Champaign County Farm Bureau

Health Insurance Options

Personalized Health Insurance with
Champaign County Farm Bureau

Champaign County Farm Bureau offers health insurance options as a membership benefit. By using CCFB’s health care options you will receive superior customer service from Donna, our in-house health insurance specialist. No automated phone answering service, no waiting for hours on hold. You’ll get real answers from a real person, for no extra cost.
Plus you get to choose from Personal Care or Health Alliance plans.

Personal Care
Member’s Choice Individual PPO Plans

Offering comprehensive benefits at a price you can afford. Our Member’s Choice Individual PPO Plans offer excellent coverage for a wide range of services, including, but not limited to:

• Doctor’s visits
• Preventive and wellness services
• Emergency care
• Optional maternity services
• Home health care
• Optional maternity services
• Home health care
• Medical equipment and prosthetic devices
• Hospice care
• Mental health services
• Rehabilitation services
• Immunizations
• Substance abuse treatment
• Prescription drug coverage

(For more information on these plans and a detailed listing of covered services, including rates, please call Donna at the Champaign County Farm Bureau office (217) 352-5235.)

Health Alliance

HMO 80:
• You must select a Primary Care Physician (PCP) for each covered family member from the list of participating PCPs.
• All covered care must be received from a network of contracted providers, which includes Carle Clinic and Carle Hospital.
• Your office visit co-payment is $20 per visit.
• Your responsibility for other covered services is 20%.
• Your emergency room co-payment is $150 per visit.
• Your out-of-pocket maximum for an individual is $1500.
• Maternity coverage is included with no waiting period.

PPO 80/50 $250 in-network deductible and $500 out-of-network deductible:

• You may receive care form any provider you chose, but you will pay less out of pocket when you receive care from a preferred provider.
• Your responsibility for covered services received from preferred providers is 20% up to a maximum out of pocket when you receive care from a preferred provider.
• Your responsibility for covered services received from non-preferred providers is 50%.
• Your emergency room co-payment is $150 per visit.
• For office visits and wellness care, members receive “first dollar coverage”, meaning that no deductible must be met before Health Alliance pays benefits on these services.

PPO 80/50 $1000 in-network deductive and $2000 out-of-network deductible:
• Same benefits listed above with exception of $2500 in-network out-of-pocket maximum and unlimited out-of-pocket maximum.

Emergency Care
All Custom Choice plans cover emergency medical care. We simply ask that you draw on your practical experience and decide whether or not a visit to the emergency department is necessary after observing you symptoms. However, regardless of the severity of illness or injury, your visit will be covered. Less required co-payment or co-insurance amount. To assure the maximum benefits under your plan, Health Alliance must be notified as soon as reasonably possible of emergency care you have received.

Reasonable and Customary Limitation for Custom Choice PPO
If you receive care from a non-proffered provider, coverage is limited to reasonable and customary charges. This means if your physician charges a higher rate that what appears on the reasonable and customary fee schedule, you will be responsible for 100% of the difference. If, however, you obtain care from a preferred provider, the reasonable and customary policy does not apply. In this case, you will only be responsible for the coinsurance once you have satisfied any remaining deductible.

Exclusions
While Health Alliance Custom Choice plans cover a wide range of services to meet your health care needs, the following services are excluded from coverage: dental care, hearing aids and fittings, cosmetic surgery unless medically necessary, custodial care, comfort and convenience items, services eligible for worker’s compensation coverage and other services not medically necessary.
Additionally, conditions for which the member has received medication or treatment during the 180 days prior to his or her effective date are covered with a 50% co-insurance for 12 consecutive months following the effective date of coverage. See the Policy for specific details.