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From 30 days up to 6 or 12 months
of Short Term Medical Insurance*
*Secure STM is not available in all states. Some states only allow a
maximum six-month coverage period.
Affordable Health Insurance with
$2,000,000 Coverage Period Maximum Per Insured Person
Important Protection:
Just because you don't have health insurance right now doesn't mean you
won't have health problems.
The Secure STM allows you and your family
to purchase, affordable major medical coverage on a short term basis.
The covered benefits include expenses for doctors services, surgery,
out-patient, in-hospital care and prescription drugs.
Eligibility:
Secure STM is offered to members, their spouses 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.
Featuring...
- $2,000,000 Coverage Period Maximum
Per Insured person
- Freedom to choose any doctor or hospital
- Choice of $250, $500, $1,000, and $2,500
deductibles
- Select to pay monthly or single payment
- Accept payment by: check, money order,
MasterCard, Visa, Discover or automatic monthly bank draft
- Child only coverage
Perfect for...
- People between jobs
- New Employee Waiting Periods
- Part-Time / Temporary Employees
- Dependent Child Coverage
- College Students / New Graduates
Next Day Coverage Available!
The insurance can be effective as early as 12:01 a.m. the next day after
the transmission date. However, the applicant can choose a later effective
date not to exceed 60 days from transmission date. Coverage ends on
termination date listed in your policy.
Insured By:
Standard Security Life Insurance Company of New York
Rated A (Excellent) for financial condition by A.M. Best Company,
as of 06/04. A.M. Best ratings range from A++ to D.
Administered By:
Health Plan Administrators, Inc.
Covered Expenses
Just because you don't have health
insurance right now doesn't mean you may not have health problems. Secure
STM allows you and your family to purchase quality, affordable major
medical coverage on a temporary basis. Coverage is provided for physician
services, surgery, outpatient and inpatient care.
How benefits are covered?
The benefit options for covered expenses for injury or sickness per
insured person per benefit period.
Secure STM pays benefits for each covered
person in the following manner: First, you meet your deductible. Choose
from four options: $250, $500, $1,000 or $2,500
Then Secure STM pays 80% or 50% of the next
$5,000 of covered expenses
After this, Secure STM pays 100% of covered
expenses up to your coverage period maximum of $2 million
What medical expenses are covered?
After satisfying the deductible amount you've selected, Secure 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 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 benefit
- 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.
** 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,
Missouri, North Carolina or North Dakota. In Kansas the maximum per
Coverage Period is $75,000.
Benefits may vary by state.
What is a family deductible?
With a family deductible benefit your insured family is only required to
satisfy a maximum of three (3) deductibles during the coverage period.
What is a usual, reasonable and
customary charge?
A "usual, reasonable and customary charge" is the charge
typically made by physicians or suppliers of medical services, medicines
and supplies within a specific geographic area as determined by us.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 precertification?
Pre-admission certification prior to eligible inpatient hospitalization or
surgery by the covered individual within 48 hours is required. This is not
a guarantee of benefits. Failure to precertify will result in a benefit
reduction of 50%. Call 1-800-367-9938 for precertification.
When does coverage terminate?
Coverage ends when the premium is not paid when due; you enter full-time
active duty in the Armed Forces; you become eligible for Medicare; the
elected coverage period expires; Standard Security Life Insurance Company
of New York determines fraud or misrepresentation has been made in filing
a claim for benefits; or a dependent ceases to be eligible; you cease to
be a member of the association or the group master policy terminates..
Can I continue coverage?
If your need for temporary health insurance continues, you may apply for
another Secure STM plan. Your application is subject to eligibility,
underwriting requirements and state availability of the coverage. The next
coverage period is not continuous and any condition incurred during the
last coverage period will be excluded as a pre-existing condition.
This website provides a brief description
of the benefits, exclusions and other provisions of the policy Form
SSL-STMP-1104. For complete listing, see the Policy/Certificate of
Insurance. Benefits may vary by state. Secure STM is not available in all
states.
Association membership may be required in some jurisdictions.
2005 HPA, Inc. All rights reserved.
SM STM-1 3/05
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