How the Medical Insurance Works

For Covered Medical Expenses during a Term of Insurance, the Gateway Premier plan works like this:

• Each Insured Person must meet the Deductible once every 12 months from the Effective Date of insurance.
  
  
• After the Deductible, the Plan pays 80% of the reasonable and customary charges for Covered Medical Expenses up to $5,000. Thereafter, the Plan pays 100% of the reasonable and customary charges for remaining Covered Medical Expenses up to the Medical Expense Maximum or the Maximum Coverage Period, whichever occurs first.
  
  
• Each Insured Person is responsible for 20% of the first $5,000 of Covered Medical Expenses once every 12 months from the Effective Date of insurance.
  
  
• The Medical Expense Maximum is applied to Covered Medical Expenses for each separate, distinct, and unrelated condition.
  
  
• The Maximum Coverage Period is the length of time in which Covered Medical Expenses are considered eligible.
  
  

The Description of Coverage section provides details about Covered Medical Expenses, Exclusions, and Limitations.

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