Health Coverage

Ommpo Health Coverage Terms of Service

1. Introduction

Welcome to Ommpo Health, a cash reimbursement health plan designed to make urgent and emergency medical expenses simple, affordable, and stress-free. These Terms of Service (“Terms”) outline the rules, coverage limits, and obligations for subscribers. By subscribing to Ommpo Health, you agree to abide by these Terms.

2. Scope of Coverage

2.1. Eligible Expenses
Ommpo Health provides reimbursement for urgent and emergency medical expenses, including but not limited to:

• Urgent care visits for emergency non-life-threatening conditions.
• Prescribed medications directly related to the covered urgent or emergency visit.

2.2. Annual Maximum Coverage
Subscribers are eligible for reimbursements up to their plan's annual limit:

• Essential Plan: $15/month – Up to $1,000 annual reimbursement.
• Priority Plan: $39/month – Up to $3,000 annual reimbursement.
• Ultimate Plan: $59/month – Up to $5,000 annual reimbursement

2.3. Ineligible Expenses
The following expenses are not covered under Ommpo Health:

• Routine, preventive, or wellness care (e.g., annual physicals, vaccinations).
• Cosmetic or elective procedures.
• Ongoing treatment or management of chronic conditions.
• Hospital stays.
• Over-the-counter medications not prescribed during an urgent or emergency visit.

3. Membership and Billing

3.1. Subscription Fees

• Subscriptions are billed monthly at the selected plan rate.
• Payments must be made on time to maintain active coverage.

3.2. Cancellation Policy

• Subscribers may cancel at any time without penalty.
• Coverage ends on the last day of the billing cycle following cancellation.

4. Reimbursement Process

4.1. Submitting a Claim
To request reimbursement, members must:

1. Log into their Ommpo Health account and access the claims portal.
2. Upload legible copies of itemized medical bills and payment receipts.
3. Provide any additional documentation requested.

4.2. Claim Review Timeline

• Claims are typically processed within 7–10 business days.
• Members will be notified of approval or denial via email.
• Reimbursements are disbursed within 45 days.

4.3. Reimbursement Payment

• Approved claims will be reimbursed directly to the subscriber’s bank account on file.
• Reimbursements are subject to the member’s annual coverage limit.

4.4. Claim Denials
If a claim is denied, members will receive an explanation of the decision. Appeals can be filed within 30 days of denial, along with any supporting documentation.

5. Membership Eligibility

5.1. Who Can Join?
Ommpo Health is available to individuals aged 18 and older, regardless of insurance status or employment situation.

5.2. Waiting Period
Coverage begins 30 days after the first successful payment.

6. Plan Modifications

Ommpo Health reserves the right to modify plan features, subscription fees, or coverage limits with 30 days’ written notice to subscribers. Existing members will have the option to cancel without penalty if changes are not agreeable.

7. Limitations of Liability

Ommpo Health is a reimbursement plan and not a substitute for traditional health insurance. It does not guarantee access to care or cover expenses beyond the specified limits. Members are responsible for verifying eligibility of claims prior to incurring expenses.

8. Privacy and Data Protection

Ommpo Health is committed to protecting your privacy. Personal and medical data provided for reimbursement purposes will only be used to process claims and improve our services. For more details, please review our Privacy Policy.

9. Dispute Resolution

Any disputes arising from these Terms will be resolved through mediation or arbitration in accordance with applicable state laws. Members agree to waive the right to a jury trial or class action lawsuit.

10. Contact Information

For questions, claims, or account management, contact us:

• Email: support@ommpohealth.com
• Phone: 855-847-7575
• Website: www.OmmpoHealth.com

By subscribing to Ommpo Health, you acknowledge that you have read, understood, and agreed to these Terms of Service. Thank you for choosing Ommpo Health for your urgent and emergency medical reimbursement needs.

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