's immunizations at 50% or 80% with no deductible.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover mammograms?
Yes, SureCare covers mammograms for women 50 and older.
Screening mammograms and breast ultrasound for dense breasts skip the deductible. The plan pays 50% or 80% until the coinsurance max. After that, it pays 100%.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover Pap smears and OB-GYN exams?
Yes, SureCare covers one annual Pap smear with no deductible.
The annual OB-GYN exam also waives the deductible. Then the plan pays 50% or 80% for it until the coinsurance max.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover prostate cancer screening?
Yes, SureCare covers prostate cancer screening for men 50 and older.
It follows national cancer network guidelines. Also, the deductible does not apply.
π Where this applies: Every state where SureCare is sold
β Is there an ER copay on SureCare?
No, SureCare has no emergency room copay.
Instead, ER care goes to the deductible and coinsurance.
π Where this applies: Every state where SureCare is sold
β What does SureCare pay for a hospital stay?
SureCare hospital stays go to the deductible and coinsurance, with no hospital copay.
The plan covers room and board up to the standard room rate. In addition, it includes ICU, surgery, anesthesia and in-hospital drugs.
π Where this applies: Every state where SureCare is sold
β Do I need to notify SureCare about a hospital admission?
Yes, you need to report emergency admissions within 48 hours or by the next working day.
However, some states allow 72 hours.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover ambulance services?
Yes, SureCare covers emergency ground or air ambulance up to $1,000.
The deductible and coinsurance apply first.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover outpatient surgery?
Yes, SureCare covers hospital outpatient surgery and freestanding surgery centers after the deductible and coinsurance.
It also covers surgeon, assistant surgeon and anesthesia fees the same way.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover cancer treatment?
Yes, SureCare covers radiation and chemotherapy for cancer that starts after the 30-day wait.
However, cancer that existed before coverage counts as preexisting, so the plan does not cover it.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover cell or gene therapy?
No, SureCare excludes cell and gene therapy and related drugs and treatments.
However, this exclusion does not affect chemotherapy.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover organ transplants?
Yes, SureCare covers organ transplants up to a $50,000 maximum transplant benefit.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover physical, occupational or speech therapy?
Yes, SureCare therapy benefits pay up to $100 per day after the deductible.
However, all therapies share a 20-visit maximum per coverage period.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover home health care?
Yes, SureCare covers up to 30 home health visits, one per day, paying up to $50 each.
Also, up to 4 hours of care in a day counts as one visit.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover a skilled nursing or extended care stay?
Yes, SureCare extended care pays $150 per day for up to 30 days.
A doctor must authorize the stay. However, the plan does not cover custodial care.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover hospice care?
Yes, SureCare covers hospice for a terminally ill person expected to live 6 months or less.
Hospice pays up to $5,000 per coverage period.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover medical equipment like wheelchairs?
Yes, SureCare offers a limited benefit for medical equipment like wheelchairs and hospital beds.
The plan may pay rental instead of purchase. However, it does not cover customization, repair or replacement.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover dental injuries?
Yes, SureCare covers treatment to restore or replace sound natural teeth damaged in an injury.
However, the plan excludes routine dental care and orthodontia.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover mental health and substance use treatment?
Yes, SureCare covers mental health and substance use treatment, with limits, after the deductible and coinsurance.
Inpatient care pays up to $100 a day for 30 days. By contrast, outpatient care pays up to $100 a day for 10 days.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover prescription drugs?
SureCare does not cover outpatient prescriptions unless they are specifically included.
However, the plan covers drugs a doctor gives in a hospital or clinic along with the related care. Members also get a prescription discount card.
π Where this applies: Every state where SureCare is sold
Quantum PPO Exclusions and Pre-Existing Rules
Every short-term plan has limits. For that reason, check these Quantum PPO answers before you buy.
β Does Quantum PPO cover preexisting conditions?
Generally, no, Quantum PPO does not cover preexisting conditions.
The plan excludes conditions a doctor treated, diagnosed or advised on in the 24 months before coverage. Symptoms that would prompt a reasonable person to seek care also count.
π Where this applies: Every state where Quantum PPO is sold
β Is there any benefit for preexisting conditions on Quantum PPO?
The certificate pays eligible preexisting expenses up to an Allowance Benefit Maximum in the Schedule of Benefits.
However, the brochure does not list that amount, so check your certificate.
π Where this applies: Every state where Quantum PPO is sold
β How long are preexisting conditions excluded on a Quantum PPO plan?
The certificate does not set a separate exclusion period for preexisting conditions.
In practice, the exclusion lasts the length of the policy, which is no more than 364 days.
π Where this applies: Florida, Arizona, Alabama and 8 more states
β Does the preexisting condition rule apply to a newborn on Quantum PPO?
No, the preexisting condition exclusion does not apply to a newborn or newly adopted child.
This holds when you add the child under the plan's eligibility rules.
π Where this applies: Every state where Quantum PPO is sold
β What is the Quantum PPO preexisting condition lookback in my state?
In these states, the Quantum PPO preexisting condition lookback is 24 months.
It covers both doctor care or advice and symptoms a reasonable person would seek care for.
π Where this applies: Florida, Arizona, Alabama and 5 more states
β What is the Quantum PPO preexisting condition lookback in Mississippi?
Mississippi uses a 6-month preexisting condition lookback on Quantum PPO.
It includes both doctor care or advice and symptoms a reasonable person would seek care for.
π Where this applies: Mississippi
β What is the Quantum PPO preexisting condition lookback in Wyoming?
Wyoming uses a 6-month preexisting condition lookback on Quantum PPO.
However, it only counts conditions a doctor treated, diagnosed or advised on, not untreated symptoms.
π Where this applies: Wyoming
β What is the Quantum PPO preexisting condition lookback in Nebraska?
Nebraska uses a 24-month preexisting condition lookback on Quantum PPO.
However, it only counts conditions a doctor treated, diagnosed or advised on. Also, the plan cannot exclude symptoms alone.
π Where this applies: Nebraska
β Does a Quantum PPO plan cover pregnancy and childbirth?
No, Quantum PPO excludes routine prenatal care, pregnancy, childbirth and postnatal care.
However, complications of pregnancy are an exception.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO include dental or vision coverage?
No, Quantum PPO does not include routine dental or vision coverage.
The plan covers dental care only to repair sound natural teeth injured in an accident, seen within 72 hours. It also excludes glasses, contacts, hearing aids and vision or hearing exams.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover chiropractic care?
No, Quantum PPO excludes spinal manipulation, muscle stimulation and other non-surgical spine treatment.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover joint replacement?
Quantum PPO covers joint replacement only when it is related to an accidental injury.
Otherwise, the plan excludes joint replacements.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover weight-loss surgery?
No, Quantum PPO excludes weight modification and surgical treatment of obesity.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover fertility treatment or birth control?
No, Quantum PPO excludes drugs and procedures that promote or prevent conception.
The plan also excludes sterilization and its reversal.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover diabetic supplies?
Quantum PPO excludes diabetic supplies and management unless your certificate expressly provides them.
However, some states require coverage.
π Where this applies: Every state where Quantum PPO is sold
β Are sports injuries covered on a Quantum PPO plan?
Quantum PPO does not cover injuries from professional, semi-professional or extreme sports.
For example, this includes skydiving, scuba diving, rock climbing, rodeo and motor racing. The plan also excludes injuries while training for these.
π Where this applies: Every state where Quantum PPO is sold
β What else does a Quantum PPO plan not cover?
Exclusions include sleep disorders, cataracts, chronic fatigue or pain disorders, genetic testing and smoking cessation.
The plan also excludes cosmetic treatment, hair loss and routine foot care. However, this is a partial list.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO cover TMJ or HIV treatment?
Quantum PPO excludes TMJ disorder and HIV/AIDS treatment unless expressly provided.
However, some states require coverage, so check your state's certificate.
π Where this applies: Every state where Quantum PPO is sold
β Are injuries covered if I was drinking on a Quantum PPO plan?
No, Quantum PPO excludes injuries from being intoxicated or under the influence of drugs.
However, drugs taken as prescribed are an exception. Intoxication follows the legal limit where the injury happened.
π Where this applies: Every state where Quantum PPO is sold
β Does Quantum PPO pay if workers' comp or Medicare should pay?
No, Quantum PPO excludes work injuries covered by workers' compensation.
It also excludes expenses eligible for Medicare or other government programs, except Medicaid.
π Where this applies: Every state where Quantum PPO is sold
SureCare Exclusions and Pre-Existing Rules
SureCare also has exclusions and pre-existing rules. So read these answers before you choose it.
β Does SureCare cover preexisting conditions?
Generally, SureCare does not cover preexisting conditions.
A condition counts if a doctor gave advice, care, treatment or medication in the 24 months before coverage. Symptoms a reasonable person would seek care for also count.
π Where this applies: Every state where SureCare is sold
β Does a phone consult count toward a SureCare preexisting condition?
Yes, a consultation counts with or without an in-person exam or visit.
π Where this applies: Every state where SureCare is sold
β Is there any benefit for preexisting conditions on SureCare?
SureCare pays covered preexisting expenses up to a Pre-Existing Allowance Maximum in the Schedule of Benefits.
However, the brochure does not list the amount, so check your certificate.
π Where this applies: Every state where SureCare is sold
β Does the SureCare preexisting rule apply to a newborn?
No, the rule does not apply to a newborn or newly adopted child added under the eligibility rules.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover pregnancy and childbirth?
No, SureCare excludes normal pregnancy and childbirth, except complications of pregnancy.
The plan also excludes elective C-sections and elective abortion.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover birth control or fertility treatment?
No, SureCare excludes birth control, infertility treatment, IVF, sterilization and sterilization reversal.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover vision or hearing care?
No, SureCare excludes routine eye and hearing exams, glasses, contacts and hearing aids.
It also excludes cataract treatment and LASIK-type surgery.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover kidney disease or dialysis?
No, SureCare excludes kidney or end-stage renal disease.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover allergy treatment?
SureCare covers only emergency treatment of allergic reactions.
However, it excludes other allergy diagnosis and treatment.
π Where this applies: Every state where SureCare is sold
β Are sports injuries covered on SureCare?
SureCare covers school and intramural sports injuries, but not hazardous or paid sports.
The plan also excludes skydiving, scuba diving, rodeo, racing and riding ATVs or dirt bikes.
π Where this applies: Every state where SureCare is sold
β Am I covered outside the U.S. on SureCare?
SureCare excludes care outside the United States, Canada or its possessions unless specifically covered.
π Where this applies: Every state where SureCare is sold
β Does SureCare cover weight-loss surgery?
No, SureCare excludes weight loss programs, obesity treatment and gastric bypass.
The exclusion applies even if you have other health conditions.
π Where this applies: Every state where SureCare is sold
β What else does SureCare not cover?
SureCare exclusions include TMJ, sleep disorders, chronic fatigue or pain, and acupuncture.
They also include private duty nursing and smoking cessation. In addition, the plan excludes cosmetic surgery and hair loss treatment. This is a partial list.
π Where this applies: Every state where SureCare is sold
β Are injuries covered if I was drinking on a SureCare plan?
No, SureCare excludes losses while intoxicated or on non-prescribed narcotics.
Intoxication means a blood alcohol level of .10 or the state limit, whichever is lower.
π Where this applies: Every state where SureCare is sold
β Does SureCare pay if workers' comp, auto insurance or Medicare should pay?
No, SureCare excludes expenses covered by workers' comp, no-fault auto insurance or Medicare.
However, Medicaid is the exception among government programs.
π Where this applies: Every state where SureCare is sold
State Rules and Texas 12-Month Coverage
Each state sets its own short-term rules. Also, Texas offers its own 12-month coverage option.
β Can I reapply for a Companion Life short-term PPO plan in Nevada after one ends?
Nevada has a reapply rule for short-term plans.
If you had short-term coverage for 185 days in the past 365, wait 180 days after it ends.
π Where this applies: Nevada
β Can I reapply for a Companion Life short-term PPO plan in Oklahoma after one ends?
Oklahoma has a reapply rule for short-term plans.
If you had short-term coverage for 185 days in the past 365, wait 185 days after it ends.
π Where this applies: Oklahoma
β What extra benefits does Arizona require on Companion Life short-term PPO plans?
Arizona requires telehealth coverage on Companion Life short-term PPO plans.
Plans also cover chiropractors the same as doctors and AIDS like any other sickness. In addition, plans cannot exclude care from immediate family members.
π Where this applies: Arizona
β Does a Companion Life short-term PPO plan cover autism in Arkansas?
Yes, Arkansas requires autism spectrum disorder coverage up to age 18, up to $50,000 per year.
π Where this applies: Arkansas
β What other Arkansas mandates apply to Companion Life short-term PPO plans?
Arkansas adds diabetic supplies and education, gastric pacemakers, craniofacial surgery and hearing or speech treatment.
Plans also cover special dietary formulas, with food products limited to $2,400. In addition, plans must cover telehealth.
π Where this applies: Arkansas
β How does Arkansas handle out-of-network emergency hospital stays on Companion Life PPO plans?
Plans pay emergency inpatient care at an out-of-network hospital at the in-network level.
However, you must transfer to an in-network hospital within 48 hours, or when safe.
π Where this applies: Arkansas
β Does a Companion Life short-term PPO plan cover prostate screening in Arkansas?
Yes, men 40 and older get an annual PSA blood test and digital rectal exam.
Plus, the deductible does not apply.
π Where this applies: Arkansas
β How long is a newborn covered on a Companion Life short-term PPO plan in Arkansas?
Newborns are eligible for the first 90 days and adopted children for the first 60 days.
Coverage also includes congenital conditions, premature birth and state newborn screening tests.
π Where this applies: Arkansas
β Does a Companion Life short-term PPO plan cover mammograms in Florida?
Yes, Florida requires a baseline mammogram at ages 35 to 39.
After that, it requires one every two years at 40 to 49 and yearly from 50. Plus, the deductible does not apply.
π Where this applies: Florida
β What Florida mandates apply to Companion Life short-term PPO plans?
Florida covers cleft lip and palate for children under 18 and post-mastectomy outpatient care.
Pap tests and routine child care through age 16 also skip the deductible. In addition, plans cannot exclude TMJ.
π Where this applies: Florida
β Is breast cancer follow-up care treated as preexisting on a Florida Companion Life PPO plan?
No, in Florida, routine follow-up to check for breast cancer return does not create a preexisting condition.
However, that changes only if cancer is found during follow-up.
π Where this applies: Florida
β How are newborns covered on a Companion Life short-term PPO plan in Florida?
Florida covers newborn transport to the nearest facility up to $1,000.
You also have 60 days to pay premium for a newborn. In addition, a dependent's newborn is covered for 18 months.
π Where this applies: Florida
β What Kentucky mandates apply to Companion Life short-term PPO plans?
Kentucky requires mental disorders, TMJ and AIDS coverage with no limits.
Home health care must also allow at least 60 visits. In addition, psychologists, social workers, chiropractors and podiatrists count as doctors.
π Where this applies: Kentucky
β Can I keep a Companion Life PPO plan in Kentucky if I leave the association?
Kentucky requires continuation of coverage if you lose eligibility only because you are no longer an association member.
π Where this applies: Kentucky
β What Louisiana rules apply to Companion Life short-term PPO plans?
Louisiana plans cannot exclude chiropractic care.
Plans also cover emergency services even if screening later shows no emergency, with some exceptions. In addition, premium changes require 45 days' written notice.
π Where this applies: Louisiana
β Can I be balance billed on a Companion Life PPO plan in Louisiana?
Possibly, because Louisiana certificates note that providers may bill up to their regular charges in some cases.
π Where this applies: Louisiana
β What Mississippi rules apply to Companion Life short-term PPO plans?
Mississippi covers applied behavior analysis for autism to age 8.
In addition, TMJ benefits have a $5,000 lifetime limit. You also get 30 days to give notice of a claim and 60 days' notice of rate changes.
π Where this applies: Mississippi
β What Nebraska rules apply to Companion Life short-term PPO plans?
In Nebraska, these plans cover oral chemotherapy like IV chemo and well-child care to age 16.
Telehealth also pays the same as in-person care. In addition, diabetes self-management training has a $500 limit every two years.
π Where this applies: Nebraska
β How does the free look work on a Companion Life PPO plan in Nebraska?
You have 10 days after receiving the certificate to cancel for any reason.
To do so, return it in person or by mail to the company, agency or agent. You then get a full premium refund.
π Where this applies: Nebraska
β Does a Companion Life short-term PPO plan cover mental health in Nevada?
Yes, Nevada plans cover severe mental illness for 40 inpatient and 40 outpatient days.
Substance use treatment also pays up to $9,000 a year inpatient. Plus, set amounts apply for withdrawal and counseling.
π Where this applies: Nevada
β What other Nevada mandates apply to Companion Life short-term PPO plans?
Nevada plans cover clinical trials, diabetes training and HPV testing.
In addition, inherited metabolic disease pays up to $2,500 a year. Women's health benefits also apply without copay or coinsurance.
π Where this applies: Nevada
β Are injuries while intoxicated covered on a Companion Life PPO plan in Nevada?
Yes, in Nevada a plan cannot exclude injuries that happen while intoxicated.
However, the plan can exclude an injury that happened while committing a felony.
π Where this applies: Nevada
β What Ohio rules apply to Companion Life short-term PPO plans?
Ohio plans cover autism screening and treatment under age 14, with visit limits.
In addition, the penalty for skipping pre-authorization cannot exceed $1,000. Ohio also gives you appeal rights for denials and rescissions.
π Where this applies: Ohio
β How fast must Companion Life pay claims in Oklahoma or Wyoming?
Companion Life must pay claims within 45 days in Oklahoma and Wyoming.
In Oklahoma, late claims also earn interest.
π Where this applies: Oklahoma and Wyoming
β What West Virginia mandates apply to Companion Life short-term PPO plans?
West Virginia plans cover chronic pain treatment up to 20 office visits.
They also cover diabetes care, including insulin. In addition, they cover annual Pap and HPV tests from age 18. Rehab for stroke, spinal injury and similar conditions is part of the benefits as well.
π Where this applies: West Virginia
β Is there an appeals process on a Companion Life PPO plan in Wyoming?
Yes, Wyoming certificates include both internal and external appeals.
However, the plan can deduct unpaid premium for the grace period from claims.
π Where this applies: Wyoming
β Can I get 12 months of short-term coverage in Texas?
Yes, you can get 12 months of coverage in Texas through a 12-month solution.
One enrollment links three 4-month short-term plans from three unaffiliated insurers. As a result, coverage continues with no break.
π Where this applies: Texas
β Do I answer health questions for each plan in the Texas 12-month solution?
No, you answer one set of eligibility questions for the Texas 12-month solution.
So each new policy starts without new underwriting.
π Where this applies: Texas
β Can I cancel the Texas 12-month short-term solution early?
Yes, you can cancel anytime before the term ends without a penalty.
π Where this applies: Texas
β What does the Texas 12-month short-term solution cover?
The Texas 12-month solution covers doctor visits, hospital stays, ER, wellness and preventive care, plus Rx discounts.
It also offers open access with no network restrictions. In addition, plans include unlimited office visit copays and one wellness visit.
π Where this applies: Texas
β Which insurance companies are in the Texas 12-month solution?
The flyer only says there are three unaffiliated carriers, without naming them.
A licensed agent can tell you which plans are included.
π Where this applies: Texas
π More Short-Term Coverage Guides
These answers cover both plans in short form. When you want more depth, these guides from our licensed agents explain how short-term coverage works. Then, if a question comes up, call 888-730-6001 anytime.
π Short-Term Coverage Guides
𧩠More Short-Term FAQ Libraries
π Questions About Quantum PPO or SureCare?
These answers cover the most common questions about both plans, but every situation is different. Therefore, our licensed agents compare them with ACA 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 Pan-American Life website, HealthCare.gov, and the National Association of Insurance Commissioners.
Vivna Insurance is an independent, licensed agency offering Companion Life and Pan-American Life products. We are not either insurer or their affiliates. Short-term plans are not ACA coverage and may not cover pre-existing conditions. Plans and availability vary by state.