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Farm Bureau Health Plans

Major Medical Health Coverage

Get catastrophic medical coverage with a lower monthly premium.

The Major Medical Health Coverage plan is ideal for individuals and families who want catastrophic protection with the advantage of a lower premium. This plan provides benefits for physician services, hospitalization, prescription drugs and more.

Farm Bureau Health Plans uses UnitedHealthcare Choice Plus Network. Please keep in mind that in-network payments are based on negotiated fees. If an out-of-network provider is used, the member's liability will increase significantly.

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Major Medical Health Coverage Plan Overview

In-Network Deductible
Individual

$5,000

Family

$5,000 per member

Out-of-Pocket Max
Individual

$10,000

Family

$20,000

Lifetime Benefit Max
Individual

Unlimited

Family

Unlimited

In-Network and Out-of-Network
Calendar Year Deductible (individual) 01

(Unless otherwise indicated, all benefits are subject to the deductible)

$5,000
Calendar Year Deductible (family) 02

(Unless otherwise indicated, all benefits are subject to the deductible)

$5,000 per member
Lifetime Benefit Maximum
Unlimited
FOOTNOTES
  1. Deductible per member per calendar year.
  1. Once the OOP maximum is met, benefits are provided at 100% for a member for the remainder of the calendar year. This applies to in-network provider services only.
COINSURANCE
In-Network
Out-Of-Network
Coinsurance
Plan pays 80%, you pay 20%
Plan pays 60%, you pay 40%
Teladoc

See Teladoc page for additional details.

No charge
No coverage
Teladoc Expert Medical Services (EMS)

See Teladoc Expert Medical Services (EMS) page for additional details.

No charge
No coverage
PREVENTIVE CARE BENEFITS
In-Network (plan pays)
Out-Of-Network (plan pays)
Well Child Services 01
80%
Not Covered
Annual OB/GYN Exam 02
80%
Not Covered
Routine Colonoscopy 03
80%
60%
Annual Routine PSA 04
80%
60%
Annual Routine Pap Smear 05
80%
60%
Mammogram 06
80%
60%
PRESCRIPTION DRUG COVERAGE

Unlimited calendar year maximum per member

  • Generic | Farm Bureau Health Plans will reimburse 80% of the maximum allowable charge, after deductible, when purchased at an in-network pharmacy
  • Brand Name | Farm Bureau Health Plans will reimburse 80% of the maximum allowable charge, after deductible, when purchased at an in-network pharmacy
  • Home Delivery service is also available
FOOTNOTES
  1. Benefits are available, subject to the deductible and coinsurance, for a member under the age of 7 for physical examinations and appropriate immunizations/vaccinations when services are rendered by an in-network provider. Exams not used during the time periods below do not carry over to the next time period. Physical Examination Guidelines:
    • AGE: Number of exams
    • UNDER AGE 1: 4 exams from birth to the child’s first birthday
    • AGE 1: 2 exams from the child’s first birthday to the child’s second birthday
    • AGE 2 THROUGH 6: 1
  1. Benefits will be available for one routine OB/GYN exam per calendar year. Services must be rendered by an in-network provider in the physician's office and billed by the in-network provider. Related pathology, including pap smear, which is provided as a part of the routine OB/GYN exam, will be covered when the services are rendered by an in-network provider in the physician's office and billed by the in-network provider. Related pathology that the physician sends to an independent laboratory will be subject to deductible and coinsurance.
  1. Benefits will be provided for 1 routine colonoscopy every 4 years for members age 50 and over when provided by an in-network or out-of-network provider, subject to the deductible and coinsurance.
  1. Benefits will be provided, subject to deductible and coinsurance, for 1 routine PSA per calendar year when services are rendered by an independent laboratory or other outpatient setting.
  1. Benefits will be provided for the interpretation of 1 routine pap smear per calendar year when services are rendered by an independent laboratory or other outpatient setting.
  1. Benefits are available for routine mammography screening, provided such examinations are conducted upon the recommendation of the member’s physician. 1 baseline routine mammogram will be allowed for members between the ages of 35 and 39. 1 routine mammogram will be allowed annually for members age 40 and above.

Maternity Benefits will be available after a member’s coverage on a family contract has been in effect for nine consecutive months, except for complications of pregnancy. Individual coverage has NO maternity benefits, except for complications of pregnancy.

Benefits will not be provided for any pre-existing condition until a member has completed a waiting period of at least12 months. A pre-existing condition is defined in the contract as “An illness, injury, pregnancy or any other medical condition which existed at any time preceding the effective date of coverage under this contract for which: Medical advice or treatment was recommended by, or received from, a provider of health care services; or symptoms existed which would cause an ordinarily prudent person to seek diagnosis, care or treatment.” The pre-existing condition waiting period does not apply to members under the age of 19 covered on a Family plan.

Provider Network

Farm Bureau Health Plans utilizes the UHC Choice Plus Network which is UnitedHealthcare's largest provider network in Tennessee.

Schedule Benefits

This schedule is intended to help you compare coverage benefits and is a summary only.

Enroll today!

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For More Information, call

1-877-874-8323