Description / Exclusions / Application

Just because you don’t have health insurance right now doesn’t mean you may not have health problems. Short-Term Health Insurance allows individuals and families to purchase quality, affordable major medical coverage on a temporary basis. Perfect solution when you’re a recent college graduate, in between jobs, a part time or temporary employee, or in a waiting period before other coverage becomes effective.

Short-Term Medical is offered to members, their spouses under 65 and their dependent children under age 19 (or under age 25 if a full-time student) who have a social security number and can answer 'no' to the health questions on the application. Children age 19 and over should apply separately. Child-only coverage is available for ages 2 through 18.

• Flexible and affordable coverage options for 1-6 months.
• Fast, easy and secure online applications with fulfillment documents
• Coverage may start 12:01 a.m. the day after application is submitted
• Choose any Doctor or Hospital
• $2,000,000 lifetime maximum per covered person.

STM pays benefits for each covered person in the following manner:

• First, you meet your deductible. Choose from five options: $250, $500, $1,000, $2,500, or $5,000
• Then STM pays 80% or 50% of the next $5,000 or $10,000* of covered expenses
• After this, STM pays 100% of covered expenses up to your lifetime maximum of $2 million*
  *Certain conditions have limited maximum benefits

What medical expenses are covered?

After satisfying the deductible amount you've selected, STM will pay the coinsurance you selected for covered expenses, up to a lifetime maximum of $2 million per insured person per Coverage Period.*

Benefits are limited to the usual, reasonable and customary charge for a covered expense in addition to any specific limits.

• Hospital Charges: Average semi-private room rate, medical care and treatment
• Outpatient Hospital or Ambulatory Surgical Center charges
• Physician Services for treatment and diagnosis
• Surgeon Services in the hospital or Ambulatory Surgical Center
• Assistant Surgeon Services: Up to 20% of the surgeons benefits
• Anesthesia Services: Up to 20% of the surgeons benefits
• Intensive Care: Up to three times the average semi-private room rate
• X-Ray Exams, Laboratory tests and analysis
• X-Ray and Radioactive isotope therapy, anesthesia, oxygen, casts, splints, crutches, braces, surgical dressings, artificial limbs or eyes, rental of medical supplies
• Blood or blood derivatives and their administration
• Ambulance Services: $250 per emergency
• Organ Transplants: $150,000 lifetime maximum
• Acquired Immune Deficiency Syndrome (AIDS): $10,000 lifetime maximum**
• Mammography, pap smear and screens

* Benefits for gallbladder surgery are limited to a $2,500 lifetime maximum per insured person. Benefits for injury or disorders of the knees are limited to a $2,500 lifetime maximum per insured person. Benefits may vary by state.
**The AIDS maximum of $10,000 per Coverage Period does not apply to Policies/Certificates of Insurance issued to residents of Arizona, California, District of Columbia, Idaho, Indiana, Maine, Missouri, New Hampshire, North Carolina or North Dakota. In Kansas the maximum per Coverage Period is $75,000.

What is the STM enhancement series discount program?
Included with your coverage is Communicating for America (CA) Healthy Lifestyle Enhancement Series, which provides members with discounts for the following services and or purchases.*

• Vitamins, herbs and nutritional supplements—25% off already low prices
• Nurse-on-call access to a registered nurse 24 hours a day, seven days a week
• Chiropractic services—10%-30% off at more than 30,000 private chiropractors and alternative health services
• Prescription drugs—15%-60% off on generic drugs and 15%-25% off on brand-name prescriptions at more than 45,000 pharmacies nationwide
• Vision care—20%-60% off exams, eyeglasses and contact lenses through a network of more than 40,000 providers nationwide, including optical retailers such as Pearle Vision^®, Target Optical^®, Sears Optical^® and LensCrafters^®
• Dental services—Save 20%-50% on dental expenses from over 62,000 providers nationwide in the CAREINGTON International dental network.**

**Discount dental program not available in MT or VT.
*The Healthy Lifestyle Enhancement Series is not insurance, nor is it affiliated with Standard Security Life Insurance Company of New York or a part of the STM insurance plan. Access to discount services is administered by CAREINGTON International. Enhancement series benefits may vary by state.

Usual, Reasonable and Customary means with respect to fees or charges, fees for medical services or supplies which are usually charged by the provider for the service or supply given and the average charge for the service or supply in the locality in which the service or supply is received; whichever is less, or with respect to treatment or medical services, treatment which is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as Usual, Reasonable and Customary for services and supplies; we may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies.

Do I need to visit a network provider?
No. With the Secure STM you can visit any provider without restrictions or benefit reductions. However, if you visit a Private Health Care System (PHCS) network provider, you may be able to take advantage of discounts for covered services.

Standard Security Life Insurance Company of New York has a Best’s rating of A- (Excellent).
A.M. Best ratings range from A++ to D.

Who is the Administrator?
Health Plan Administrators, Inc. (HPA) is a fully licensed, full service Third Party Administrator servicing business worldwide. HPA provides state of the art industry leading insurance services.

Why buy from us?
HPA has provided innovative health care solutions for over 60 years, meeting the needs of our customers with integrity, creativity and value. We strive to provide the best possible insurance coverage in a cost effective manner.

HPA is a customer-driven company differentiating itself through knowledge and experience. We, in conjunction with our trusted insurance carriers and licensed agents, share a mutual desire to provide important benefits to our customers and to meet their needs in an innovative, hassle-free manner.

HPA has a professional team of customer support, marketing, underwriting, claims and compliance specialists. State-of-the-art computer systems and reporting capabilities allow HPA to provide superior service and flexibility to agent distributors and clients. Licensed and approved nationally, HPA has always met or exceeded all state-mandated requirements including financial security, surety bonds, insurance coverage, and licensing.