Wondering What Atlas Direct Covers?
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Overview of Coverage
Atlas Direct covers a limited set of medical services, including:
- Hospital admissions
- Emergency room visits
- Skilled nursing
- Ambulance transportation
- Childbirth
- Hospice care
- Up to 439 surgical and diagnostic procedures
Atlas Direct also includes a $100,000 per calendar-year maximum per covered person.
Our Schedule of Benefits
| Critical Medical Services (PER PERSON) | We Pay |
|---|---|
|
Inpatient Hospital Confinement (Non-Observational, Non-Maternity, Illness/Injury) (maximum per calendar year) |
$3,700 per day (26 days) |
|
Intensive Care Unit (maximum per calendar year) |
$5,200 per day (18 days) |
|
Hospital Admission (First Inpatient Day, Non-Observational, Non-Maternity, Illness/Injury) (maximum admissions per calendar year) |
$1,500 per admission (2 admissions) |
|
Emergency Room (maximum per calendar year) |
$1,500 per day (1 day) |
|
Ground/Water Ambulance (maximum per calendar year) |
$1,500 per day (1 day) |
|
Air Ambulance (maximum per calendar year) |
$5,000 per day (1 day) |
| Medical Procedures Benefit (PER PERSON) | We Pay |
|---|---|
|
Up to 439 Surgical and Diagnostic Procedures (maximum per calendar year) |
$1,500 to $30,500 per day (10 procedure days per year) |
| Maternity Benefits (PER PERSON) | We Pay |
|---|---|
|
Vaginal Delivery (maximum per calendar year) |
$5,000 per delivery† (1 delivery) † Differs for Kansas residents |
|
Caesarean Delivery (maximum per calendar year) |
$8,000 per delivery† (1 delivery) † Differs for Kansas residents |
| Additional Benefits (PER PERSON) | We Pay |
|---|---|
|
Skilled Nursing Facility (after hospital confinement of 3 or more continuous days) (maximum per calendar year) |
$300 per day (30 days) |
|
Outpatient Radiation or Chemotherapy* (maximum per calendar year) <a href="/faq/view/134/how-does-atlas-directs-coverage-vary-in-kansas">* Not available to Kansas residents.</a> |
$750 per day (40 days) |
|
Hospice Care (maximum per calendar year) |
$300 per day (60 days) |
$100,000 per calendar year maximum per covered person.
Our Surgical and Diagnostic Benefits
Atlas Direct covers up to 439 surgical and diagnostic procedures. The table below gives examples of the 439 procedures and their respective cash-payment amounts. Each procedure’s Current Procedural Terminology (CPT) billing code is given in parentheses.
| Tier | Payment Amount | Examples of Covered Procedures |
|---|---|---|
| 1 | $1,500 | Liver Biopsy (47000), Cervical Myelogram (62302), Skin Cancer Removal (11602), Trabeculoplasty for Glaucoma (65855) |
| 1 | $1,500 | Liver Biopsy (47000), Cervical Myelogram (62302), Skin Cancer Removal (11602), Trabeculoplasty for Glaucoma (65855) |
| 2 | $2,500 | Percutaneous Renal Biopsy (50200), Carpal Tunnel Surgery (29848), Brain PET Scan (78608) |
| 3 | $3,500 | Strabismus Correction (67311), Hemorrhoidopexy (46947), Insertion of Intraocular Lens (66985) |
| 4 | $4,500 | Shoulder Arthroscopy (29821), Laryngoscopy (31510), Appendectomy (44950), Cardiac Angiography (93454) |
| 5 | $5,500 | Knee Arthroscopy (29883), Umbilical Hernia Repair (49580), Tubal Ligation (58600) |
| 6 | $6,500 | Removal of Tonsils and Adenoids (42820), Diagnostic Elbow Arthroscopy (29830), Canaloplasty (66174) |
| 7 | $7,500 | Thyroidectomy (60220), Stapedectomy (69660), Unilateral Partial Mastectomy (19301), Ankle Arthroplasty (29892) |
| 8 | $8,500 | Sling Incontinence Surgery (57240), Lymphadenectomy (38740), Anterior Cruciate Ligament (29888) |
| 9 | $9,500 | Epigastric Hernia Repair (49570), Laparoscopic Colostomy (44188), Complete Cervical Lymphadenectomy (38720) |
| 10 | $10,500 | Bilateral Partial Mastectomy (19301-50), Laparoscopic Cholecystenterostomy (47570), Clavicle Osteoplasty (23485) |
| 11 | $11,500 | Open Adrenalectomy (60540), Open Fibroid Tumor Removal (58140), Laparoscopic Supracervical Hysterectomy (58543) |
| 12 | $12,500 | Posterior Cruciate Ligament (29889), Post-Mastectomy Breast Implant (19342), Partial Colectomy (44160) |
| 13 | $13,500 | Splenectomy (38100), Colpopexy (57280), Laparoscopic Repair of Paraoesophageal Hernia (43281) |
| 14 | $14,500 | Osteoplasty to Length Radius and Ulna (25393), Stomach Tumor Removal (43610), Salpingectomy (58700) |
| 15 | $15,500 | Ruptured Spleen Repair (38115), Total Hip Arthroplasty (27130), Freeing of Bowel Adhesion (44005) |
| 16 | $16,500 | Bilateral Complete Mastectomy (19303-50), Total Colectomy with Proctectomy (44156) |
| 17 | $17,500 | Laparoscopic Partial Nephrectomy (50543), Laparoscopic Radical Hysterectomy (58548) |
| 18 | $18,500 | Total Knee Arthroplasty (27447), Laparoscopic Total Prostatectomy (55866) |
| 19 | $19,500 | Laparoscopic Radical Nephrectomy (50545), Total Colectomy with Proctectomy (44158) |
| 20 | $20,500 | Ectopic Pregnancy Surgery (59120), Laparoscopic Closure of Enterostomy (44227) |
| 21 | $21,500 | Cardiac Ablation for Supraventricular Tachycardia (93653) |
| 22 | $22,500 | Removal of Kidney and Ureter (50236), Laparoscopic Partial Prostatectomy (55867) |
| 23 | $23,500 | Revision of Total Hip Replacement (27137) |
| 24 | $24,500 | Revision of Shoulder Replacement (23473) |
| 25 | $25,500 | Laparoscopic Total Colectomy with Proctectomy and Ileostomy (44211) |
| 26 | $26,500 | Partial Lung Removal (32484) |
| 27 | $27,500 | Transcatheter Closure of Congenital Atrial Septal Birth Defect (93580) |
| 28 | $28,500 | Transcatheter Closure of Congenital Ventricular Septal Birth Defect (93581) |
| 29 | $29,500 | Lung Lobectomy (32480) |
| 30 | $30,500 | Lung Bilobectomy (32482), Insertion of Brain-Cavity Shunt (62220) |
CPT® codes are included for informational purposes only and do not imply endorsement or approval by the American Medical Association (AMA®), which holds the copyright to CPT® codes. Fewer than 439 surgical and diagnostic procedures are available in certain states. For complete details about benefits, eligibility, limitations and exclusions, please see the Atlas Direct brochure.
A Reminder about Coverage and Payments
Because Atlas Direct is fixed-indemnity insurance, it pays predetermined, fixed dollar amounts for a limited set of medical services. Those predetermined dollar amounts may not always cover the full cost of the medical services that you receive from providers. You are responsible in all cases for paying providers for the cost of your care and our insurance carrier has no legal responsibility other than to pay you the fixed amounts specified in the Schedule of Benefits.
To view the full list of 439 surgical and diagnostic procedures, please click here.
For complete details about benefits, eligibility, limitations and exclusions, please see the Atlas Direct Brochure.
For a personalized quote, please click here.
The insurance policy advertised on this website offers limited health benefit coverage and is a supplement to, rather than a replacement for, comprehensive major medical insurance coverage. It is designed to provide benefits at preselected, fixed dollar amounts for covered diagnoses. This limited benefit coverage does not satisfy the minimum essential coverage requirements of the Affordable Care Act. Coverage is not available to insureds age 65 or over.
The policy is a group fixed-indemnity plan that is underwritten by Pan-American Life Insurance Company, 601 Poydras Street, New Orleans, LA 70130 under policy form G-NHI23-P. The policy has exclusions and limitations. Coverage and plan options may vary or may not be available in all states. Refer to the policy and certificate of coverage for complete terms and conditions. Premiums may vary by state. Get a quote to see your premiums. Underwriting approval is required to purchase coverage.
The Direct Care Foundation is the policyholder and membership in the Direct Care Foundation is required for eligibility to buy this coverage.
Atlas Direct Agency LLC (ADA) is a licensed insurance agency (Nevada #4005774) appointed by Pan-American Life Insurance Company. The purpose of the material on this website is the solicitation of insurance. An insurance agent may contact you. Insurance quotes are provided by ADA.
Atlas Direct is a service mark of ADA.
This website and its contents are a resource that is for informational purposes only and reflect information available at the time of publication. This information is not a guarantee of rates, coverage, or benefit levels. Nothing on this site changes or overrides any terms of insurance policies issued by Pan-American Life Insurance Company. If there is any conflict between the information provided here and the terms of a policy, the policy terms will take precedence.
The Omnibus Budget Reconciliation Act of 2026 revised the rules governing health savings accounts (HSAs) in ways that allow them to be used to pay for direct primary care (DPC) monthly membership fees. The new rules still impose important limitations on the use of HSA funds and require regulations or guidance to be issued in the future. The premiums paid for the Atlas Direct insurance program do not qualify as an eligible HSA expense.
The material on this website has been prepared for informational purposes only and is not intended to provide, and should not be relied on, for tax, legal or accounting advice. Employees and employers should consult their own tax, legal and accounting advisors before engaging in any transaction. Atlas Direct cannot guarantee a favorable tax outcome in all situations as federal and state laws are continuously changing. The benefits paid on this program may be taxable income.
This website contains wording that was created by Atlas Direct Agency LLC. All contents of this website are © Atlas Direct Agency LLC, 2026. All Rights Reserved.