TruGap Hospital

ACA Health Insurance Supplement (Inpatient Only)

THIS IS A LIMITED SUPPLEMENTAL PLAN ONLY. THIS IS NOT MAJOR MEDICAL COVERAGE. TruGap Hospital is designed to supplement your Affordable Care Act (ACA) major medical plan which must be enrolled in separately. Ensure that you are enrolled for coverage under an ACA qualifed Bronze health plan prior to enrolling in TruGap Hospital.

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ACA Health Insurance Supplement

TruGap Hospital supplements your Bronze Afforable Care Act (ACA) Major Medical health plan for Inpatient hospital expenses, reducing your out-of-pocket exposure under that plan's coverage by up to $7,500 per Covered Person per Calendar Year.

Bronze ACA plans have the lowest monthly premiums but the highest out-of-pocket costs, with the majority of Bronze plans having an individual out-of-pocket maximum (including coinsurance and copayments) of over $9,000 with an individual deductible amount of at least $5,500.

TruGap Hospital is designed to help reduce your overall healthcare costs by paying up to $7,500 of your Bronze ACA plan's out-of-pocket costs (per Covered Person; up to $15,000 per family) for hospital stays.

Benefits are payable for any out-of-pocket deductible, copayment, and coinsurance amounts incurred under the Covered Person's ACA Major Medical plan while the covered person is an inpatient in a hospital¹, subject to the TruGap Hospital Supplemental Deductible, limitations and exclusions, Waiting Period² (if applicable), and Calendar Year Maximum Benefit.

All family members enrolled in TruGap Hospital must be enrolled in a Bronze ACA Major Medical plan to be eligible for benefits.

This plan must be paired with a Bronze ACA Plan.

¹Benefits payable under this coverage are limited to any out-of-pocket deductible, copayment, and coinsurance amounts incurred under the Covered Person's underlying ACA Major Medical plan while the Covered Person is an Inpatient. This plan does not cover outpatient medical expenses, outpatient prescription drugs, or any expense for which benefits are not payable under the Covered Person's ACA Major Medical plan. Other exclusions apply. Please see the Certificate of Insurance for full details including all terms, descriptions, state variations, limitations, and exclusions of coverage.

Read the Certificate of Insurance carefully. This is a brief description and is not an insurance contract, nor part of the Certificate of Insurance. If there are any discrepancies between this description and the Certificate, the Certificate will govern.

Calendar Year Plan: All benefit amounts and deductibles renew annually on January 1st regardless of your enrollment / effective date.

²30-Day Waiting Period after the Effective Date upon initial enrollment only. No waiting period will apply when coverage renews annually on January 1st. Family members added to the plan after the Effective Date will be subject to the 30-day waiting period as a Late Entrant.

³Your healthcare provider(s) will file claims and be paid any benefit amount directly. Be sure to give your TruGap plan ID card or coverage information to your healthcare provider(s) along with your ACA major medical coverage information.

Coverage ends when the Covered member turns 65 year old.

Insurance coverage underwritten by SiriusPoint America Insurance Company.

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Paramount RX Prescription Drug Discount Program

Retail Pharmacies

While the TruGap Hospital plan does not cover prescriptions, with your TruGap plan, you will receive a FREE Paramount RX® Prescription Discount Card to use at retail pharmacies and for your pets! Learn more by viewing the details below.

Paramount RX^® is a nationally recognized prescription discount program that provides discounts on all FDA approved prescription drugs. The nationwide network includes over 57,000 pharmacies, including all national and regional chains, as well as many local community pharmacies.

Pet Medications

Members can save hundreds of dollars or more per year on pet medications with retail pharmacy and online discounts. Our Pet RX customer service team is also available to assist utilizing the program for maximum savings.

¹ Savings can vary greatly depending on the individual drug and the participating pharmacy. The agreed upon discount rates and network prices can vary by pharmacy contract. It is important to research pharmacies in your community to find the best available price using the online search tool. In any case where the participating pharmacy's retail price is lower than the discounted network price, you will pay the lower retail price.

This is not insurance -- discount only.

There is no cost to the member for this FREE prescription discount card. Read the guide carefully. This is a brief description of a prescription discount program through Paramount RX® and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.

SiriusPoint America Insurance Company does not offer and is not affliated with the discount programs offered in connection with Paramount RX® or membership in United Business Association.

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30-Day Satisfaction Assurance Policy for TruGap Hospital

If for any reason you are not completely satisfied with your enrollment, just notify us anytime up to thirty (30) days after your Effective Date to cancel and receive a full refund of all dues, premiums, or fees paid.

Notice: for any enrollment in a program or product that provides insurance benefits or coverage, enrollment costs cannot be refunded if an insurance claim has been filed.

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This is a brief description of the benefits included with TruGap Hospital. Please review the document(s) below for full details, including terms, conditions, limitation, and exclusions. Certificates of insurance are the official state-specific explanations of insurance benefits, which supercede any benefit descriptions provided here or elsewhere, so be sure to read the Certificate(s) carefully.

You must be a member of the United Business Association (UBA) in order to enroll in the supplemental TruGap Hospital plan. Membership dues are $10 per month for the entire family and are separate from the TruGap Hospital plan costs. View for Membership details.

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TruGap Hospital Certificates of Insurance

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TruGap Comprehensive

ACA Health Insurance Supplement (Inpatient & Outpatient)

THIS IS A LIMITED SUPPLEMENTAL PLAN ONLY. THIS IS NOT MAJOR MEDICAL COVERAGE. TruGap Comprehensive is designed to supplement your Affordable Care Act (ACA) major medical plan which must be enrolled in separately. Ensure that you are enrolled for coverage under an ACA qualifed Bronze health plan prior to enrolling in TruGap Comprehensive.

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ACA Health Insurance Supplement

TruGap Comprehensive supplements your Bronze Afforable Care Act (ACA) Major Medical health plan, reducing your out-of-pocket exposure under that plan's coverage by up to $7,500 per Covered Person per Calendar Year.

Bronze ACA plans have the lowest monthly premiums but the highest out-of-pocket costs, with the majority of Bronze plans having an individual out-of-pocket maximum (including coinsurance and copayments) of over $9,000 with an individual deductible amount of at least $5,500.

TruGap Comprehensive is designed to help reduce your overall healthcare costs by paying up to $7,500 of your Bronze ACA plan's out-of-pocket costs (per Covered Person; up to $15,000 per family), potentially reducing your actual out-of-pocket exposure to significantly less than that of even Gold ACA plans.

Benefits are payable for any out-of-pocket deductible, copayment, and coinsurance amounts incurred under the Covered Person's ACA Major Medical plan for Inpatient hospital expenses as well as Outpatient medical treatment and services¹, subject to the TruGap Comprehensive Supplemental Deductible, limitations and exclusions, Waiting Period² (if applicable), and Calendar Year Maximum Benefit.

All family members enrolled in TruGap Comprehensive must be enrolled in a Bronze ACA Major Medical plan to be eligible for benefits.

This plan must be paired with a Bronze ACA Plan.

¹Benefits payable under this coverage are limited to any out-of-pocket deductible, copayment, and coinsurance amounts incurred under the Covered Person's underlying ACA Major Medical plan. Benefits payable for Outpatient medical expenses are limited to treatment, surgery, therapy, and diagnostic testing and imaging performed at a Hospital Emergency Room, Urgent Care Facility or Outpatient Facility as specified in the Certificate of Insurance, as well as group and air ambulance services and chiropractic services. This plan does not cover outpatient prescription drugs or any expense for which benefits are not payable under the Covered Person's ACA Major Medical plan. Other exclusions apply. Please see the Certificate of Insurance for full details including all terms, descriptions, state variations, limitations, and exclusions of coverage.

Read the Certificate of Insurance carefully. This is a brief description and is not an insurance contract, nor part of the Certificate of Insurance. If there are any discrepancies between this description and the Certificate, the Certificate will govern.

Calendar Year Plan: All benefit amounts and deductibles renew annually on January 1st regardless of your enrollment / effective date.

²30-Day Waiting Period after the Effective Date upon initial enrollment only. No waiting period will apply when coverage renews annually on January 1st. Family members added to the plan after the Effective Date will be subject to the 30-day waiting period as a Late Entrant.

³Your healthcare provider(s) will file claims and be paid any benefit amount directly. Be sure to give your TruGap plan ID card or coverage information to your healthcare provider(s) along with your ACA major medical coverage information.

Coverage ends when the Covered member turns 65 year old.

Insurance coverage underwritten by SiriusPoint America Insurance Company.

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Paramount RX Prescription Drug Discount Program

Retail Pharmacies

While the TruGap Comprehensive plan does not cover prescriptions, with your TruGap plan, you will receive a FREE Paramount RX® Prescription Discount Card to use at retail pharmacies and for your pets! Learn more by viewing the details below.

Paramount RX^® is a nationally recognized prescription discount program that provides discounts on all FDA approved prescription drugs. The nationwide network includes over 57,000 pharmacies, including all national and regional chains, as well as many local community pharmacies.

Pet Medications

Members can save hundreds of dollars or more per year on pet medications with retail pharmacy and online discounts. Our Pet RX customer service team is also available to assist utilizing the program for maximum savings.

¹ Savings can vary greatly depending on the individual drug and the participating pharmacy. The agreed upon discount rates and network prices can vary by pharmacy contract. It is important to research pharmacies in your community to find the best available price using the online search tool. In any case where the participating pharmacy's retail price is lower than the discounted network price, you will pay the lower retail price.

This is not insurance -- discount only.

There is no cost to the member for this FREE prescription discount card. Read the guide carefully. This is a brief description of a prescription discount program through Paramount RX® and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.

SiriusPoint America Insurance Company does not offer and is not affliated with the discount programs offered in connection with Paramount RX® or membership in United Business Association.

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30-Day Satisfaction Assurance Policy for TruGap Hospital

If for any reason you are not completely satisfied with your enrollment, just notify us anytime up to thirty (30) days after your Effective Date to cancel and receive a full refund of all dues, premiums, or fees paid.

Notice: for any enrollment in a program or product that provides insurance benefits or coverage, enrollment costs cannot be refunded if an insurance claim has been filed.

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This is a brief description of the benefits included with TruGap Comprehensive. Please review the document(s) below for full details, including terms, conditions, limitation, and exclusions. Certificates of insurance are the official state-specific explanations of insurance benefits, which supercede any benefit descriptions provided here or elsewhere, so be sure to read the Certificate(s) carefully.

You must be a member of the United Business Association (UBA) in order to enroll in the supplemental TruGap Comprehensive plan. Membership dues are $10 per month for the entire family and are separate from the TruGap Comprehensive plan costs. View for Membership details.

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TruGap Comprehensive Certificates of Insurance

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