Extra Info Type of coverage

What Limited Medical Indemnity Insurance?

  • Offers benefits for specified procedures up to a certain limit or cap. Thereafter, the insured is responsible.
  • Offers first-dollar coverage; there are no deductibles or co-payments.
  • Benefits are paid directly to the doctor/provider at the insured’s option.
  • Guaranteed Acceptance is based on NFM member eligibility and state availability; there are no medical questions or underwriting.
  • Although not designed to replace existing coverage, if applicable, it can be used as a supplement with a high deductible comprehensive plan.

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Most Common Exclusions:

  • Coverage is not provided to members age 65 and over; coverage will terminate at the end of the monthly billing cycle prior to turning age 65.
  • Routine health checkups or immunizations for covered person ages 6 and older except as specifically provided; allergy testing.
  • Spinal manipulations and manual manipulative treatment or therapy or physiotherapy.
  • Normal pregnancy or childbirth, except for complications of pregnancy.
  • Treatment or removal of warts, moles, boils, skin blemishes or birthmarks, bunions, acne, corns, calluses, the cutting and trimming of toenails, care for flat feet, fallen arches or chronic foot strain.
  • Treatment of mental or nervous disorders, or alcohol or substance abuse, unless specifically provided for under this plan. Prescription medicines; a discount prescription card is provided.
  • Changes to coverage can only be made only if the change is the result of a qualifying life event (marriage, divorce, the death of your spouse, or the birth or adoption of a child).
  • If coverage is cancelled, persons may not re-enroll until 6 months after their termination date.

 
 

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