Wagner Insurance Agency of Greater Dayton Ohio

Basic Health Plan

The most affordable health insurance is available to those who prefer basic coverage.

With a Basic Plan, less money is spent on options that you don't want.

You pay...the calender-year deductible (Maximum 3 per family per year). We pay...80% to the coinsurance limit. Then we pay...100% (For remaining covered expenses each calender year.

Subject to all policy provisions, the following expenses are covered.

Preventive Care Expense Benefits

Charges for mammography exams, pap smears, and prostate-specific antigen tests.

Inpatient Expense Benefits

Daily hospital room and board and nursing services at most common semiprivate rate.
Reasonable and customary charges for an intensive care unit.
Drugs and medicines.
Dressings, sutures, casts, or other necessary medical supplies.
Artificial limbs, eyes, larynx, or breast prosthesis (but not replacements).
Charges for outpatient diagnostic testing performed before an inpatient confinement that begins within three days of testing.
Professional fees of doctors and surgeons (but not for standby availability).
Hemodialysis, processing, and administration of blood or components.
Charges for an operating, treatment, or recovery room for surgery.
Cost and administration of an anesthetic, oxygen, and other gases.
Radiation therapy or chemotherapy.
Diagnostic tests using radiologic, ultrasonographic, or laboratory services.

Outpatient Expense Benefits

Charges for outpatient surgery, including:

the fee made by an outpatient surgical facility;
the fee for the primary surgeon;
the fee for the assistant surgeon; and/or
the fee for administration of anesthetic.

Hemodialysis, radiation, and chemotherapy.
Prescription drugs to protect against organ rejection in transplant cases.

Outpatient Testing Expense Benefits

CAT scan and MRI testing.
Diagnostic testing, related to and performed within three days of surgery or inpatient confinement.

Exclusions

Expenses incurred for mental or nervous disorders or substance abuse.
Outpatient prescription drugs (except as provided for under Outpatient Expense Benefits).
Outpatient medical services, including doctor office visits and diagnostic testing (except as provided for under Outpatient Expense Benefits and Outpatient Testing Expense Benefits above).

For information on additional Basic Plan Provisions, including Transplant Expense Benefit, Limited Exclusion for AIDS and HIV-Related Disease, Preexisting Conditions, General Exclusions, General Limitations, and Pre-certification & Utilization Review, call us at (937)223-2232 or email us at insure@wagnerinsurance.com

Important Note:
Premiums for a Basic Plan are significantly less because coverage is not provided for most outpatient services (doctor office visits, diagnostic testing, and prescription drugs).

World of FACT Value

FACT makes it possible for members to pick and choose from a full menu of important benefits:

Prescription drug discounts
Eye-wear savings
Van line discounts
Vitamins, minerals, and other health products at a 20% savings
Health insurance plans
Utilization review services
Consumer library
Consumer hotline referral service
Amusement park discounts
Travel service and savings
Informative newsletter
Other special buying opportunities as they become available throughout the year

Plus . . .

You may apply for: FACT scholarships, classroom grants, and community project grants
You are eligible to request: Financial assistance in the event of a natural disaster
You are kept aware of matters of importance through: FACT's legislative watch

Benefits and suppliers change from time to time. For the most current information: Visit FACT's Web site:
http://www.fact-org.org.
Or call toll-free: 1-800-USA-FACT.

These health insurance plans are available as group coverage only to members of FACT. If you're not already a member, you must join FACT.

When you join FACT and sign up for insurance with us, you enjoy group benefits and maintain your independent status!

Basic Plan - Coverage for the more costly health care needs

We now offer a Basic Plan^SM, the affordable alternative to traditional health insurance protection. This plan costs a lot less than traditional coverage.

It's the perfect coverage for individuals who:

Believe cost is the bottom line;
Need affordable health coverage for only the more costly health care needs; and
Prefer the basics in covered expenses.

For More Information:

If you have questions or desire further information regarding Basic Plan, including costs, benefits, exclusions, limitations, and renewal terms, please contact us at:
(937)223-2232

Review Our
Plan 100^® / Plan 80^SM