Short Term



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Overview

Short Term Medical Insurance is temporary medical insurance designed for people who are between permanent health plans. Coverage can be purchased for as few as 30 days or as many as 365 days. The application process is simple with only a few qualifying questions to answer and coverage can begin as early as the next day. Because of their quality benefits and competitive rates, Assurant Health is the #1 seller of short-term medical plans in the U.S.

Short Term Medical Insurance is perfect for individuals who are:
  • Recent college graduates
  • Between jobs or laid off
  • Waiting for employer-sponsored coverage
  • Losing dependent status
  • Looking for a lower-cost alternative to COBRA
  • Recently retired and not eligible for Medicare
  • On strike

Assurant Short Term Plan Options

Rate of Payment (Coinsurance)

Percentage of covered expenses we pay after the deductible

Benefit Up to 6 Months
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Length of Coverage 30 – 185 daysUp to 6 monthly payments
DeductibleAmount you pay toward covered expenses before the plan pays benefits $1,000, $2,500, $3,500 $5,000,Only one deductible needs to be satisfied for the plan.
Coinsurance 100%, 80%, 50% The 100%, 80%, and 50% option are available with the all deductible options except the $1,000 deductible which only has an 80% or 50% coinsurance option.
Out-of-Pocket MaximumThe amount of money an individual pays toward covered hospital and medical expenses. Does not include deductible For the 100% option, the out-of-pocket is $0.For the 80% option, the out-of-pocket maximum is $2,000 for one individual. ($4,000 for 2 individuals, and $5,000 for 3 or more individuals)

For the 50% option, the out-of-pocket maximum is $5,000 for one individual. (It is also $5,000 for 2 or more individuals)

Prescription Drugs Covered
Lifetime Benefit MaximumThe total maximum amount the plan pays $2 million

  • Rate of payment (coinsurance) options: 100%, 80/20, 50/50. The 100% rate of payment option is only available for plans with deductibles of $2,500 or greater.
  • Lifetime Maximum Benefit is the total benefit that can be paid out over the lifetime of the policy (effective dates of the policy). You may choose to increase your Lifetime Maximum Benefit by upgrading your policy at the time of enrollment/purchase.

Flexible Plan Options

Assurant short-term medical plans allow you flexibilty to design the plan that’s right for you. You can choose your:

  • Length of coverage – Anywhere from 30-185 days
  • Deductible amount – $1,000, $2500, $3,500, or $5,000
  • Coinsurance – 100%, 80%/20%, or 50%/50% after deductible

First, you pay your deductible, next Assurant Health pays 100%, 80%, 50% of the next $10,000 (this is called your coinsurance). Once your deductible and coinsurance are paid, Assurant Health pays 100% up to the policy limits of $2 Million. Plus, if you choose a $500 or greater deductible, only one deductible needs to be satisfied for your entire family.

Freedom to use any Doctor or Hospital

Assurant short-term medical plans allow you the freedom to visit any doctors and hospitals you choose. The plan benefits including the deductible and coinsurance are the same for any licensed doctor or hospital so you will not be penalized by “out-of-network” benefits. However, you can get PPO network discounts and reduce your medical bills an average of 20%-35% by using doctors and hospitals in the PHCS Healthy Directions network.

What’s Covered

Short Term Medical Insurance plans allow you to choose any doctor or hospital and do not limit you to in-network providers. Once your deductible and coinsurance amounts have been met, the short-term medical plan pays for all covered medical, hospital, and surgical surgical expenses. This includes physician services, prescriptions, x-rays, laboratory services, inpatient hospital stays, inpatient hospital surgeries, anesthesia services, skilled nursing facility care and rehabilitation up to a lifetime maximum of $2 million.

Prescription Coverage

Prescriptions are covered under Assurant short term medical plans, but there are no copayments. When you present your STM prescription card, which is part of your ID card, at a participating pharmacy, you will receive a negotiated disounted and then will be subject to deductible and coinsurance amounts. Below are some real-life savings examples of some commonly used precriptions with the Short Term Medical prescription drug card.

Drug

Strength andquantity

Retail price

Price usingcard

Percentagesavings

Lipitor 10 mg, qty 30 $96.99 $69.99 28%
Levaquin 500 mg, qty 10 $145.99 $98.79 32%
Nexium 20 mg, qty 30 $179.99 $125.89 30%
Singulair 10 mg, qty 30 $124.99 $88.24 29%
Zyrtec 10 mg, qty 30 $83.99 $56.59 33%

Assurant Health Short Term Medical – Eligibility Guidelines

In Illinois, persons eligible for Assurant Health short-term medical insurance include:

  • Healthy individuals between the ages of 30 days and age 64 and 11 months
  • Dependent children through age 18 (age 24 if a full-time student)
  • Foreign residents living in the U.S. for at least one year at the time of enrollment, with proof of Alien Registration Receipt Card, Visa or other appropriate documentation

Additionally, individuals must be able to answer “no” to the 2 questions in the Assurant medical questionnaire below. If you can “yes” to any of the questions in the questionnaire, you are not eligible for coverage.

Assurant Short-Term Medical Questionnaire

Answer the following questions completely and accurately.
1. Have/Are you, your spouse, or any person to be insured:

  • now pregnant, an expectant parent, in the process of adopting a child or undergoing infertility treatment?
  • over 300 pounds if male, or over 250 pounds if female?





2. For any of the following conditions within the last 5 years, have you or any person to be insured received any abnormal test results or medical or surgical treatment, or consulted a health care professional, or taken medication for:

  • heart disorder including but not limited to heart attack or chest pain?
  • Emphysema?
  • Crohn’s disease, ulcerative colitis or hepatitis?
  • AIDS or tested positive for HIV?
  • stroke?
  • kidney disorder, excluding kidney stones?
  • diabetes?
  • cancer or tumor?
  • alcoholism, chemical dependency, drug or alcohol abuse?





Benefit Exclusions

Short Term Medical Insurance coverage is designed to protect you in the event of an unexpected illness or injury. Because of this, medical insurance coverage for preventive care, pre-existing conditions, physicals, pregnancy, immunizations, dental or eye care services are not covered by short term medical plans. Any medical expense incurried outside the U.S. or Canada is also excluded from temporary insurance plans. Individuals that need medical coverage outside the country should get an international travel insurance policy.

Payment Options

For short-term plans, Assurant gives the option of either paying for the entire amount up front, or making a monthly payment. You can pay with either Visa or Master Card, automatic charge to a checking account, or by check.

Single payment option: This is ideal if you know the exact number of days that your coverage is needed. If you make a single, up-front payment, you save about 20% on your premium (compared to monthly payments). The minimum number of days you may apply for is 30 days, the maximum is 365 days. No refunds are available after the 10-day free look period.

Monthly payment option: If you are unsure of how long you will need coverage, this option would be the best for you. The “pay as you go” option gives you the flexibility to continue coverage for as long as it is needed, or simply stop payments and discontinue the plan once your temporary health insurance need ends.

If you pay your initial 35 day premium by MasterCard or VISA, each additional 30 days of coverage will be automatically charged to your account for up to 365 days. If your temporary medical insurance need ends prior to this date, simply call 1-800-800-5453 and the automatic account charge will be stopped. Seven day advance notice is required to ensure future account charges are stopped.

If you choose to pay monthly by the automatic charge to checking account, all subsequent monthly payments will be automatically debited from your checking account for up to 365 days. If your short term health insurance needs end prior to this date, simply call 1-800-800-5453 and we will stop the automatic account charge.

Purchasing an Additional Short-Term Plan

Short term health insurance plans are not renewable. However, if you need temporary health insurance beyond your policy period, you may apply for a new plan under the following circumstances:

  • No claims were submitted while covered under a previous short term medical insurance plan
  • There has been no significant change to your health

There is no limit on the amount of Assurant Health short-term policies you can purchase, but any previous or current health condition or symptom will be considered a pre-existing medical condition that will not be covered under a new plan. For example, if you brake your leg while covered under a short-term plan and you need to purchase an additional short-term plan, the new short-term plan will not cover any claims related to the broken leg.

Short Term Plan Benefits

Our Rating:

Plan Feature 6 Month Plan
Length of Coverage 30-185 days
Lifetime Maximum Benefit $2,000,000 per person
Deductible
The amount you must pay before Assurant Health pays any benefits
$1,000, $2,500, $3,500, or $5,000
Family Deductible
Same as indvidual deductible, only one deductible needs to be satisfied by all covered family members
Only one deductible needs to be satisfied by all covered family members
Coinsurance Options
Percentage of covered expense insurance pays after satisfaction of the deductible. For the 100% coinsurance option, the plan pays 100% of eligible expenses after the deductible is met. For the 80% and 50% coinsurance options, the plan pays 80% or 50% of the next $10,000 of eligible expenses after the deductible is met. Then the plan pays 100%.
100%
80%
50%
Doctor Visits
Subject to deductible and coinsurance
Covered for unexpected illness and injury. Discounts of 20%-35% for using network doctors
Hospital Benefits
Subject to deductible and coinsurance
Inpatient and outpatient services covered. Discounts of 20%-35% for using network facilities
Emergency Room Care
Subject to deductible and coinsurance
Covered
Ambulance Covered
Outpatient Surgery
Subject to deductible and coinsurance
Covered
X-ray and Laboratory
Subject to deductible and coinsurance
Covered
Prescription Drug Benefits
Subject to deductible and coinsurance
Includes prescription drug card for instant savings and covered subject to deductible and coinsurance
Optional Add-On Benefits 6 Month Plan
Term Life Insurance $25,000 for insured or $25,000 for both insured and spouse
Accidental Medical Expense
Provides first dollar coverage for treatment of an accidental injury.
Benefit amounts per accident are equal to the Short Term Medical deductible chosen.
Dental-Vision Discount Plan Save 10% to 60% on eyeglasses, contact lenses (disposables via mail order only), and other retail eyewear items through a network of over 13,000 eye care professionals nationwide. You can also receive discounts on eye examinations and surgical procedures including Lasik where available.

Save 10% to 50% on dental care expenses such as orthodontics (braces), dentures, cosmetic dentistry, crowns, extractions, fillings, oral surgery, periodontics and most other services through a network of more than 24,000 providers nationwide.

Save 25% to 50% off suggested retail prices on vitamin and nutritional supplements.

FAQ

Why would I want coverage for a short period of time?

If you’re between jobs, waiting for coverage from another health insurance plan to start, laid off, on strike, a recent college graduate or seasonal employee and know that you only need coverage for a specific period of time, short-term health insurance may be a great option for you.


How soon can Short Term Medical begin?

Your short term medical coverage can begin the next day if you apply on the internet using a credit card or auto bank debit, as long as the eligibility criteria is met. If you decide to mail your application with a check, the earliest your STM policy can begin is the next day following the U.S. Postal Service postmark. (As long as eligibility requirements are met and application is legible.)

All transmissions take place and are recorded based on the time and date in the Central Time Zone. For example, if you submit your application on-line at or after 10:00 p.m. on March 15th from a location in the Pacific Time Zone, the time of the transmission will be at or after 12:00 a.m. Central Time. The transmission date of your application will be March 16th.


Does a Short Term Medical plan cover prescription drugs

Yes. However, there are no copayments. When you present your STM prescription card, which is now conveniently part of your ID card, at a participating pharmacy, you will receive a negotiated disounted and then will be subject to deductible and coinsurance amounts.

Look at the real-life savings examples below for some commonly used prescriptions and see what you could save when you use your Short Term Medical (STM) prescription drug card.

Drug Strength and quantity Retail price Price using card Percentage savings
Lipitor 10 mg, qty 30 $96.99 $69.99 28%
Levaquin 500 mg, qty 10 $145.99 $98.79 32%
Nexium 20 mg, qty 30 $179.99 $125.89 30%
Singulair 10 mg, qty 30 $124.99 $88.24 29%
Zyrtec 10 mg, qty 30 $83.99 $56.59 33%

Retail pricing based on Walgreens Pharmacies in Milwaukee and Oconomowoc, Wisconsin, June 6, 2007. Pricing examples are for illustration purposes only. Prices are subject to change without notice and may vary by region. Payment must be made at the time of service to receive discount. Prescription drug savings do not guarantee benefits under your STM plan.


Is a Short Term Medical plan considered “creditable coverage” under HIPAA?

Under HIPAA, Short Term Medical coverage is generally considered creditable coverage to help satisfy any pre-existing condition period. Previous creditable coverage includes:

  • A group health plan
  • Health insurance coverage
  • Part A or Part B of title XVIII of the Social Security Act (Medicare)
  • Title XIX of the Social Security Act, other than coverage consisting solely of benefits under section 1928 (Medicaid)
  • Chapter 55 of title 10, United States Code (Champus)
  • A medical care program of the Indian Health Service or of a tribal organization
  • A state health benefits risk pool
  • A health plan offered under chapter 89 of title 5, United States code (Federal Employee Health Benefit Plan)
  • A public health plan (as defined in regulations)
  • A health benefit plan under section 5(e) of the Peace Corps Act

Should I pay monthly or make a single payment up front?

Most short-term health insurance plans give you the option of paying in monthly installments, or in a single up-front payment. Often, single payment plan costs may be lower than monthly plan costs.

We recommend you select “Monthly“, if you:

  • don’t know exactly how long you will need coverage, or
  • don’t want to make a single up-front payment

We recommend you select “Single Up-front Payment“, if you:

  • know exactly how long you will need coverage for,
  • want lower plan costs, and
  • don’t mind paying your whole premium up-front

If you select “Single Up-Front payment” you will need to specify the duration of your coverage (30-365 days). Also, if you select “Single Up-Front payment”, you will enjoy the convenience of not having to manually cancel your plan at the end of your coverage period, although typically you will not be able to get a refund once coverage starts. If you need short-term health insurance after your specified duration, you will need to re-apply for a new short-term plan.


Do Short Term Medical plans include dental and vision benefits?

No. Short-term health insurance plans are designed to protect you in the event of an unexpected illness or injury and are not intended to cover dental and vision care. Short-term health insurance plans are for temporary coverage only and therefore do not include some of the benefits offered by standard, longer-term heath insurance plans.


Will purchasing a Short Term Medical plan make it harder for me to get coverage in the future for a pre-exisiting medical condition?

No. Short Term Medical actually makes it easier to get coverage from an employer in the future. It is generally considered creditable coverage and can prevent a break in coverage and help satisfy any pre-existing condition periods


How will I know if I qualify for Short Term Medical coverage?

In most cases, as soon as you complete the application, the insurance company will notify you online if do not qualify.


If I don’t qualify for a Short Term plan, will my credit card still get charged?

No. If you choose to use a credit card, your card will only be charged if you qualify for short-term coverage. Please note that credit card billing of premiums is optional and you can obtain coverage without using that method of payment.