Platinum Plan Example

What Matt pays with only medical.

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Medical Expense Example When Paying with Medical Only
Matt’s medical expenses.1 Cost of service
Ambulance (ground) $150
Emergency room visit $180
Treatment of wrist, including pharmacy cost for pain medications $1,800
Arthroscopic knee surgery $3,300
Eight physical therapy visits $320
Total of actual expenses:

$5,750

What Matt gets paid if he has the Accident Protection Plan.

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Base Plan Coverage Example Payment
Base Plan coverage.2
  Payment amount
Ambulance (ground) $400
Emergency room visit $200
Initial physician visit $80
Total payment to Matt:
$680
Premium cost:4 $10/month
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Base Plus Enhanced Coverage Payment Example
Base + Enhanced Plan coverage.2
  Payment amount
Base plan coverage $650
Diagnostic X-ray exam $320
Wrist fracture treatment $960
Surgical ligament tear repair $800
Knee brace $280
Follow-up physician visit $80
Physical therapy sessions
($30 per day up to 6 days)
$360
Organized sports injury benefit3 $700
Total payment to Matt: $4,180
Premium cost:4 $22/month

1 Example reflects reimbursement rates for a high-deductible health plan based on UnitedHealthcare’s health care cost estimator. Matt reached his annual out-of-pocket maximum of $5,000 because of expenses with his accident.

2 Benefit amounts may vary by state.

3 Organized sports injury benefit provides an additional 25% coverage up to $10,000. In this example, the organized sports injury enhanced benefit provides an additional $700 ($2,800 X 25% = $700).

4 Example reflects premium rates for 500-employee company, 24-hour plan design, voluntary (100% employee-paid) funding option, employee-only coverage).