Message from Wiley Long
President - ColoHealth
Share this page:

Celtic Health Insurance in Colorado

Plans: Celtic Basic- CelticSaver HSA

 

 

Coverage synopsis Optional Riders Rate Information PPO Network Underwriting Effective Dates About Celtic

The CelticSaver HSA health plan is a qualified high deductible health plan designed to provide you with major medical coverage including up to $7,000,000 of health insurance protection, combined with a Health Savings Account (HSA) option to make your health plan even more affordable. 

Health Savings Accounts (HSAs) are savings accounts that are coupled to high-deductible health insurance policies. You can deposit tax-deductible money into the HSA and use it to pay health care expenses throughout the year that aren't covered by your health insurance plan.

Celtic Basic at a Glance:

Please view the Celtic Basic brochureAdobe Acrobat Reader Information for complete details

Features/Benefits

Specifics

Eligibility Ages 6 months - 641/2 years*
Plan Options PPO** or Managed Indemnity
Annual Deductibles Please run an instant quote for deductibles in your area.
Lifetime Maximum $7,000,000 per person
Non-Preventive office visits Covered after deductible subject to coinsurance.
Emergency Room Deductible
(in addition to annual plan deductible)
$250 per visit, (waived if admitted to hospital)
Prescription Drugs Covered after deductible subject to coinsurance.
Psychiatric Care *** Inpatient annual maximum of $2,500 per person, per calendar year.  Outpatient annual maximum of $1,000 per person, per calendar year.  Lifetime maximum of $10,000 per person for inpatient and outpatient combined.
Manipulative Therapy *** $500 maximum per person, per calendar year.
Hospital Average semi-private room rate.  Intensive care at four times the average semi-private room rate.
Home Health Care 30 visits per person, per calendar year.
Rehabilitation Facility Inpatient - up to 30 days confinement per person, per calendar year.
Rehabilitation Therapy Outpatient - up to 30 visits per person, per calendar year.
Extended Care Facility Up to 12 days of confinement per person, per calendar year.
Transplants Covered up to amount negotiated by network if Transplant Network used; capped at $100,000 per procedure if insured goes out of network.
Ambulance $3,000 maximum per person, per calendar year, for emergency air or ground ambulance service.

Optional Benefit

Specifics

Preventive Care (Eligibility begins after 90 days of coverage) Eligible expenses for medical services and supplies incurred for preventive care in an asymptomatic individual are covered firstdollar at 100%, up to $300 per person, per calendar year, which includes up to $50 for routine eye exams.

       * The Primary Applicant cannot be claimed as a dependent on any tax return.

       ** If PPO plan is chosen, out-of-network eligible charges reduced additional 20%.

     *** Benefit will vary by state.

This information is presented only as a very brief overview of some of the benefits of this plan, and is intended only for general education.  The amount of benefits provided depends on the plan selected.  Premium will vary with the type of benefits selected.  These plans contain exclusions from and limitations of coverage.  Please see the product brochure for more complete information, as well as information about terms of renew ability, preexisting conditions, out-of-network penalties, and notification requirements.  Plans are subject to health underwriting.  To be considered for reimbursement, expenses must qualify as covered expenses.  Expenses are also subject to reasonable and customary limits, unless you use a network, and all other policy provisions, including determinations of medical necessity..

Coverage Synopsis: 

CelticSaver HSA PPO Plan

After you have met your deductible (one deductible for the entire family), the plan pays 100% of all covered expenses, up to $7 million per person. Eligible expenses for medical services and supplies incurred for preventive care in an asymptomatic individual are covered up to $300 per person, per calendar year, including up to $50 for routine eye exams (after coverage has been in effect 90 days). Plus, no deductible or co-payment is required. Manipulative care is covered up to $500 per person, per calendar year.

CelticSaver HSA Managed Indemnity Plan

This plan offers you the same comprehensive coverage as above, with the flexibility to select the doctors and hospitals of your choice. This plan is more popular in very rural areas where there may not be many doctors in the PPO network.

Full Credit for Meeting Prior Deductibles: If you choose to replace your current insurance coverage with the CelticSaver HSA health plan, you'll receive credit for satisfying any portion of a previous carrier's deductible met during the same calendar year. This valuable benefit is very rare to find in today's health insurance market.

The deductible for each of these plans needs to be met only once for the entire family. Both plans cover up to $500 per person in preventive care after the deductible, including routine physicals. Expenses for mammogram exams, prostate screenings, and age-appropriate well-child visits and routine immunizations (up to age 13) are not subject to the deductible.

These plans both qualify as HSA-eligible. Combining a Health Savings Account with any CelticSaver HSA plan allows you to make tax-deductible contributions, pay medical expenses with pre-tax dollars, and earn tax-deferred interest. This account works much like an IRA, except you may use your tax-free savings for qualified medical expenses your health plan does not cover, such as your deductible, dental, eyewear, and most types of alternative medicine (see the HSA qualified medical expenses page).  If you do not use these funds, they are always yours and continue to grow tax-deferred. 

Optional Riders: 

Supplemental Accident Coverage

Many of our customers add a supplemental accident plan to their coverage. These plans cover a set amount ($2,000, $5000, or $10,000) for any accident, after a $100 deductible. Having a supplemental accident plan can greatly reduce the exposure of a high-deductible plan. These plans are not associated with Celtic Insurance Company, and must be purchased separately.  Complete information is available on our Accident Plans page.

Rates: 

Preferred rates without riders are available on our instant quote page. The quoted rates are for the $5 million maximum benefit, and do not include any optional benefits. Rates depend on gender, smoking status, zip code, and health status.

The premium can be paid via monthly quarterly, semi-annual, or annual billing, or a monthly bank draft.  The bank draft will occur on the premium due date each month. The initial premium can be paid with a check or credit card. All monthly and quarterly billing includes an $8 fee per billing cycle.

PPO Network: 

Celtic's PHCS network includes more than 320,000 physicians and ancillary care providers in 50 states and the District of Columbia, serving 1.3 million PPO members. The nationwide Celtic PPO network assures you access even when traveling or relocating to another state.

Celtic also partners with the largest network of pharmacies in the country to give you prescription drugs at the lowest pre-negotiated rates. Show your Celtic ID card at any of the 50,000 participating pharmacies nationwide and receive substantial savings on your prescription drug purchases.

Underwriting: 

Underwriting of your application with Celtic normally takes two to four weeks, though again if medical records are ordered it could take longer. Celtic is fairly lenient compared to many other insurance companies, and often accepts applicants who may have been turned down by other insurance companies.

It is standard practice to request a Blood Pressure Inquiry on all applicants who are currently being treated for or who have recently discontinued treatment for high blood pressure. Certain conditions may be waived with a temporary rider (usually for one to two years), or an indefinite rider.

Effective dates: 

The earliest your coverage can go into effect is the day after you have signed your application. You may request an effective date any time between 1 and 60 days after you sign your application.

Please note, if you are requesting an effective date of less than 21 days from the time you complete the application, you may not receive notification of your approval until after your effective date. If you have claims during this period, they will be eligible for coverage if submitted after you have been approved.  Also note that you will be billed starting on your requested effective date, even if you have not yet been notified that you have been approved. This is very good for someone who does not have any present coverage and would like for their benefits to begin right away. For those who are already covered, it is suggested that you maintain your current coverage in force until you have received notice from either ColoHealth or directly from Celtic that your coverage has been approved and is in force.

Because underwriting can sometimes take 3 weeks or longer, if you do not currently have coverage we recommend that you apply for a Short Term plan. This plan can go into effect tomorrow, giving you important protection until your new permanent plan is in place.

About Celtic: 

Celtic Insurance Company is headquartered in Chicago, IL. Celtic began operating in 1978 as a broker, insurance and reinsurance company for group life and health coverage. Today, the company has narrowed its focus and holds a strong commitment to the individual health marketplace.

Celtic has been assigned an "A-" (Excellent) from the A.M.  Best Company, an independent insurance rating organization.  A.M.  Best assigned this rating after a thorough quantitative and qualitative evaluation of a company's financial condition and operating performance. For more than 10 years, Celtic has earned a rating of "Excellent" for consistently demonstrating profitable operating results, high-quality investment portfolio and favorable capital position.  Celtic holds no junk bonds, real estate or direct mortgage loans and maintains no outstanding debt.

ColoHealth is an independent authorized Celtic agent in Colorado.