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TIME/Assurant Health Short Term Medical
What Is It?
Temporary health insurance, such as Assurant Health’s Short Term Medical plan, is designed to fill short gaps in health insurance coverage.
Typically, insurers offer coverage for periods ranging from one to twelve months. Exact length of coverage may vary by company and by state.
Assurant Health policies typically cover periods of 30 to 365 days, for example.
Who Needs It?
Typical customers for Short Term Medical insurance are:
• People changing jobs or making a transition to a new career.
• Graduating students no longer covered by a family plan, but not yet covered by an employer’s group plan.
• New employees facing a short waiting period before becoming eligible for an employer’s group insurance plan.
• Workers who are in a part-time or temporary position for a short period of time.
• Employees who are laid off or on strike.
• New Business Entrepreneurs who need time to shop around for a more permanent insurance plan.
• Early retirees who may face a short waiting period before they’re eligible for Medicare.
What Does It Cost?
Rates vary by age, sex, area of the country, whether or not a spouse and/or children are covered, and plan features such as deductibles.
Generally, temporary plans are more affordable than permanent insurance plans because the insurer is taking less risk. For example, for a 25-
year-old single male, rates for an Assurant Health $500 deductible, 80/20 plan would currently range from about $29 to about $87 for 30 days of
coverage. Typically, temporary health plans are about one-third the cost of continuing coverage through government regulated extension
programs such as COBRA.
How Consumers Can Cut Costs
• Choose a high-deductible plan.
• Consider a 50/50 coinsurance option rather than the more typical 80/20. With the 50/50 option, the insurance company covers 50 percent of
covered expenses after the deductible; the customer pays the other 50 percent up to a cap. Customers are protected from the costs of
catastrophic illness or injury by the cap on the amount of out-of-pocket expenses they need to pay.
• If a consumer knows the exact length of time coverage is needed, he or she can usually save money with a one-time premium payment.
Costs of Not Having Insurance
Here are some claims that Assurant Health has paid under its Short Term Medical plan in recent years:
• $623,000 — spinal cord injury following a fall. (The consumer paid $266.40 for this $2500 deductible, six-month policy.)
• $466,000 — climbing accident
• $129,000 — aortic aneurysm
• $75,000 — pneumonia
Some Statistics
A 1998 Census Bureau study, “Who Loses Coverage and for How Long,” found that young adults (between the ages of 18 and 24) were the most
likely of any age group to lack insurance for at least one month. More than half of this group was not continuously covered during the 36-month
period studied. This study also found that about half of those who lost coverage lost it for 5.3 months or less. The same study found, not
surprisingly, that 56.1% of those with one or more job interruptions were not continuously covered.
A 1999 Public Opinion Strategies survey report showed that there are a significant percentage of people who shift in and out of health insurance
coverage. The survey data showed that 40% of the uninsured surveyed had coverage sometime during the year. Although there are many factors
causing this movement in and out of the health insurance market, temporary health insurance may provide a solution for some of those who are
uninsured for short periods.
Considerations in Choosing Temporary Health Coverage
Temporary insurance covers a limited period. Consumers who think they’ll need coverage for longer than twelve months may want to look at a
more permanent health insurance option. Most temporary policies are not renewable. Some companies do allow consumers to take out a
second short-term policy under certain conditions. Assurant Short Term coverage may be renewed once, for up to a total coverage period of 12
months.
Temporary policies generally do not cover pre-existing conditions. The reasons are obvious to consumers who understand that insurance is
designed to protect against the unforeseen. If pre-existing conditions were covered under temporary policies, people could just wait until they
were diagnosed with an illness or suffered an injury, buy a policy to cover the treatment, then drop it. The cost of such policies would be
prohibitive. Because temporary policies are usually designed to cover the unexpected, most do not include coverage for Preventive Care,
Routine/Annual Physical Exams, Immunizations, Dental or Vision care.
The definition of a pre-existing condition varies by state, but most temporary policies exclude conditions that have been diagnosed or treated
within the previous five years. Consumers with an existing medical condition may want to see if extending their current insurance to fill a gap in
coverage is an option for them. Employer-sponsored insurance can be extended under a government-regulated option called COBRA.
Consumers also have rights to extend health insurance coverage under HIPAA (the Health Insurance Portability and Accessibility Act). Temporary
health insurance policies are available in most states, but a few states require all health insurance policies to be guaranteed issue and/or
guaranteed renewable. Temporary insurance is not available in those states.
Temporary policies generally include a provision to handle coverage for ongoing conditions that begin under the policy, but continue after the
temporary policy expires. Exact coverage will vary and may depend on whether the condition is short-term or results in total disability.
General Information
Q.When does my coverage begin?
A.If you are submitting your application by:
Internet using a credit card - The earliest your coverage can begin is the day following transmission, if all other eligibility criteria have been met.
For example, if you submit your application online on March 16th, your coverage begins at 12:01 A.M. on March 17th. Dates of the 29th, 30th and
31st are not available.
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.
Mail and writing a check - The earliest that your coverage can begin is the day following the U.S. Postal Service postmark, if all other eligibility
criteria have been met. (If the envelope containing your application is not postmarked by the U.S. Post Office or if the postmark is not legible,
coverage will begin the later of a) your requested date or b) two days prior to the date the application was received by Assurant Health.) Dates of
the 29th, 30th and 31st are not available.
Coverage will take effect provided the following conditions are met: Your completed application and full premium payment are received by
Assurant Health and you meet the requirement for acceptance.
Q. When will I receive confirmation or acceptance of the application?
We will review the application for eligibility and check the submitted premium.
If you apply via the Internet, you will receive an email message with confirmation or acceptance of the application shortly after it is submitted. Your
identification card and contract will be sent to the "correspondence address" indicated within approximately 72 hours of receipt.
If you print out the application and mail it to us, most eligibility determinations are made within 48 hours of receipt. If the application is complete
and the full premium is paid, the identification card and contract will be sent to the "correspondence address" indicated within approximately 72
hours of receipt.
Please Note: If you are required to provide proof of insurance to your school, please submit the application at least two weeks before proof of
coverage is needed.
Payment Options
Q. What are my payment options?
A. You may select an annual, semi-annual or monthly (Bank Draft) payment mode. Single Premium and Monthly MasterCard and Visa charges
are also accepted.
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TIME/Assurant Health Student Select
The plan provides for high cost items such as hospital stays and surgery as well as everyday occurrences like doctor visits. However, it is
important to understand that Student Select is not designed to pay for injuries and illnesses that exist at the time a customer's policy becomes
effective. Following are some highlights of the plan benefits.
Summary of Coverage
The following general summary of features on the Student Select plan may vary according to the state in which the insured resides. This
summary is not an insurance contract. The policy itself sets forth in detail the rights and obligations of both you and your insurance company.
Once you receive your policy, please read it carefully.
FEATURES of Student Select - Policy Maximum $1 Million Lifetime $100,000 per illness/injury
Plan Deductible
This is the annual amount a customer pays before benefits are paid. Individual: $250, $500, $1,000, $2,500
This is a calendar year deductible
Coinsurance (also referred to as Rate Payment)
This is the percentage of covered medical expenses Assurant Health pays after the deductible is met. 80% of the next $10,000 in covered
expenses
Assurant Health pays 100% thereafter to $100,000
Prescription Drugs
Only inpatient prescriptions are covered. Cost is subject to deductible and coinsurance. There is no co-payment and no prescription card is
issued.
Office Visits Subject to deductible and coinsurance
Wellness Benefit Not covered except where state mandated
Hospital Room and Board Semi-private rate, subject to deductible and coinsurance
Intensive Care Subject to deductible and coinsurance
In and Outpatient Surgery Subject to deductible and coinsurance
Lab and X-ray Subject to deductible and coinsurance
Substance Abuse, Mental/Nervous Disorders Not covered except where state mandated
Medical Evacuation Coverage is up to $10,000 per lifetime when medically necessary after illness or injury resulting in hospital admission.
Evacuation will be to home country or to a facility operating within the laws and standards of home country. (Not available in all states)
Repatriation Benefit Benefit is $10,000 over and above any other maximum benefit amount. (Not available in all states)
Pregnancy Normal pregnancy is not covered. Complications of pregnancy are covered but are subject to deductible and coinsurance.
Pre-Existing Conditions Not covered for the first 12 months
Extension of Benefits Coverage may be extended up to 12 months if the covered person is confined as an inpatient in a hospital on the date
coverage terminates, due to an injury sustained or an illness which commenced while the policy was in force. The extension of benefits provision
applies only if the covered person remains confined as an inpatient in a hospital beyond the termination date.
Payment Options
Q. What are my payment options?
A. You may select an annual or semi-annual payment mode. MasterCard and Visa are accepted.
Q. If I graduate or drop out of school, will I lose coverage?
A. No, your Student Select policy stays with you for as long as you need it and, of course, as long as premiums are paid.
Q. How many times can the plan be renewed?
A. Student Select is renewable as long as you need it...and, of course, as long as the premiums are paid. This is important after graduation while
looking for a job.
Q. Will coverage be in jeopardy if I drop a class?
A. No, not as long as:
1) You met the definition of an eligible student on the date the application was signed.
2) You attended school full-time for 31 days after the policy effective date.
3) The premium is paid in full.
Q. When can I apply for a policy? I would like to apply now but won't be a student for another month?
A. You can apply as soon as you are enrolled to be an eligible student.
Q. How far in advance can I apply if requesting a later effective date? In other words, can I apply in July but request an effective date for
September 1st when school begins?
A. Yes, but keep in mind the full premium must be paid with the application. The policy will be sent out as soon as it is issued. We would prefer
that the application not be completed more than 60 days prior to the requested effective date.
Note: This chart is not all-inclusive. The actual contract provides a complete list of benefits, limitations and exclusions. For a complete
explanation on policy benefits, limitations and exclusions, see the insurance contract.
More specifically Student Select covers...
Covered charges incurred for: office, inpatient and emergency room visits, including treatment rendered during such visits; surgical services,
including necessary post operative care following inpatient or outpatient surgery; services of an assistant surgeon, when we determine the
services of an assistant are required to perform the surgery; anesthesia services.
Covered charges incurred for: room, board and routine nursing services that are generally provided to all persons while confined in a hospital. If
the covered person is confined in a private room, only charges up to the average semi-private rate of the hospital are covered; inpatient medical
care and treatment provided in a hospital; outpatient medical care and treatment provided by a hospital, freestanding ambulatory surgical center
or freestanding urgent care center; medical care and treatment provided in an emergency room.
Covered charges incurred for outpatient x-ray, radioactive treatment and laboratory services including one screening mammographic exam per
calendar year for a covered female, age 35 or over.
Covered charges incurred for the first 30 days of confinement in a rehabilitation or skilled nursing facility for the covered person per calendar year.
Covered charges incurred for the first 40 home health care visits for the covered person per calendar year.
Covered charges incurred for professional ground or air ambulance service to the nearest hospital that is able to treat the illness or injury.
Covered charges incurred for treatment and diagnosis of vertebrae, disc, spine, back, neck and adjacent tissues. The maximum amount we will
pay is limited to $750 for the covered person per calendar year. The $750 maximum does not apply to covered charges incurred for hospital
confinements, surgery, anesthesia, drugs, laboratory services, x-rays, MRIs or EMGs.
Covered charges incurred for rental (not to exceed the purchase price) of one basic manual wheelchair, one basic hospital bed, one pair of basic
crutches, the initial permanent basic artificial limb or eye and oxygen and the basic equipment needed to administer oxygen; and the initial
external breast prosthesis needed because of the medically necessary surgical removal of all or part of the breast, provided the surgical removal
was done while the covered person was covered under the plan. Charges for repairs to, replacement of, maintenance of, or enhancement of the
whole or parts of such items are NOT covered.
Covered charges incurred for reconstructive surgery required due to an illness which commenced or an injury which occurred while the covered
person is insured under the plan.
Covered charges incurred for surgical treatment of temporomandibular joint (TMJ) or craniomandibular joint (CMJ) dysfunction, provided the
charges are for services included in a dental treatment plan authorized by us prior to the surgery; charges for nonsurgical treatment of TMJ or
CMJ. The maximum amount we will pay for surgical and non-surgical treatment combined is limited to $1,000 for the covered person during his
or her lifetime.
Covered charges incurred for the following complications of pregnancy: missed abortion (miscarriage); spontaneous, incomplete or complete
abortion (miscarriage); ectopic pregnancy; spontaneous premature delivery of a nonviable fetus; and other medical conditions whose diagnoses
are distinct from pregnancy but are adversely affected by pregnancy such as acute pyelonephritis, renal failure, diabetes, cardiac
decompensation, malignancy, chronic hypertension and phlebitis.
Covered charges incurred for the covered person's medical evacuation to his or her home country or to a facility operated pursuant to the laws of
his or her home country for the care and treatment of illness or injury, should the covered person be admitted as an inpatient to a hospital as a
result of illness or injury. The maximum amount we will pay for medical evacuation of the covered person during his or her lifetime is limited to
$10,000.
Covered charges incurred for repatriation of the covered person's remains to his or her home country or country of regular domicile should the
covered person die while insured under this plan, provided treatment of the illness or injury would have been covered under this plan had the
person not died. The maximum amount we will pay for repatriation of the covered person's remains is limited to $10,000.
Covered charges incurred for the following organ transplants: lung(s), heart, heart/lung, liver, kidney, cornea, skin, or allogeneic autologous bone
marrow and/or stem cell rescue for acute leukemia in remission, neuroblastoma, advanced Hodgkin's disease, chronic myelogenous leukemia,
or severe aplastic anemia. The maximum amount we will pay for any and all organ transplants is limited to $100,000 for the covered person
during his or her lifetime.
Although this is a good description of the important features of the Student Select plan, this is not the insurance contract and only the actual
contract defines coverage. Benefits may vary by state and by the terms of the insurance contract. The policy itself sets forth in detail the
rights and obligations of both you and the insurance company.
