“I have been with
Educators most of my life, they are the best.”
AT EDUCATORS MUTUAL, we
provide comprehensive health benefit plans with access to an outstanding
network of physicians and facilities.
Plans can be designed to fit your needs and budget. Customer service is handled fast and friendly
by real people. Educators maintains one of the highest
satisfaction ratings in the industry. Whether
you need help creating a new health care plan or looking for a better provider,
we invite you to experience the real value in your benefits with Educators
Mutual.
FEATURES
Comprehensive
benefit plans
Access to all IHC
Hospitals
Custom plan design
to fit your needs and budget
Excellent discounts
through Educators ancillary provider networks
World class claims
processing
Industry’s highest
overall satisfaction rating
Freedom to use any
provider
Fast, friendly customer service by dedicated representatives
WE MAKE IT EASIER
With
our fast friendly benefit plan design team, we can custom design your health
care plan to fit your every need. Educators is committed to being your long term benefit provider
and will ensure your plan's success from the initial design to implementation.
ON SITE SERVICE GUARANTEE
Each
month, one of our knowledgeable representatives will come to your organization
to help with enrollment, present plan highlights, and answer questions.
DECREASED RISK OF FRAUD
With
a perfect balance of internal controls and quick claim processing turn around,
Educators is unique in that it audits itself regularly to ensure the most
accurate processing of claims. This
control helps to keep premium costs down and benefits at a maximum.
REAL CUSTOMER SERVICE
Educators
has a team of customer service representatives standing
by waiting to help. It is their goal to
answer your calls within 20 seconds.
FREEDOM TO CHOOSE
With
the freedom to choose any provider, you have the power to control your standard
of care. Medical plans can also include
the many IHC hospitals and urgent care centers. Provider Search
REVENUE INCREASES YOUR BENEFITS
Unlike many competitors, Educators Mutual Insurance Association is a
non-profit entity. This means that
instead of shareholder dividends, earnings remain in the Association enabling
an enhanced offering of benefits.
EDUCATORS CarePlus™ SAMPLE MEDICAL PLAN
|
Educators Mutual CarePlus |
Participating
Provider
Option |
Non-participating Provider
Option |
|
|
GENERAL
INFORMATION |
|
|
First Dollar Deductible (Per Person / Family
Per Year) |
None |
$400
/ $800 |
|
Out-of-pocket Maximum (Per Person / Family Per
Year) |
$2,000
/ $4,000 |
$4,000
/ $8,000 |
|
|
HOSPITAL
AND FACILITY BENEFITS |
|
|
Medical / Surgical / Maternity / Intensive
Care (semi-private room) |
$200
then 10% |
50%
after deductible |
|
Emergency Room (ER) |
$100
then 10% |
50%
after deductible |
|
Urgent Care Clinic |
$35 |
50% after
deductible |
|
|
PHYSICIAN
AND PROFESSIONAL
SERVICES |
|
|
Routine Preventive Exams (1 visit per Plan
year) |
$10 |
Not
covered |
|
Physician Office Visits (primary care) |
$10 |
50%
after deductible |
|
Physician Office Visits (secondary care &
after hours) |
$20 |
50%
after deductible |
|
Routine Prenatal and Delivery |
10% |
50%
after deductible |
|
Major or Minor Diagnostic Test, X-ray, Lab |
10% |
50%
after deductible |
|
Surgery, Injections, Anesthesiology, Radiology, Pathology |
10% |
50%
after deductible |
|
Chiropractic Therapy (20 visits per year) |
$20 |
50%
after deductible |
|
|
PRESCRIPTION
DRUG BENEFITS |
|
|
Retail Pharmacy (30 day supply) |
$5 Generic
/ $25 Preferred Brand / $50 Non-Preferred Brand |
$5
Generic / $25 Preferred Brand / $50 Non-Preferred Brand |
|
Mail Order (90 day supply) |
$10
Generic / $50 Preferred Brand / $100
Non-Preferred Brand |
$10
Generic / $50 Preferred Brand / $100
Non-Preferred Brand |
|
|
MEDICAL
SUPPLIES AND EQUIPMENT
BENEFITS |
|
|
Medical Supplies |
20% |
50% after
deductible |
|
Durable Medical Equipment |
20% |
50%
after deductible |
|
|
MENTAL
HEALTH BENEFITS |
|
|
Inpatient Physician Visits / Facility
Semi-private Room |
50% |
50%
after deductible |
|
Outpatient Physician Office Visits |
50% |
50%
after deductible |
|
|
ACCIDENT
AND LIFE THREATENING
CONDITION |
|
|
|
20% |
Covered
as a participating benefit |
The
Educators Medical Plans are underwritten by Educators Health Care or Educators Health Plans Health.
*Plans
may vary