Smokey Bones Online Benefits Information

PAN AMERICAN MEDICAL PLAN

Medical Plan Summary 

PanAmerican is a limited benefit indemnity plan that pays a clearly defined, fixed amount to help you cover the cost of common medical services, such as doctor’s office visits, hospitalization, intensive care, accidents, and much more. This limited benefit indemnity plan is designed to provide the most value for everyday healthcare expenses as opposed to plans that cover major illness and catastrophic injuries.

How to get the best from your Plan:

  • Call or go online to locate an in-network provider
  • Schedule your appointment
  • Visit provider and present ID card
  • Provider files claim
  • PPO Network applies discounts and forwards claims to Pan-American Life (insurance carrier)
  • If the claim is less than the allowable benefit amount in your plan, you owe nothing
  • If the claim is more than allowable benefit amount in the plan, you will owe the balance to the provider.

Benefit Description

Plan 1

Hospital Indemnity Benefit

Intensive Care

Substance Abuse

Mental Illness

Skilled Nursing Facility

$300 per day (Max to 60 days)

$600 per day (Max to 30 days)

$150 per day (Max to 30 days)

$150 per day (Max to 60 days)

$150 per day (Max to 57 days)

Doctor’s Office Benefit

$75 per day (Max 6 days)

Outpatient Diagnostic Labs

$35 per day (Max 3 days)

Outpatient Diagnostic Radiology

$70 per day (Max 4 days)

Outpatient Advanced Studies

$300 per day (Max 2 days)

Impatient Surgical Benefit

$1000 per day (Max 1 day)

Outpatient Surgical Benefit

$500 per day (Max 1 day)

Impatient Anesthesia Benefit

$250 per day (Max 1 day)

Outpatient Anesthesia Benefit

$125 per day (Max 1 day)

Emergency Room Sickness Benefit

$75 per day (Max 4 days)

 

The limited benefit indemnity plan alone does not constitute comprehensive health insurance coverage (major medical coverage) and does not satisfy the requirement of minimum essential coverage under the affordable care act. However, the preventive care plan offered as part of Panabridge Advantage (*2017 PBA Benefits Guide link below) does meet the individual responsibility requirement under the Affordable Care Act as it provides Minimum Essential Coverage. 

Click on link(s) below: 

Panabridge Advantage Summary of Benefits 

2017 PBA Benefits Guide

 

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