How does my  Limited Medical Plan work?

ALTA offers two different insurance plan designs. Indemnity plans and Co-pay plans with Coinsurance. Both plans include an assignment of benefits provision. Benefit amounts for reimbursement or assignment to providers are shown within the Schedule of Benefits. If you utilize a PPO provider or hospital, your fees/charges for services will be reduced. Co-Pay and Coinsurance plans are unique to the extent they mirror traditional managed care plan designs, with limits on a per occurrence basis. Limited Medical Plans are not Major Medical plans.

Does this Plan cover maternity?

Yes. Maternity is covered the same as any other illness, and the plan will pay benefits out for whatever line of coverage it falls under, subject to the limits of the plan.

If I have other coverage, will my Limited Medical Plan
  still pay benefits?

Your Limited Medical Plan pays in addition to any other health insurance plan you may have. (subject to policy limitations)

Is this Major Medical coverage?

No. This is not major medical coverage.

Which doctors and hospitals may I use?

You are free to use any licensed doctor or any certified hospital in the United States. You may also choose to go to a PPO Network Provider and receive discounts for hospital and physician services.

Why should I use a PPO Network provider?

You can reduce your out-of-pocket expenses because the PPO Network provider will charge a discounted fee for his or her service.

Am I allowed to assign my benefits to my Healthcare Provider?

Yes. Benefits are fully assignable to your Healthcare Provider.

What pharmacies can I go to?

ALTA Health Plans include a national network of over 58,000 providers nationwide, including but not limited to those found at Walgreens, CVS, Albertsons and Target stores.


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