Symetra Health

A supplemental health insurance plan

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Note: Symetra Health is only available in certain states at this time. Please contact your Symetra representative if you have questions regarding product availability.

Overview

Symetra Health covers over 13,000 injuries and illnesses in one plan to help ease the burden of out-of-pocket medical costs. Paired with simple, user-friendly technology, this supplemental health insurance plan empowers employees to get the most out of their benefits.

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Top talking points

  • Benefits are based solely on diagnosis codes.
  • Moderate, severe, and catastrophic conditions are covered.
  • Simple, convenient claim submissions and benefit payments via a mobile app.
  • Benefits typically paid within 72 hours.

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Plan features

  • No preexisting condition limitations or exclusions.
  • Guaranteed-issue coverage with no medical underwriting.
  • No coordination with other insurance.
  • 24-hour coverage.
  • HSA-compatible.
  • Streamlined implementation.
  • Dedicated customer support for employers and employees.

Plan design options

Employers can offer one, two or all three plan designs.

  Moderate Severe Catastrophic
Base $200 $500 $1,000
Classic $300 $1,000 $2,000
Premier $500 $1,500 $3,000

The broker or employer can customize the Base, Classic and Premier configurations.

Examples of covered conditions

Moderate Severe Catastrophic
Anaphylactic reactions Acute respiratory failure Abdominal aortic aneurysm
Basal cell carcinoma Appendicitis ALS (Lou Gehrig's disease)
Bell's palsy Benign neoplasm Alzheimer's disease
Benign breast tumor Chronic adenoiditis/tonsillitis Cardiac arrest
Concussion Deep-vein thrombosis Heart attack
Dehydration Detached retina HIV
Foreign body in eye/ear/nose Diverticulitis Leukemia
Hepatitis C Gallstones Malignant neoplasm
Kidney stone Inguinal hernia Multiple sclerosis
Knee sprain Preterm newborn (32-33 weeks) Parkinson's disease
Laceration Pulmonary embolism Perforation of intestine
Pneumonia Torn ACL Preterm newborn (<31 weeks)
Preterm newborn (34-35 weeks) Torn rotator cuff Sepsis
Simple fracture Unstable angina Spina bifida

This chart is for illustrative purposes only. Symetra Health covers over 13,000 ICD-10 codes across all three categories of severity.

To learn if Symetra Health is available in your state, contact your Symetra representative.

IMPORTANT: This is a fixed indemnity policy, NOT health insurance

This fixed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care.

  • The payment you get isn’t based on the size of your medical bill.
  • There might be a limit on how much this policy will pay each year.
  • This policy isn’t a substitute for comprehensive health insurance.
  • Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance.

Looking for comprehensive health insurance?

  • Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
  • To find out if you can get health insurance through your job, or a family member’s job, contact the employer.

Questions about this policy?

  • For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (naic.org) under “Insurance Departments.”
  • If you have this policy through your job, or a family member’s job, contact the employer.

Symetra Health is insured by Symetra Life Insurance Company, 777 108th Avenue NE, Suite 1200, Bellevue, WA 98004. Products, features, terms and conditions may vary by state. It is designed to provide benefits at a preselected, fixed dollar amount for covered diagnoses. This policy provides limited benefit coverage and is a supplement to health insurance. It is not a replacement for major medical or other comprehensive coverage, and does not satisfy the minimum essential coverage requirements of the Affordable Care Act. Base policy form number is SBC-05540 03/22. Symetra Health is only available in certain states at this time. Please contact your Symetra representative if you have questions regarding product availability.

Administration of Symetra Health is managed by a third-party administrator that provides enrollment, claims and billing administration. Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.

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