Ca$hBack Plan^SM Frequently Asked Questions

 

Q: How can accident and hospital reimbursement coverage benefit me?

A: Medical insurance premiums have been increasing much faster than the rate of inflation. Deductibles and co-insurance expenses have gone up, too. Supplemental coverage provides you with money to help pay for accidental injury and hospital expenses.

 

Q:  I do not have a health plan through my employer because I'm covered under my spouse’s insurance. Am I eligible for this coverage?

A: Yes, you are eligible for this coverage regardless of any other health insurance plans. You may also choose to cover your dependents, including your spouse.

 

Q: If I have a claim, should I wait for my health insurance to process it first?

A: No, you do not need to wait to submit your claim. Covered expenses and reimbursement for eligible claims are paid directly to you, independent of when your main health insurance carrier pays your health care provider.

 

Q: How do I submit and check on the status of a claim?

A: You will receive instructions for accessing claim information online after enrollment. Claim forms and instructions to submit a claim or check claim status are available on your MedBen Access page. You may also contact Customer Service to check on the status of a claim. See the claim form for details for how to submit your claim.

 

Q: Who is MedBen^® and what is MedBen Access^®?

A: Nationwide^® has partnered with MedBen^® to provide administrative services. Once you have enrolled in coverage, we will provide you with access to the MedBen Access website in which you can check the status of claims and view your plan documents.

 

Q: Will benefits be paid directly to my health care provider?

A: No. Reimbursement for medical expenses will be paid directly to you.

 

Q: When can I expect claim reimbursement for my covered expense?

A: You may view the status of your claim online or contact customer service with questions pertaining to claims. Most claims submitted with proper documentation will be processed within 15 business days. Please allow additional business days for check delivery by mail.

 

Q: What types of doctors are covered for accidental injuries?

A: You can visit the doctor/provider of your choice, as long as your treatment is directly related to your accident. Providers must be properly licensed or certified to provide medical care under the laws of the state of practice and include doctors, health care facilities, urgent care facilities, or other health care practitioners, including but no limited to: Doctor of Dentistry (D.D.S. or D.M.D.), Doctor of Podiatry (D.P.M.), Doctor of Optometry (O.D.), Doctor of Chiropractic (D.C.), Doctor’s Assistant (P.A..), Psychologists (Ph. D.), Nurse (R.N. or L.P.N), or Physical Therapist (P.T. or R.P.T.).

 

Q: I have an FSA through my employer. Can I submit a claim for reimbursement and also request reimbursement from my FSA?

A: Please contact your HR/Benefits representative. You may be eligible to request reimbursement for any portion of your direct expenses not already reimbursed.

 

Q: Will my coverage remain intact if I no longer work for my employer?

A: No. These products are not transferable or portable.

 

Q: How are premiums paid?

A: Your premiums will be paid via payroll deduction. You will not receive bills or handle payments.

 

Q; I hurt my knee in a ski accident two years ago and have recurring problems. How does this affect my accident coverage?

A: Eligible expenses must be incurred within 90 days of the event that caused the injury.

 

Q: I was diagnosed with a condition in December of ‘08, and my coverage took effect on January 1st, 2009. The condition requires surgery and a week long hospital stay in March 2009. Will my hospitalization be covered?

A: If you have a pre-existing condition and treatment for the condition occurs within six months prior to enrollment, coverage will not start for claims involving that condition for one year from the date of enrollment. (Six month lookback-12 month waiting period).

 

Q: What if I have the combination Accident & Hospital Ca$hBack Plan and my claim exceeds the lifetime maximum?

A: Coverage will terminate when the lifetime maximum is met.

 

Q: What if I become disabled?

A: If your premium payment has been submitted through your employer when you are disabled, your coverage will continue.