Reduce Your Out-of-Pocket Health Insurance Costs with this New Benefit Option for State Employees That Lowers Monthly Premiums and Eliminates Deductibles, Coinsurance and Copays.*
Tired of giving up a significant portion of your paycheck each month for health insurance, only to be left with out-of-pocket expenses?
Pay an affordable monthly premium and eliminate your medical deductible and coinsurance.
It’s all possible with Pre-Med Defender!
Step 1: Choose the HealthChoice Basic Plan Option.
Step 2: Click the Enroll Now button to begin your PMD Enrollment.
Step 3: Print and sign
completed forms, then submit to your Supervisor/HR.
HealthChoice Basic Plan
Pre-Med Defender Supplemental Plan
Step 1: When seeking care, simply present BOTH your HealthChoice Basic Plan card and your Pre-Med Defender Supplemental Plan card.
Step 2: Pre-Med Defender coordinates with the carrier to determine your claim responsibilities.
Step 3: Claims can then be paid directly to your provider.
Benefits cover up to $4,000 for Single and up to $9,000 for family coverage that can eliminate or significantly reduce a family’s Maximum Out of Pocket (MOOP) exposure. First dollar coverage that can be utilized before their primary /catastrophic coverage begins.
Out-Patient benefits are paid at the same level as InPatient benefits.
PRE-MED DEFENDER covers an array of out-patient procedures and test including Emergency Room, Imaging, Laboratory & X-rays.
PRE-MED DEFENDER plan does NOT provide pharmacy coverage. Pharmacy benefits are covered under your HealthChoice Basic plan.
^ HealthChoice Basic plan pays the first $500 of eligible expenses. HealthChoice Alternative pays the first $250 of eligible expenses. Pre-Med Defender pays a calendar year benefit of up to $4,000 for individual / $9,000 for family towards eligible medical expenses. This is only a sample summary of each plan. For all plan benefits/limitations, contact each plan.
* Pre-Med Defender does not provide coverage for Prescription Drugs. Member will use their HealthChoice Basic Prescription Copay plan.
Frequently Asked Questions
Unpaid medical bills can create financial hardship for almost every family. Bankruptcy, depleted savings and loss of real estate are a few risks directly associated with medical plans that have high out of pocket exposure. Secondary coverage can eliminate or reduce that risk significantly. When you combine Pre-Med Defender to your HealthChoice Basic plan, you virtually eliminate your deductibles and coinsurance.
Since the PRE-MED DEFENDER coverage is a “true SECONDARY plan” to an existing Major Medical plan; we follow the same guidelines as your Primary Medical plan. So, if something is not covered or allowed by your Primary plan; then PRE-MED DEFENDER will not cover it as well. We also follow the waiting period and eligibility requirements of the in force medical plan.
No. PRE-MED DEFENDER does not cover prescription drugs. Prescriptions are covered under your primary HealthChoice Basic medical plan. Please refer to your 2024 Employee Benefits Guide for additional plan details.
For eligibility or claims assistance, call the customer service phone number located on the back of your Pre-Med Defender ID card.
With our PRE MED DEFENDER plan; participants and providers will understand that there are two forms of coverage and there are two different payer ID’s.
1. Primary care or major medical plan (Card One) and
2. PRE-MED DEFENDER Supplemental Plan (Card Two – “Secondary Coverage”).
Therefore, healthcare providers and or facilities should automatically send Primary Coverage claims information electronically for processing. Once that process has taken place and your initial claim is accepted and processed; our job is to make sure your provider has the information they need to make sure your “secondary benefits”; or PRE MED DEFENDER benefits are paid as well.
We have set up an electronic payer ID for your provider to file the claim electronically; let your Provider file the claim for the Major Medical plan (Primary) and your PRE MED DEFENDER plan (Secondary).
You will need to provide your primary medical card as well as the PRE MED DEFENDER card to the provider. Most providers will file the claim electronically because it is easy and they get paid faster. A claim contact phone number is printed on the ID card along with the claim’s payer information for the provider. If needed, our customer service staff can and will send a letter to each provider explaining how to file claims.
PRE MED DEFENDER will pay the applicable benefit percentage for the Covered Expenses up to the Coverage Year maximum. The Covered Person must be under a Doctor’s care, and the treatment must be for covered Injury or Sickness after the secondary deductible (If applicable) has been met.
Covered Expenses are the unpaid portion of charges for medical care, treatment and services that are eligible for reimbursement under and deemed allowable by the Policyholder’s other Health Benefit Plan, which are not excluded from coverage under the policy.
Yes. You must re-enroll in Pre-Med Defender during each annual enrollment period.
If you are a new hire needing to elect Pre-Med Defender coverage for 2023 or if you have experience a Qualifying Event in 2023, you can contact Joe Brining at (405) 615-6996 or via email at firstname.lastname@example.org.
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*Pre-Med Defender is the marketing name for the Supplemental Medical Expense Insurance underwritten by A rated insurance carriers. State specific provisions may apply. Pre-Med Defender helps to reduce out-of-pocket medical costs. Pre-Med Defender does not cover Prescription drugs. This site is for informational purposes only and provides sample summaries of each plan. For all plan benefits, limitations, and exclusions, contact each plan.