Assurant Health Short Term Medical Insurance

• Healthy individuals between the ages of 30 days and 64 years, 11 months who answer "no" to all questions.
• Dependent children under age 18* (age 24 if a full-time student) may be covered as dependents on a parent’s plan

* For residents of CO, IA, ME, MN, MT, NM, TX, UT, and VA: under the age of 25 regardless of student status.
* For residents of IN & TN: under the age of 24 regardless of student status.
* For residents of LA: under the age of 21 (age 23 if full-time student).
* For residents of ND: under the age of 22 (age 25 if full-time student).
* For residents of ID, NH & OK: under the age of 26 regardless of student status.
* For residents of SD: under the age of 19 (age 24 if full-time student).

Your Short Term Medical plan design is based on three things:
• deductible
• length of time you need coverage
• coinsurance

Decide on the deductible right for you.
Consider the tradeoff when choosing:
• A lower deductible means you’ll pay higher premiums (the amount you pay for your health coverage) but less out of pocket initially if you get sick or injured.
• A higher deductible means lower premiums but a greater initial sum out of pocket if you get sick or injured.

To decide how long you need health coverage, consider your needs.
If you pay by the month, simply stop paying when you secure permanent health insurance.
If you already know how long you’ll need coverage, you can save 20% on your premium by making a single, up-front payment. Premium refunds are not available when making a single payment. Your payment is due when you enroll, regardless of effective date.

Now you can have access to a national network of licensed physicians 24 hours a day, 365 days a year — by phone! TelaDoc is a convenient, cost-effective alternative for minor medical problems and a current solution for the health care issues of cost and access.
* Not available in OK.

With Short Term Medical, you get the following valuable benefits for unexpected illnesses and injuries. More details will appear in your enrollment kit. Coverage starts as early as the next day!

This Short Term Medical plan does not cover:
Treatment of a pre-existing condition, including those not inquired about on the enrollment form
• Routine care, examinations, or immunizations
• Illness or injury that is self-inflicted or caused while engaged in a felony, under the influence of an illegal substance, driving under the influence, in military service, in a hazardous occupation or activity for which compensation is received, Intercollegiate sports
• Vision or dental treatments, foot care, or orthotics
• Maternity^**, genetics, or fertility treatment or testing
• Custodial care or private nursing
• Cosmetic, experimental, investigational, or not medically necessary treatment
• Treatment of mental illness or substance abuse
• Expenses incurred outside the United States, its possessions, and Canada

* Covered charges in excess of reasonable and customary amounts are not covered under this Short Term Medical plan.
Notice for NE residents: This plan does not provide basic coverage for the treatment of mental health conditions and alcoholism.
** Does not apply to MT residents.

Short Term Medical plans provide coverage for unexpected illnesses and injuries, meaning they do not cover pre-existing conditions. While the definition of "pre-existing condition" varies by state, in general it is a condition that has been diagnosed or treated, or for which you experienced signs or symptoms, during the 5 years immediately prior to the Short Term Medical effective date.^*

If you need your insurance plan to cover treatment of an existing medical condition, consider extending your current plan to fill your gap in coverage. Employer-sponsored insurance can be extended under a government-regulated option called COBRA.

Because Short Term Medical is designed to cover the unexpected, it does not provide coverage for preventive care, physicals, dental care, or vision care. * Please see below for your state's pre-existing definition.

Your coverage will begin at 12:01 a.m. the day of your approved effective date, provided the enrollment form received is complete,^* meets the requirements for acceptance, and includes the full initial premium. Your requested effective date must be within 45 days of the date you signed the enrollment form.

* Enrollment forms that do not meet eligibility requirements will be returned to the applicant or agent. Incomplete enrollment forms may be returned and/or re-dated by Assurant Health.

Paying for your Short Term Medical plan is easy with these two convenient payment options:
• Single payment option: save 20% on your premium if you know the exact number of days you need coverage. The minimum plan duration you may apply for is 1 month, the maximum is 12 months (varies by state). No refunds are available after the 10-day free look period.†
• Monthly payment option: ideal if you are unsure how long you’ll need coverage. This "pay as you go" option gives you the flexibility to continue coverage for as long as you need—simply stop paying and discontinue the plan once you secure permanent insurance.

When you purchase Short Term Medical insurance, you are enrolled in Health Advocates Alliance, an association dedicated to the health and well-being of its members. Membership benefits include access to a 24-hour nurse helpline and discounts on vitamins and LensCrafters^® purchases.

If you are not 100 percent satisfied with the plan, you may return it and your identification cards within 10 days of delivery for a premium refund. No questions asked! After the 10-day free look period, premiums are not refundable.^† The one-time application fee is not refundable at any time.
†Not applicable to residents of FL, GA, ID, KS, KY, MI, OH, SC, and TX.

You may be able to reduce your medical bills by using the doctors and hospitals participating in the PHCS Healthy Directions provider network. Simply call or go online to see if your doctor or hospital is part of PHCS Healthy Directions:
1-800-357-6847 • PHCS
* Not applicable in RI.

When your plan expires, you may apply for another plan.^† Since a Short Term Medical plan will not cover medical conditions that existed before the plan began, a new Short Term Medical plan will not provide benefits for any condition or symptom that began during a previous plan.

† For CA residents: When your plan expires you may not be eligible for another STM plan if you've submitted a claim while covered by the previous plan.

For CO residents: You may apply for a new plan under the following condition:
• You have not had more than two Short Term Medical plans during the past 12 months.

For ID residents: You may apply for a new plan under the following condition:
• 64 days have passed since you were last covered by a Short Term Medical plan.

For ME residents: You may apply for a new plan under the following condition:
• Total days of coverage for all Short Term Medical plans cannot exceed 360 days. If you have reached the maximum 360-day limit, you must wait 12 months from the termination date of the last policy before reapplying for additional coverage.

For MI residents: You may apply for a new plan under the following condition:
• Total days of coverage from all our Short Term Medical plans cannot exceed 180 days in any 360-day period.

For MN residents: You may apply for a new plan under the following condition:
• Total days of coverage from all our Short Term Medical plans cannot exceed 360 days in any 555-day period.

For NH residents: You may apply for a new plan under the following condition:
• You have not been insured by a Short Term Medical plan more than two times in the past 12 months.

For NM residents: When your plan expires you may not be eligible for another STM plan if you've submitted a claim while covered by the previous plan.

For OR residents: You may apply for a new plan under the following condition:
• 90 days have passed since the last time you were insured for 180 days or more by a Short Term Medical plan.

For UT residents: When your plan expires you may not be eligible for another STM plan if you've submitted a claim while covered by the previous plan.

For WI residents: When your plan expires, you may apply for another plan if you have not exceeded a total of 18 months of coverage under Assurant Health Short Term Medical plans. If you have exceeded the 18 months, you must wait at least 64 days after the termination of your last Assurant Health Short Term Medical plan.

IMPORTANT : You can get an interpreter at no cost to talk to your doctor or health insurance company. To get an interpreter or to ask about written information in Spanish, first call your insurance company’s phone number at 800-800-1212. Someone who speaks Spanish can help you. If you need more help, call the Department of Insurance Hotline at 800-927-4357.
IMPORTANTE : Puede obtener la ayuda de un intérprete sin costo alguno para hablar con su médico o con su compañía de seguros. Para obtener la ayuda de un interprete o preguntar sobre información escrita en español, primero llame al número de teléfono de su compañía de seguros al: 800-800-1212. Alguien que habla español puede ayudarle. Si necesita ayuda adicional, llame a la línea directa del Departamento de seguros al 800-927-4357.

Colorado law requires carriers to make available a Colorado Health Benefit Plan Description Form, which is intended to facilitate comparison of health plans. The form must be provided automatically within three (3) business days to a potential policyholder who has expressed interest in a particular plan or who has selected the plan as a finalist from which the ultimate selection will be made. The carrier also must provide the form, upon oral or written request, within three (3) business days, to any person who is interested in coverage under or who is covered by a health benefit plan of the carrier.

We maintain an access plan for each network offered in Colorado. The access plan includes information regarding availability and accessibility of participating providers and our method of informing you of the plan’s services and features. The access plan is available upon request by contacting us.

WARNING : IF YOU OR YOUR FAMILY MEMBERS ARE COVERED BY MORE THAN ONE HEALTH CARE PLAN, YOU MAY NOT BE ABLE TO COLLECT BENEFITS FROM BOTH PLANS. EACH PLAN MAY REQUIRE YOU TO FOLLOW ITS RULES OR USE SPECIFIC DOCTORS AND HOSPITALS, AND IT MAY BE IMPOSSIBLE TO COMPLY WITH BOTH PLANS AT THE SAME TIME. BEFORE YOU ENROLL IN THIS PLAN, READ ALL OF THE RULES VERY CAREFULLY AND COMPARE THEM WITH THE RULES OF ANY OTHER PLAN THAT COVERS YOU OR YOUR FAMILY.

Please see the information below that corresponds to your state
AK, AL, AR, AZ, FL, GA, HI, IA, IN, KS, KY, MD, MN, NE, NV, OH, OK, OR, TN, TX, VA, WA , WI, WV and WY

PRE-EXISTING CONDITION: A medical condition due to sickness or injury:

For which the insured received medical treatment or advice from a provider within the 5-year period immediately preceding the effective date of coverage, regardless of whether the condition was diagnosed or not diagnosed; or
That produced signs or symptoms within the 5-year period immediately preceding the effective date of coverage. The signs or symptoms must have been significant enough to establish manifestation or onset by one of the following tests:
1. The signs or symptoms would have allowed one learned in medicine to make a diagnosis of the disorder; or
2. The signs or symptoms should have caused an ordinarily prudent person to seek diagnosis or treatment.

A pregnancy that exists on the day before your effective date will be considered a pre-existing condition.

PRE-EXISTING CONDITION: A medical condition due to sickness or injury for which medical advice, diagnosis, care or treatment, including the use of prescription drugs, was recommended or received from a health care practitioner within the 6-month period immediately preceding the effective date of coverage.

PRE-EXISTING CONDITION: A medical condition due to sickness or injury for which the insured received medical advice, diagnosis or care or for which treatment was recommended or received from a provider within the 12-month period immediately preceding the effective date of coverage, regardless of whether the condition was diagnosed or not diagnosed.