My American Access Insurance

My American Access agencies are licensed insurance and financial services firms with access to multiple companies. Their commitment to quality service enables us to offer clients competitive pricing, a broad choice of products and unparalleled advocacy.

My American Access independent insurance agents and insurance brokers represent more than one insurance company, so they can offer clients a wider choice of auto, home, business, life, health coverage’s as well as retirement and employee-benefit products.

My American Access agents and brokers not only advise clients about insurance, they recommend loss-prevention ideas that can cut costs. If a loss occurs, the independent insurance agent or broker stands with the client until the claim is settled.

FAQ's Who is eligible for coverage? Who are eligible dependents? When Should I enroll my dependents? What are the medical underwriting requirements? Where is the plan available? How do I pay for coverage? When does coverage begin? When does coverage end? Who files the claims under my coverage? Can members use any doctor, clinic, or hospital? Are preexisting conditions covered? What is a preexisting condition? Still have questions?

WHO IS ELIGIBLE FOR COVERAGE? Any individual and their dependents who are members of the My American Access provided they • are between the ages of 18 to 65 • are actively at work, performing all the normal duties of their job or, if not employed, performing the normal activities of a person of like age and gender; • reside in the United States; • are not in full-time service of the Armed Force; • are not receiving workers comp or disability benefits • are not eligible for Medicare. WHO ARE ELIGIBLE DEPENDENTS? Members’ dependents are also eligible. Spouses (if not legally separated or divorced) and children, including adopted and stepchildren who are unmarried and dependent on the member for support, up to age 19 (25 if a full-time student), and provided they meet the above requirements as well. Also dependents must be performing the normal duties of persons who are the same age and gender. Newborns are covered from birth provided we are notified of the birth and the appropriate premium is paid within 31 days of birth. Otherwise, the newborn is considered a late enrollee and may not be enrolled until the next open enrollment period. WHEN SHOULD I ENROLL MY DEPENDENTS? Eligible dependents must be enrolled within 31 days of the date the dependent becomes eligible (enrollment date of Member, birth or adoption). WHAT ARE THE MEDICAL UNDERWRITING REQUIREMENTS? The Health Solutions Insurance policy is a group policy. As a member of the My American Access, you may be eligible to enroll in the plan. All individual and family members of the My American Access who satisfy the eligibility requirements listed above are automatically accepted. WHERE IS THE PLAN AVAILABLE? THE PLAN IS AVAILABLE IN ALL 50 STATES. HOW DO I PAY FOR MY COVERAGE? Monthly billings will be sent to the insured. A modal billing fee of $10.00 will be reflected on each Monthly bill. Alternatively, monthly premium may be charged to the insured’s Bank account ( EFT=electronic funds transfer). There is no modal administrative fee charged for this method of payment. WHEN DOES COVERAGE BEGIN? Eligible Members will be effective on the first day of the month following approval of the application and receipt of the first premium. Coverage is not effective on the date of the application. The effective date for the dependent of an enrolled Member will be the same as the Member’s (unless the Member adds additional dependent coverage at a later time).Only first of the month starts are available WHEN DOES COVERAGE END? An insured Member’s coverage ends when the Member is no longer eligible, premiums are discontinued (subject to the grace period), when the policy terminates, Member reaches age 70, or when the Member is no longer in good standing with My American Access (AIM), whichever occurs first. Coverage on a dependent ends on the earliest date they no longer meet the definition of an eligible dependent or on the date the Member’s coverage terminates, whichever occurs first. WHO FILES THE CLAIMS UNDER MY COVERAGE? You are responsible for paying the provider at the time of service (or, if the provider allows, upon receipt of the bill). You then file a claim form (at least one per year) and your bill(s) with claims administrator, Triad Benefits administrator. Your claim will be processed and benefits payable are sent directly to you. Instructions for filing a claim are provided on your member ID card. CAN MEMBERS USE ANY DOCTOR, CLINIC OR HOSPITAL? Yes. Covered members and dependents can use any licensed medical provider. OR to receive a discount ( 25%-60%) use the Multi Plan Network (Multiplan.com 500,000 providers in 50 states. ARE PRE-EXISTING CONDITIONS COVERED? Benefits under the Hospitalization or Surgery provisions of the plan are not payable for a “pre-existing condition” for the first 12 months following an insured’s effective date. If an insured has a HIPPA certificate they will be given credit for credible coverage for the total amount of months shown on the certificate. WHAT IS A PRE-EXISTING CONDITION? A “pre-existing condition” is defined as any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within 6 months prior to becoming covered under the plan. It includes any condition manifesting itself in symptoms which would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment. STILL HAVE QUESTIONS? If your question(s) have not been answered on this website, please contact your broker.