ultimate health: member overview - armadaglobal · dental, vision, prescription and other 213(d)...
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ULTIMATE HEALTH: MEMBER OVERVIEWThe Ultimate Health insurance policy is a supplemental healthcare reimbursement plan provided to you by your company. Since 2004, Ultimate Health has been delivering excellent member support, innovative conveniences and valuable health services.
RAPID MEDICAL REIMBURSEMENT Ultimate Health provides a broad range of robust supplemental coverages for medical, dental, vision, prescription and other 213(d) eligible expenses, going beyond what is typically offered by your primary plan. See the next page for examples of what is covered, though your Certificate of Insurance is the best place to find your insurance plan’s coverage specifics. Refer to the benefits chart on the fourth page to see your benefit levels.
NEW MEMBERSThis information will help give you the basics to get familiar with your insurance plan until you receive your Ultimate Health welcome materials.
CURRENT MEMBERSUse this information packet as a refresher on all the benefits and services included with your Ultimate Health insurance plan. Remember, your Member Portal can provide you with more detailed information. You can access your Member Portal at www.ArmadaCare.com/myaccount.
DIAMOND
QUICK LINKSTo familiarize yourself with your
Ultimate Health insurance plan, please:
Access the Member Portalwww.ArmadaCare.com/myaccount
Sign up for direct depositwww.ArmadaCare.com/GoDirect
Prescription Sunglasses & Designer Frames
Brand Name Prescriptions(Lipitor, Viagra, Nexium, etc.)
Medical Equipment
Custom Orthotics
Hearing Aids
Adult Orthodontia (& Child)
Contacts
Acupuncture
In Vitro Fertilization
Prescribed Massage Therapy and
Chiropractic Care
Crowns & Bridges
WigsLASIK
Elective Executive Physicals
ULTIMATE HEALTH HAS YOU COVERED
Ultimate Health provides coverage for various types of healthcare expenses, filling the coverage gaps in most primary care plans.
1-855-943-4595 [email protected]
Insurance plans and coverage may vary by state. Detailed coverage and exclusions and limitations are listed in the Certificate of Insurance.
TopDoc Connect: Whether facing a routine or serious diagnosis, we understand that it’s difficult to know where to turn, especially while feeling the pressure to take action. With TopDoc Connect, you receive objective guidance and access to specialty care. We’ll quickly connect you to the right specialists with proven expertise to treat your specific condition* in order to speed you on your journey to better health.
To request this service, visit www.ArmadaCare.com/TopDoc or call Member Services.
*Not including behavioral health or addiction
Executive Physicals: Ultimate Health includes an elective Executive Physical Program that provides coverage toward and coordination of executive physicals. The plan reimburses for Executive Physicals up to the stated plan benefit limits. We’ll also help you find a quality location to have the physical.
For details on how to file these types of claims, see the “How to File Your Executive Physical Claims” flier on your Online Resource Guide.
What are Executive Physicals?
Executive Physicals are designed for early detection of medical conditions. In addition to a physical exam, these typically day-long physicals include a battery of tests, which are completed on the same day at the same facility. At the end of the top-to-toe physical, the physician reviews the available exam results and outlines areas for improvement to help avoid major health issues. If needed, follow-up care is also recommended. We can assist in finding specialists for follow-up care with TopDoc Connect.
Get Me Home: Our Get Me Home emergency travel program includes a suite of travel support services to keep you protected while away from home. The services are available whether you’re traveling domestically or internationally for business or pleasure.
The program offers fully-paid medical air evacuation if you’re hospitalized 100 or more miles from home to transport you to a hospital of your choosing that is closer to home once you are stabilized. You also have access to a number of other travel and medical emergency support services, like urgent medical and dental referrals, facilitation of hospital payments, and replacement of lost or stolen prescriptions, passports and other items! There’s also a mobile-friendly travel portal that houses destination intelligence reports and security assessment ratings.
To access these services 24/7, please refer to the phone numbers on your Membership Card.
For more detailed information about these services, please refer to your Member Portal at www.ArmadaCare.com/myaccount.
1-855-943-4595 [email protected]
ADDITIONAL FEATURES
In addition to healthcare expense reimbursement, Ultimate Health includes other beneficial services to support your health while at home and on the road.
1-855-943-4595 [email protected]
Insurance plans and coverage may vary by state. Detailed coverage and exclusions and limitations are listed in the Certificate of Insurance. Get Me Home is available 100+ miles from home and is subject to the terms, conditions, limitations and exclusions provided by ArmadaCare’s designated provider and as defined in the policy and corresponding certificate of insurance. TopDoc Connect is facilitated by ArmadaHealth and subject to their terms and conditions; ArmadaHealth is not a provider of healthcare or medical treatment or advice.
THE ULTIMATE HEALTH DIFFERENCE
CONVENIENCESYou can submit your claims online using a secure Member Portal and from your phone using our mobile app. Our average processing turnaround time is 5 to 7 business days from claims receipt, and we issue direct deposits to members’ bank accounts on a daily basis. There’s also a prepaid Prescription Visa® Card to pay for eligible prescription expenses right at the pharmacy.
YOUR BENEFITS AT-A-GLANCE: DIAMOND
Benefits Type Samples of What is Covered (Not a Complete List)
Medical (Per-Occurrence*) Deductibles, co-pays, balance bills or other out-of pocket costs for medically necessary services $10,000
Additional Plan Benefit Types and Maximums: Per Covered Person
Dental Treatments Routine dental, orthodontia, crowns and bridges $5,000
Vision Treatments LASIK eye surgery, contact lenses and prescription sunglasses $1,500
Mental Health Mental and substance use programs $3,000
Prescriptions Co-pays, brand name and lifestyle prescriptions $3,000
Medical Equipment Durable medical equipment, wigs and hearing aids $5,000
Wellness Treatments Acupuncture, massage therapy and chiropractic care $1,500
Elective Executive Physicals Top-to-toe physical for the primary member and enrolled spouse $2,500 each
Annual Family Maximum $100,000
Premiums, plans and programs vary by state. For detailed coverage information and plan exclusions and limitations, refer to your specific Certificate of Insurance.
*Covered medical expenses that are incurred by the same covered person during any one plan year and that result from the same or related injury, condition and diagnosis.
Ultimate Health is underwritten by Transamerica Financial Life Insurance Company (TFLIC), Harrison, NY, and Transamerica Premier Life Insurance Company (TPLIC), Cedar Rapids, IA. TFLIC is authorized to conduct business in New York. TPLIC is authorized to conduct business in all other states.
1-855-943-4595 [email protected] MBO037 12/19
122749 02/20