* Example of ACA Silver plan monthly premium vs. PivotCare Elite Plan 5 monthly premium with demographics of male, age 37, in the state of Illinois.

Most common claims families experience every year

Example — Ruptured Appendix

Procedure Description In-Network Charges
Removal of ruptured infected appendix $1,389.00
Anesthesia $1,139.00
4 day hospital stay (assume average daily cost of $2,296) $8,265.60
TOTAL $10,793.60  
Out-of-pocket expenses you pay —  
Procedure Description Zero Deductible Insurance Pays (Plan 3)
Removal of ruptured infected appendix $1,000.00
Anesthesia $200.00
4 day hospital stay (assume average daily cost of $2,296) $6,000.00  
TOTAL $7,200.00 paid by insurance
Out-of-pocket expenses you pay $3,593.60  
Procedure Description Major Medical Plan Insurance Pays*
Removal of ruptured infected appendix $0
Anesthesia $0
4 day hospital stay (assume average daily cost of $2,296) $3,643.60  
TOTAL $3,643.60 paid by insurance
Out-of-pocket expenses you pay $7,150.00 (includes deductible and coinsurance)

Example — Car Accident With Contusions and Fracture to Lower Leg Which Required Surgery

Procedure Description In-Network Charges
3 day hospital stay (assume average daily costs of $2,296) $6,199.20
Open reduction & internal fixation of leg fracture $3,339.00
Anesthesia $745.00
ER Admission $2,000.00
Plan Fracture Benefit
TOTAL $12,283.20  
Out-of-pocket expenses you pay —  
Procedure Description Zero Deductible Insurance Pays (Plan 3)
3 day hospital stay (assume average daily costs of $2,296) $9,000.00  
Open reduction & internal fixation of leg fracture $1,000.00  
Anesthesia $200.00
ER Admission $200.00
Plan Fracture Benefit $2,500.00
TOTAL $12,900.00 paid by insurance
Out-of-pocket expenses you pay $(616.80)  
Procedure Description Major Medical Plan Insurance Pays*
3 day hospital stay (assume average daily costs of $2,296) $159.36  
Open reduction & internal fixation of leg fracture $3,061.46  
Anesthesia $745.00
ER Admission $2,000.00
Plan Fracture Benefit $0
TOTAL $5,965.82 paid by insurance
Out-of-pocket expenses you pay $6,317.38 (includes deductible and coinsurance)

Example — Vaginal Hysterectomy Due to Uterine Cancer

Procedure Description In-Network Charges
Abdominal removal of uterus, cervix and lymph nodes on both sides of pelvis and aortic lymph node biopsy $3,582.00
Anesthesia for removal of uterus $1,836.00
3 day hospital stay (assume average daily costs of $2,296) $6,199.00
Critical Illness Benefit
TOTAL $11,617.00  
Out-of-pocket expenses you pay —  
Procedure Description Zero Deductible Insurance Pays (Plan 3)
Abdominal removal of uterus, cervix and lymph nodes on both sides of pelvis and aortic lymph node biopsy $1,000.00    
Anesthesia for removal of uterus $200.00
3 day hospital stay (assume average daily costs of $2,296) $4,500.00  
Critical Illness Benefit $5,000.00
TOTAL $10,700.00 paid by insurance
Out-of-pocket expenses you pay $917.00  
Procedure Description Major Medical Plan Insurance Pays*
Abdominal removal of uterus, cervix and lymph nodes on both sides of pelvis and aortic lymph node biopsy $0    
Anesthesia for removal of uterus $0
3 day hospital stay (assume average daily costs of $2,296) $5,329.00  
Critical Illness Benefit $0
TOTAL $5,329.00 paid by insurance
Out-of-pocket expenses you pay $6,288.00 (includes deductible and coinsurance)

* Assumes a $6,000 Deductible, 20% co-insurance & $7,150 maximum out-of-pocket
Schaumburg IL (60193)
Used www.fairhealthconsumer.org for average pricing
Hospital in-network charges are not available on Fair Health — used a 10% discount amount

money

Zero deductible
health plans

Get cash to pay for everyday services, like doctor office visits and hospital stays, with no deductible to meet.

confusion

Coverage for
active families

Affordable insurance for childhood immunizations, diagnostic lab work, office visits and more, at rates that fit nearly any family’s budget.

umbrella

Large provider
network

Access to one of the largest provider networks in the nation, with 96% of providers within 20 miles from home.

Introducing Zero Deductible Insurance

Get cash benefits with no deductible

Traditional major medical insurance has continued to rise in costs, and medical deductibles have only gotten larger. For young families on a budget, they either skip necessary wellness checks or are paying all of their medical expenses out-of-pocket before they can meet their deductible, which for most, is thousands of dollars.

With PivotCare, an affordable alternative to major medical insurance offered by Pivot Health, healthy families can spend less on their monthly premiums and get cash benefits for medical services without ever having to meet a deductible before their insurance kicks in.

Differences Between Zero Deductible and Traditional Health Insurance

Compare with traditional health plans
Traditional Major Medical Zero Deductible Insurance
Up to a $14,300 family deductible NO deductible
20%-30% coinsurance responsibility NO coinsurance
Required network for lowest cost Same benefit no matter the network
Referrals required for specialists No referrals necessary
Rate increases averaging 20% per year Rate stability with limited increases

This health insurance product is not considered minimum essential coverage under the Affordable Care Act, and you may be subject to the tax penalty.