Description / Exclusions / Application (choose Short-term Health Iinsurance)
Covered Benefits* for All Plans
- Physician office visits
- Urgent care and emergency room
- Durable medical equipment
- Inpatient hospital care
- Outpatient surgery
- Home health care
- Prescription drugs—including our prescription discount program
- Global Emergency Services from Assist America
For all types of care, you choose your own doctors and hospitals. Plus, we offer a large provider network, meaning greater discounts for you.
*Pre-existing conditions and prescription medications for those conditions are excluded.
Benefits at a Glance
Our Short Term Medical coverage is based
on a participating provider network. You may
seek care from any doctor or hospital you
wish; however, you will save a little money by
choosing a provider in our PPO network.
The chart below shows our four deductible plan options and the benefits you can expect when you use providers both in and out of our participating provider network.
STM 80+500 |
STM 80+1000 |
STM 70+2000 |
STM 70+2500 |
|
| Maximum Lifetime Benefit | $1,000,000 |
$1,000,000 |
$1,000,000 |
$1,000,000 |
| Deductibles (per policy period) | ||||
|
$500/$1,500 |
$1,000/$3,000 |
$2,000/$6,000 |
$2,500/$7,500 |
|
$1,000/$3,000 |
$1,500/$4,500 |
$2,500/$7,500 |
$3,000/$9,000 |
| Out-of-pocket Limit (per policy period) | ||||
|
$1,500/$4,500 |
$2,000/$6,000 |
$3,000/$9,000 |
$3,000/$9,000 |
|
$3,000/$9,000 |
$4,000/$12,000 |
$6,000/$18,000 |
$6,000/$18,000 |
| Coinsurance Participating/Nonparticipating | 80%/50% |
80%/50% |
70%/50% |
70%/50% |
| Preventive Care Services | Participating Provider Reimbursement |
Participating Provider Reimbursement |
Participating Provider Reimbursement |
Participating Provider Reimbursement |
| Routine Gynecological Exam | 80% |
80% |
70% |
70% |
| Colorectal Cancer Screening | 80% |
80% |
70% |
70% |
| Prostate Cancer Screening | 80% |
80% |
70% |
70% |
| Professional Services | ||||
| Office and Home Visits | 80% |
80% |
70% |
70% |
| Urgent Care Center Visits | 80% |
80% |
70% |
70% |
| Surgery | 80% |
80% |
70% |
70% |
| Hospital Services | ||||
| Inpatient Room and Board | 80% |
80% |
70% |
70% |
| Inpatient Rehabilitative Care | 80% |
80% |
70% |
70% |
| Skilled Nursing Facility Care | 80% |
80% |
70% |
70% |
| Outpatient Services | ||||
| Outpatient Surgery | 80% |
80% |
70% |
70% |
| Diagnostic Therapeutic Radiology/Lab | 80% |
80% |
70% |
70% |
| CT/MRI/PET Scans, CATH Labs | 80% |
80% |
70% |
70% |
| Emergency Room Visits | 80% |
80% |
70% |
70% |
| Other Covered Services | ||||
| Outpatient Therapy | 80% |
80% |
70% |
70% |
| Ambulance Ground & Air | 80% |
80% |
70% |
70% |
| Durable Medical Equipment | 80% |
80% |
70% |
70% |
| Home Healthcare | 80% |
80% |
70% |
70% |
| Generic and Preferred Brand Prescription Drugs (Not subject to deductible) |
$15 or 50%, whichever is greater |
$15 or 50%, whichever is greater |
$15 or 50%, whichever is greater |
$15 or 50%, whichever is greater |
This is only a brief summary of benefits. Please refer to the additional information provided for a further explanation of benefits including limitations and exclusions.
