| Short
Term Health Insurance - Summary of
Coverage
The
following general summary of features on
Assurant Health's Temporary Health
Insurance plan may vary according to the
state in which the insured resides. This
summary is not an insurance contract. The
policy itself sets forth in detail the
rights and obligations of both you and
your insurance company. Once you receive
your Short Term Medical policy, please
read it carefully.
Short Term
Health Insurance is designed to provide
coverage for major hospital, medical and
surgical expenses incurred as a result of
medically necessary care for a covered
illness or injury. Coverage is
provided for daily hospital room and
board, miscellaneous hospital services,
surgical services, anesthesia services,
in-hospital services, and out-of-hospital
care, subject to any deductibles or rate
of payment provisions or other limitations
which may be set forth in the policy.
A covered
illness or injury is an expense
that is: 1) incurred for services,
treatment or supplies prescribed by a
physician; 2) incurred by a covered person
as the result of sickness or injury; 3)
incurred for medically necessary care; and
4) incurred while this policy is in force.
Covered
Assurant Temporary Health Insurance
Services
The
following general summary of covered
medical services may vary according to the
state in which the insured resides.
- Covered
charges incurred for: physician and
surgical services.
- Covered
charges incurred for drugs which
require the written prescription of a
physician.
- Covered
charges incurred for: room, board and
routine nursing services that are
generally provided to all persons
while confined in a hospital. If the
covered person is confined in a
private room, only charges up to the
average semi-private rate of the
hospital are covered.
- Covered
charges incurred for outpatient
medical care and treatment provided by
a hospital or freestanding ambulatory
surgical facility.
- Covered
charges incurred for x-ray,
radioactive treatment, laboratory and
anesthesia services, including one
screening mammographic exam per
benefit period for a covered female,
age 35 or over.
- Covered
charges incurred for the first 30 days
of confinement in a rehabilitation or
skilled nursing facility for the
covered person per benefit period.
- Covered
charges incurred for the first 40 home
health care visits for the covered
person per benefit period.
- Covered
charges incurred for up to 10
outpatient physical medicine visits
for the covered person per benefit
period. (Includes chiropractic care in
most states.)
- Covered
charges incurred for professional
ambulance service to the nearest
hospital that is able to handle the
sickness or injury.
- Covered
charges incurred for rental (not to
exceed the purchase price) of one
basic manual wheelchair, one basic
hospital bed, one pair of basic
crutches, the initial permanent basic
artificial limb or eye and oxygen and
the basic equipment needed to
administer oxygen; and the initial
external breast prosthesis needed
because of the medically necessary
surgical removal of all or part of the
breast, provided the surgical removal
was done while the covered person was
covered under the plan.
- Covered
charges incurred for reconstructive
surgery required due to an injury
which occurred while the covered
person is insured under the plan.
- Covered
charges incurred for surgical
treatment of temporomandibular joint (TMJ)
or craniomandibular joint (CMJ)
dysfunction, provided the charges are
for services included in a dental
treatment plan authorized by Assurant
Health prior to the surgery; charges
for nonsurgical treatment of TMJ or
CMJ.
- Covered
charges incurred for the following
complications of pregnancy:
spontaneous termination of pregnancy
(miscarriage) which occurs before the
26th week of gestation; missed
abortion (miscarriage); ectopic
pregnancy when pregnancy is ended; and
other medical conditions such as acute
nephritis, nephrosis and cardiac
decompensation.
- Covered
charges incurred for the following
organ transplants: heart, liver, and
bone marrow. Tissue transplants
include: cornea transplant; prosthetic
tissue replacement, including joint
replacement; vein or artery graft;
heart valve replacement; and
implantable prosthetic lens in
connection with cataracts. The maximum
amount we will pay for any and all
organ transplants is limited to
$250,000 for the covered person during
his or her lifetime.
- Covered
expense incurred for the treatment of
AIDS, AIDS Related Complex (ARC) or
related immuno deficiency disorders.
Extension
of Benefits: When the benefit
period expires, coverage may be extended
for a continuous injury sustained or
sickness which commenced while the policy
was in force and for which a covered
person is then being treated. The
extension of benefits provision will apply
when:
- The
covered person receiving treatment
remains totally disabled beyond the
benefit period expiration date and is
under the care of a physician for the
disability during the benefit period.
- The
covered person who has met his or her
deductible during the benefit period
and is being treated for complications
of or needs follow-up treatment for an
injury sustained or sickness which
commenced during the benefit period.
Although
the above provides a good description of
the important features of the Short Term
Medical plan, this is not the insurance
contract and only the actual contract
defines coverage. Benefits may vary by
state and by the terms of the insurance
contract. The policy itself sets forth in
detail the rights and obligations of both
you and the insurance company.
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