GUARDIAN HEALTH CARD FAQs

Why is LASCO Financial offering a Guardian Health Plan to its customers?

LASCO Financial is concerned about the well-being of its customers, and believes in the value of a Health Insurance plan. This will enable its customers to have more timely access to necessary health care. The Insurer is Guardian Life Ltd. and the product is Guardian Health.

How do I know if I am eligible for LAS Cover?

You must be an existing LFSL loan customer and be between the ages of 18 and 74 years.

Can I add my dependents?

Yes at an additional cost and only if they are eligible for coverage.

Is there a limit to the amount of dependents I can add?

You may add as many dependents to the plan as you like once the eligible for coverage?

Who are my eligible dependents?

One (1) spouse of the opposite sex, including common law spouse; children, step-children, legally adopted children or children for whom you have court appointed guardianship. Coverage is extended from 14 days up to their 25th birthday. Formal evidence of relationship must be provided.

Can only my child or spouse be on the policy ?

A member 18-74 years must be attached to the policy for the dependents to gain access.

Can a dependent 18-25 be a policy holder and a dependent?

The age limit for dependents are 25 years however, they can only be a dependent OR a member.

What are the documents required to access this plan?

Members only: ID (national ID, passport, driver’s license) and TRN
Spouse: ID (national ID, passport, driver’s license)
Immediate children: Birth certificate
Adopted and Children appointed by legal guardianship: legal documents and birth certificate

How soon after enrolling on the Guardian Health Plan will I receive the card and how soon can I start using it?

You may make arrangements to collect your Guardian Heath cards at LFSL within ten (10) days of enrolling on the plan. The card is activated on the 1st of each month and will be immediately available for use. NB. There is a waiting period of six (6) months for surgery and specialized diagnostic services for all pre-existing conditions whether known or unknown.

What if I received my card after it became effective?

If cards were issued and were not received until after they became effective, the member will be able to claim if any medical treatment was done before getting the card.

What are the benefits of enrolling on the Guardian Health Plan?

Each covered person under the LFSL Group Health policy will receive a schedule of health benefits as well as a swipe and benefit card.

Some of the benefits include:
 Doctors’ visits/ prescription drugs
 Diagnostic services (X-rays, Labs, Ultrasound)
 Hospitalization & surgery
 Dental, Optical and Maternity*

These and other benefits are available on a co-pay basis as your Guardian Health card will facilitate coverage at the point of service.
Both cards must be presented and you copay the difference between the charge and the benefit on the card.

Are there any other benefits?

Yes, once the health provider prescribes any generic drug sold by LASCO for the treatment of hypertension, diabetes, respiratory illnesses and infections, you will be given an additional 10% discount.

Where will I be able to benefit from the 10% discount

The pharmacies included are all Supermed and Fontana locations

Why limit to just two group of pharmacies?

We are currently only offering at those 2 locations but for sure other will be added to the list in the near future.

What is meant by co-pay?

Co-pay means that the covered cost is shared between the customer and the Insurance Company. Guardian Health pays based on the Schedule of Benefits and the customer pays the difference

How will I know how to calculate all of this?

It is all done for you at the point of service once you present your LASCO Financial and Guardian Health Cards. You may review the calculations on your receipt.

Are there limits on the Guardian Health card?

Yes. These are shown on the Summary of Benefits outlined in the brochure. For certain benefits, however, additional coverage may be available through the Major Medical feature of the plan. To access
this feature, a covered member must pay the first $3,000 (deductible) of eligible expenses before the Major Medical benefit will apply.

What is Major Medical (MM)?

Major Medical provides the extra coverage required to assist with large expenses resulting from catastrophic illnesses or accidents. It is subject to a Lifetime Maximum (LTM) amount of J$1M.

What does the term deductible refer to?

The deductible refers to the amount that the member must pay out of pocket before he/she can start to receive benefits from Major Medical. This is separate from your copayment.

What does Usual Customary & Reasonable (UCR) mean?

This relates to a charge which is reasonable for a particular service or supply as determined by the general charges being observed for similar services or supplies being rendered by Professionals in the same geographic area.

If I have an NHF/JADEP card, can I use both cards for prescriptions?

Yes, you should. Ensure that you present the NHF/JADEP cards first and then your Guardian Health cards after. Doing this will further reduce your copay.

For how long is the Guardian Health card valid?

The LASCO Financial Group Health policy is valid for one (1) year, and is renewable annually. Each customer who signs on during the contract year will pay only for the number of months left in that year. E.g. If the policy year is September 2017 to August 2018 and the month of enrollment is January 2018, the customer would pay only for eight (8) months (January to August 2018).

How is the term of my loan affected by the health insurance premium?

Once you agree on your loan with LFSL and you accept the Guardian Health Plan, we will calculate the number of months left in the policy year and determine the premium payable. The amount is then added to your loan principal and the payment spread over the life of the loan. Regardless of the term of the loan, the Guardian Health card would only be valid for the number of months which were calculated. If you would like to continue your membership on the Guardian Health Plan, you may visit a LFSL location and do so.

What may cause my application to be rejected?

The medical history of the applicant will determine eligibility for the policy

What if the loan is approved and application is not?

You will be compensated for the transaction.

Do I have to be accessing a loan to benefit from this coverage?

Once you are willing to pay the annual or quarterly premiums you will be able to get access to coverage.

If I become delinquent with payments, will I have access to the health insurance?

Once you stop paying the premiums the card is revoked and there will be no access

Can I get back my money if the card was not used during the period?

Regrettably all premiums paid are non-refundable. However, we do recommend using the card in the event that there is some underlying illness. Besides, in some cases the card covers up to 80% of the cost.

Why would I need the card?

Can you imagine having to do a major surgery and is unable to cover all the expenses. The health insurance will assist in the sense that it offers up to 80% coverage and major medical access. Also imagine if you had more than one access to medical coverage you may end up paying nothing. Be contingent and prepare for any illness or accidents that may occur.

Can I add dental and optical to my plan? (Lascare Loan Package and LasCoverage)

Dental and optical is only offered in option 3 of the coverage

Why is the waiting period to access surgery and other major diagnosis 6 months?

It is the policy of the insurer that the waiting period is 6 months to access that aspect of the insurance.

Will I be able to benefit from the plan after 74 years.

Once you are enrolled on the plan before 75 years old you will be able to access coverage for as long as you want once premiums are paid

Are there any other products that LASCO will be offering to their customers in the near future?

Stay tuned. More value-added products are coming soon!