Coverage Information

Services
  • Hospital services for in-patient and out-patient treatment which is determined as medically necessary to the patient
  • This includes cancer treatment and prenatal services
  • Ambulance transportation and may include non-emergency certified transportation (air and ground)
  • Primary Care Services (In-state Certified) ($4,000 limit)
  • Hospice Care Services (In-state Certified) ($9,000 limit)
  • Mental & Suicidal Services ($10,000 limit)
  • Substance Abuse Services (In-state Certified) ($9,000 limit)
  • Home Health Services (In-state, Medicare Certified, Profit, and not-for-profit) ($9,000 limit)
  • Physician Services may be covered if the treatment was an emergency treatment in a hospital
Limitations
The above services do have specific limitations. Contact the IHC Office for these limits. Services which exceed the allowed limits will be pro-rated. These limits are per fiscal year, not calendar year. These services are both considered in $15,000 limit. Services are limited to 1 lifetime claim.