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Allstate Enhanced PPO Short Term Medical Plan

Plan Year:

2023

Health Insurance Carrier:

Allstate

This is a private health insurance option. This plan is underwritten, which means there are a few health questions we are required to answer and a prescription check. Unlike a Marketplace plan, this option will not include a free annual physical, have prescription benefits, or cover any preexisting conditions. One great benefit is the large national network. This plan is more like traditional health insurance where you have a deductible to be met before the insurance pays any portion of your medical expenses. After you meet your deductible the insurance will pay 100% of your medical expenses up to $1M.

Snapshot of benefits

This is a quick snapshot of the most popular copays, deductibles, and coinsurance that you would be responsible for on this plan. To learn what each of these terms mean, please visit our terms and definitions page. Copays and coinsurance listed are amounts that you would pay before deductible unless specified otherwise. This is not a full list of services included on the plan. This snapshot is not guaranteed to be accurate. To verify plan benefits or for full details please see the full summary of benefits or or get a complete terms of coverage on the health plan carrier's website.  

Individual Deductible

Individual Max out of Pocket

Family Deductible

Family Max out of Pocket

Doctor Office Visits

Urgent Care Visit

Er Visit

Ground Ambulance Transport

Coinsurance after Deductible 

Coverage Period Maximum

Child Immunizations

Preventative Care Screenings

Mental Health Visits

Labor & Delivery

Preferred Generic Rx

$10,000

$10,000

$30,000

$30,000

$0 copay after deductible

See full summary of benefits

See full summary of benefits

See full summary of benefits

0% after deductible

$1,000,000

Covered 100% after deductible

Applies to deductible/coinsurance

Not Covered

Not Covered**

No Rx Benefits

**This plan does not cover any expenses for pregnancy, except for complications of pregnancy. See full summary of benefits for limitations and exclusions. 

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Frequently Asked Questions

Why is pregnancy, prescriptions, preventative care, pre-existing conditions and mental health not covered on these plans?

The reason that private health plans can keep their monthly premiums so low is because they don't cover the most expensive medical services. These plans are designed for those that are healthy and make too much money to qualify for subsidies on the Marketplace. By not covering prescriptions, yearly preventative visits and screenings like mammograms, mental health and any pre-existing conditions, the health insurance company can keep their premiums much lower. 

What is considered a pre-existing condition?

A Sickness, Injury, or condition, including any related or resulting complications: for which medical advice, consultation, diagnosis, care, or treatment was received or recommended from a provider or prescription drugs were prescribed. The signs or symptoms reasonably should have caused or would have caused an ordinarily prudent person to seek medical advice, consultation, diagnosis, care, or treatment.

How do I get my ID card?

You'll receive your ID cards in the mail about two weeks after you sign up for this plan. Be on the lookout in your mail box for an envelope with the company's logo on it. You can also download and get a digital copy of your ID card in the member portal. Visit the website below or download the member portal app on your phone. If you need to see a provider before your ID cards arrive in the mail, your doctor's office will be able to look up your plan with your name and birthday. You can also call or text our office and we will help get you the right information. 

Is your doctor and hospital in network?

Here you can search on the provider's website to see if your preferred doctor and hospital are in network. One great benefit of private short term medical health insurance plans is that they have a large national network. So if you are traveling or are a snow bird, you'll be able to find in-network doctors and hospitals close to you. Have questions or need help searching? Please feel free to reach out to your agent. We're happy to help with this for free. 

Currently Enrolled with this plan? Log into your portal.

Below is the link to log into your client portal. Most companies have an app you can also download onto your phone. The best place to view information about your health insurance is through the member portal. The member portal gives you easy access to your plan details, claims information, deductible and out-of-pocket details, ID cards, and more. You can update your payment information in the member portal, too. Simply set up an account and login by clicking the member portal link below. If you have any issues logging in, just give us a call and we can help.  

Premium Payments

Premium payments is the monthly amount you pay for your health insurance plan. It is usually due on the first of each month. The initial premium, or binder payment, needs to be made before your plan starts. Be sure to watch your account to make sure the premium has been debited. Most carriers accept bank accounts, debit cards and credit cards as payment. If you need to update your account, you can log into your portal or call our office for help. 

Deductible? Copays? Coinsurance? What does it mean?

Learn the basic terms about health insurance to better understand your plan. Don't worry, most people don't know what these terms mean and how they apply to your plan. That's why we're here. Please contact us if we missed any terms or if you'd rather talk to us instead of read. 

Learn more about this plan and if you qualify for lower monthly premiums

This plan offers discounts if you can answer some additional health questions to qualify. Get a quote for you and your family or book an appointment with a local Utah health insurance agent. You can book a phone, virtual or office appointment. 

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Schedule a consultation with a local Utah health insurance agent

We're happy to meet with your in-person or over the phone to help you with your health insurance needs. We can help you with health insurance on or off the marketplace, Medicare Advantage & supplements, dental insurance, vision insurance, life insurance or accident plans. Thank you for letting us be your advocate. Best part, is our help is always free! 

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