Enhanced CHOICE

Enhanced CHOICE

About the Plan
The Farm Bureau Health Plans Enhance CHOICE plan is ideal for those who are looking for a health plan with preventative health, dental and vision benefits and who are not eligible for a government subsidy. 

Farm Bureau Health Plans uses UnitedHealthcare Choice Plus Network. Please keep in mind that in-network payments are based on negotiated fees. If an out-of-network provider is used, the member’s liability will increase significantly.

Resources
Provider Network
Schedule of Benefits

  In-Network Out-of-Network

CALENDAR YEAR DEDUCTIBLE (CYD)

(Unless otherwise indicated, all benefits are subject to CYD)

$3,000
$6,000

OUT-OF-POCKET MAXIMUM (OOP)

(Once the OOP maximum is met, benefits are provided at 100% for a member for the remainder of the calendar year. This applies to in-network provider services only. Copayments do not apply to OOP and must still be paid after OOP is met)

$3,000 CYD:

$12,000

$6,000 CYD:

$24,000

Unlimited
LIFETIME BENEFIT MAXIMUM Unlimited

  In-Network Out-of-Network

OFFICE VISIT

(Not subject to CYD or OOP)

$40 copayment per visit

CYD/Coinsurance

COINSURANCE

(Based on the maximum allowable charge)

0% for covered preventative services (Plan pays 100%)

20% for all other covered services (Plan pays 80%)

40% (Plan pays 60%)

PREVENTATIVE CARE BENEFITS In-Network Out-of-Network

(NO WAITING PERIOD)

(Plan pays 100%)

(Plan pays 60%)

Preventative health exam1

0%

40%

Annual well woman exam2

0%

40%

Routine colonoscopy3

0%

40%

Annual routine PSA4

0%

40%

Routine physical exam

0%

40%

EMERGENCY ROOM
Not resulting in admission

$75 deductible per visit
(in addition to CYD)

PRESCRIPTION DRUG COVERAGE
Unlimited calendar year maximum

  • In-Network | Farm Bureau Health Plans will reimburse 80% of the maximum allowable charge, after CYD Out-of-Network | Farm Bureau Health Plans will reimburse 60% of the maximum allowable charge, after CYD
  • Home delivery service is also available

DENTAL

Routine dental services, including two exams, x-rays and fillings per calendar year. Services are subject to CYD and coinsurance; quantity and visit limits.

  • Pediatric Only
    • No calendar year dollar maximum
    • Limited orthodontic care
  • Members Age 19 and Older
    • There is a $40 copay for preventative and restorative services
    • Maximum benefit per calendar year is $500

VISION

Pediatric Only - Routine vision benefits including eye exams, eyeglasses and contact lenses

  • Eye exams are covered at 100% once every calendar year
  • Eyeglass or contact lenses are covered once every calendar year subject to CYD and coinsurance
  • Eyeglass frames are covered once every calendar year subject to CYD and coinsurance

Members Age 19 and Above – Benefits are available for routine eye exams, eyeglass or contact lenses

  • Eye exams are covered once every calendar year with a limit of $40
  • Eyeglass or contact lenses are covered once every calendar year with a limit of $100
FOOTNOTES

1. 
Preventative health exam for adults and children and related services as outlined below and performed by the physician during the preventative health exam or referred by the physician as appropriate, including: 2. Annual well woman exam –
  • Routine well woman preventative exam office visit
    • Cervical cancer screening
    • Screening mammography at age 40 and older, with one baseline mammogram between the ages of 35 and 39
    • Other USPSTF screenings with an A or B rating 
    • Pap smears 
    • Bone density measurement screening
3. Colorectal cancer screening for members age 50 and older

4. Prostate cancer screening for men age 50 and older

Benefits will not be provided for any pre-existing condition until a member has completed a waiting period of at least six months. A pre-existing condition is defined in the contract as “An illness, injury, pregnancy or any other medical condition which existed at any time preceding the effective date of coverage under this contract for which medical advice or treatment was recommended by, or received from, a provider of health care services; or symptoms existed which would cause an ordinarily prudent person to seek diagnosis, care or treatment.”

*A copayment will be applied to each office visit for the covered services performed in the office and provided and billed by a physician who is an in-network provider. The remaining charges for covered services rendered during the office visit will be paid at 100% of the maximum allowable charge. If a physician who is an out-of-network provider is utilized for covered services, benefits will be determined on the basis of the out-of-network coinsurance percentage after deductible is met.

Copayments do not apply to the following services: advanced radiological imaging, allergy testing and injections, biopsy interpretation, bone density testing, cardiac diagnostic testing, chemotherapy services, chiropractic services, dental services except preventative and restorative for all Members (and pediatric only), diagnostic services sent out, durable medical equipment, growth hormone injections, IV therapy, Lupron injections, mammography, maternity services, nerve conduction studies, neuropsychological or neurological tests, nuclear cardiology, nuclear medicine, orthotics, preventative services as indicated in contract, prosthetics, provider administered specialty pharmacy products, sleep studies, surgery performed in a physician’s office and related surgical supplies, Synagis injections, therapeutic/rehabilitative/habilitative services, ultrasounds and vision services.

These services are subject to the terms and conditions of the contract and deductibles and coinsurance will apply except where otherwise indicated. Copayments will not be applied toward deductibles or out-of-pocket maximums.

Ready to Enroll?

Farm Bureau Health Plans is proud to offer quality coverage at an affordable cost.

Medicare Supplements Insured by TRH Health Insurance Company, Columbia, TN.
TRHH-POST-POLA-FL14-174; TRHH-POST-POLB-FL14-175; TRHH-POST-POLC-FL14-176; TRHH-POST-POLD-FL14-177; 
TRHH-POST-POLF-FL14-178; TRHH-POST-POLG-FL14-179; TRHH-POST-POLM-FL14-180; TRHH-POST-POLAN-FL14-181
Not connected with or endorsed by the U.S. or state government. This is a solicitation of insurance. A representative of TRH Health Insurance Company may contact you. Benefits not provided for expenses incurred while coverage under the policy is not in force, expenses payable by Medicare, non- Medicare eligible expenses or any Medicare deductible or copayment/coinsurance or other expenses not covered under the policy.

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