LRFA Health Supplemental Plans are designed to assist individuals and families in the payment of medical expenses.
Enrollment is open to LRFA members ages 18 to 65, and their dependents ages 1 to 26.
We offer three plans: H1, H2, H3
Plans differ by limits set on the amount of covered expenses and maximums payable in a calendar year.
Three percentage groups: 20%, 50%, 80%
Reflects the percentage at which LRFA will reimburse its members for LRFA approved medical expenses.
Plan H1 is available as secondary coverage. It is a low-cost option to cover the deductibles and co-pays of your primary insurance. Proof of primary insurance is required.
Plans H2 and H3 can be used as secondary coverage, or as primary coverage, provided the member recognizes that it does not qualify as primary insurance under government regulations.
Rx drug coverage is included in Plans H2 and H3
All Rx drug expenses are reimbursed by the percentage group of your plan, after the annual Rx drug deductible is met, up to a set maximum benefit amount per calendar year.
All brand name, generic, specialty, rare, and high cost drugs, including drugs purchased outside of the US, are covered.
Coverage for dependents ages 1 to 26
For each dependent child added to the plan, there is an additional monthly fee. Any child covered under their parent's plan must be a member.
The maximum benefit amount payable in a calendar year is shared by the parent and child covered under the same plan.
Examples of covered medical services:
See plan Regulations for coverage limits, annual limits and maxiumum services.
- Preventative care
- Diagnostic tests
- Office visits (including specialist)
- In-patient & out-patient services
- Some dental & vision services
- Ambulance transportation
- Emergency room services
- Physical fitness benefits
- Chiropractic care
In order to qualify for benefits, the following waiting periods apply.
- New LRFA members may request benefits for medical expenses occurring at least three (3) months after the date of admittance into a plan.
- Existing LRFA members - membership of one (1) year or more - may request benefits for medical care occurring at least one (1) month after the date of admittance into a plan.
These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.