Preventive Care Expense Benefits

• Charges for mammography exams, pap smears, and prostate-specific antigen tests.
• Routine physical exam expenses, up to $150 per covered person, per calendar year.
• Immunization expenses.
• Charges for well-child care services as defined in the policy.

Major Medical Expense Benefits

• Daily hospital room and board and nursing services at most common semiprivate rate.
• Reasonable and customary charges for an intensive care unit.
• Hospital emergency treatment of an injury or illness.
• Surgery at an outpatient surgical center.
• Professional fees of doctors and surgeons (but not for standby availability).
• Dressings, sutures, casts, or other necessary medical supplies.
• Professional fees for outpatient services of licensed physical therapists.
• Diagnostic tests using radiologic, ultrasonographic, or laboratory services, in or out of the hospital.
• Local ground ambulance service to a hospital for necessary emergency care. Air ambulance, within the U.S., if requested by police or medical authorities at the site of an emergency.
• Charges for an operating, treatment, or recovery room for surgery.
• Dental expenses due to an injury which damages natural teeth if expenses are incurred within six months.
• Surgical treatment of TMJ disorders.
• Cost and administration of an anesthetic, oxygen, and other gases.
• Radiation therapy or chemotherapy.
• Prescription drugs.
• Hemodialysis, processing and administration of blood or components.
• Artificial eyes, larynx, breast prosthesis, or basic artificial limbs (but not replacements).
• Reconstructive surgery following covered surgery or to correct a birth defect of a child covered since birth.

Limitations

• Covered expenses for all diagnosis or treatment of mental or nervous disorders, mental incapacity, or substance abuse will be limited to a lifetime maximum benefit of $3,000. Outpatient diagnosis or treatment will be further limited to $50 per visit. As with any other illness or injury, inpatient care which is primarily for educational or rehabilitative care will not be covered.
• Outpatient expenses relating to diagnosis or treatment of any spine or back disorders will be limited to $50 per visit and to no more than six visits in any three-month period. CAT scan and MRI tests are not subject to this limitation.

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

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!