Temporary Health Insurance for
People Who
Are:
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 Between
Jobs
Looking for an
alternative to COBRA
Recent
college graduates
Waiting
for employer-sponsored coverage
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No one plans to have an unexpected illness or accident
happen to them.
But let's
face it — the unexpected does happen. That's why going without health
insurance, even for a short time, puts you or your family at serious financial
risk.
Don't take the chance! Short
Term Medical from Fortis Insurance Company provides affordable, health coverage
that protects you or your family — for only
dollars a day.
Choose from two convenient plans — up to six
months coverage or up to 12 months coverage — the choice is
yours.
Short Term Medical is designed for people who are between
permanent health plans. So, whether you are:
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Between
jobs, |
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Looking
for an alternative to COBRA, |
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A recent
college graduate, |
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In a
waiting period for employer-sponsored coverage, |
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A
temporary or seasonal employee, |
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A
dependent no longer covered by parent's plan, |
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On strike,
laid-off losing your job.
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Short Term Medical can provide you with the peace of mind you
deserve.
How The Plans
Work
You choose the plan that best meets your needs and
budget! Simply select from your choice of deductibles, rate of payment options,
lifetime maximum benefit and length of coverage. Since these plans are not an
HMO or PPO, you choose your own doctors and hospitals.
For
additional savings - You can use the doctors and hospitals participating in
PHCS Healthy Directions. Simply call PHCS at 1-800-357-6847 or visit
them on the web at www.phcs.com to verify that your doctor or hospital
is part of the PHCS Network. When using the web, click on "Find a Provider,"
then "Start New Search." Under Step #2, choose "Healthy Directions/Access
advantage" from the drop down menu.
Who's Eligible for These Plans? |
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Healthy
individuals between the ages of 15 days and age 64 and 11 months, who have a
temporary insurance need. |
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Dependent
children through age 20 (age 24 if full-time student) may be covered as
dependents on their parent's plan. |
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Foreign
residents living in the U.S. for at least one year with proof of an Alien
Registration Receipt Card, Green Card, Visa, or other appropriate
documentation. |
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| 6 Month Plan (30-185 days) |
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| If you know you'll only need temporary health insurance for a
short time, then this plan is ideal for you. You can purchase up to a maximum
of six months coverage and pay for it in single or monthly payments. If your
temporary need continues beyond six months, you may be eligible for another
Short Term Medical policy*. However, it is important to know that there is no
continuous coverage between plans. |
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Deductible choices: $250, $500, $1000,
$2500
If
the $250 or $500 deductible option is selected, each covered person needs to
satisfy a deductible before benefits are paid. Families will only need to
satisfy a maximum of three deductibles.
If the $1,000 or $2,500 deductible option
is selected, only one deductible needs to be satisfied by all covered family
members. |
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Rate of payment options (coinsurance):
100%, 80/20 or 50/50
Note: The 100% option is not available with a $250
deductible. |
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Lifetime maximum benefit
options:
$2 million or $5 million |
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Length of coverage options: 30-185
days
*
To obtain a new policy, you must complete a new enrollment form. If the
enrollment form is approved, a new certificate will be issued. There will be a
new pre-existing condition period and a new deductible must be met. |
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You pay the deductible. |
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100%
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80/20
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50/50
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You pay 20% of the next $10,000 up to a maximum
of $2,000. |
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You pay 50% of the next $10,000 up to a maximum
of $5,000. |
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Fortis Insurance Company pays 100% of remaining
covered expenses up to the plan maximum of $2 million or $5 million for each
covered person. |
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Plan Highlights
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Coverage
as early as the next day |
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Freedom to
choose your own doctors and hospitals |
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Prescription drug coverage |
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In-hospital and outpatient benefits |
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Managed
care/pre-authorization procedure |
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Extension
of Benefits — up to 12 months if totally disabled |
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Extension
of Benefits Plus — 60 day/$1,000 benefit for non-disabling
conditions |
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| 12 Month Plan (30-365 days) |
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| This plan is ideal if your temporary need stretches beyond six
months or if your are unsure how long you will need coverage. It provides
continuous coverage for up to 12 months and can be paid for in single or
monthly payments. |
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Deductible choices:
$500, $1000, $2500 or $5,000
If the $500 or $1,000 deductible option
is selected, each covered person needs to satisfy a deductible before benefits
are paid. Families will only need to satisfy a maximum of three
deductibles.
If the $2,500 or $5,000 deductible option is selected,
only one deductible needs to be satisfied by all covered family
members. |
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Rate of payment options
(coinsurance):
80/20 or 50/50 |
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Lifetime maximum benefit
options:
$1 million or $2 million |
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Length of coverage
options:: 30-365 days |
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You pay the deductible. |
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80/20
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50/50
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You pay 20% of the next $10,000 up to a maximum
of $2,000. |
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You pay 20% of the next $10,000 up to a maximum
of $2,000. |
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(Copays not included)
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Fortis Insurance Company pays 100% of remaining
covered expenses up to the plan maximum of $1 or $2 million for each covered
person. |
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Plan Highlights
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Coverage
as early as the next day |
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Freedom to
choose your own doctors and hospitals |
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Prescription drug coverage |
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In-hospital and outpatient benefits |
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Managed
care/pre-authorization procedure |
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Copays of
$150 per emergency room visit and $500 per inpatient hospital stay. |
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A waiting
period of up to three days for sickness benefits may apply. |
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Extension
of Benefits — up to 90 days if hospitalized |
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Extension
of Benefits Plus — 60 day/$1,000 benefit for non-disabling
conditions |
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Plan Exclusions
Short Term Medical plans do not cover:
pre-existing conditions*; intentionally self-inflicted injury; non-injury
related dental or optical treatments; hearing aids; routine physical exams;
normal pregnancy or childbirth; routine well child care; sterilization;
treatment for infertility; weight reduction or weight control programs and
related surgery; mental disorders, mental illness or substance abuse except as
may be provided by an Amendment Rider; treatment for learning disorders or
disabilities; removal of tonsils or adenoids; injuries due to hazardous
occupations or activities; custodial care; repairs or replacement to prosthetic
devices; cosmetic treatment of reconstructive or plastic surgery that is
primarily a cosmetic procedure; expenses incurred outside the United States,
its possessions, territories or Canada; or experimental or investigative
treatment. Other exclusions are listed in detail in the certificate you will
receive when you purchase Short Term Medical.
* 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; or that producedsigns or symptoms within the 5-year period
immediately preceding the effective date of coverage, which should have caused
an ordinarily prudent person to seek diagnosis or
treatment. |
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When Does Your Coverage Begin?
Your coverage will begin the later
of:
1) 12:01 a.m. the day of
your requested effective date; or 2) 12:01 a.m. the day after the postmark date
affixed by the U.S. Post Office*, provided the following conditions are
met: |
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Your
enrollment form and the full premium payment are received by Fortis Insurance
Company; |
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Your
answers on the enrollment form are complete and meet the requirements for
acceptance. |
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* If the envelope containing your enrollment form is not
postmarked by the U.S. Post Office, or if the postmark is not legible, the
effective date of coverage will be the later of: a) your requested date; or b)
the date the enrollment form is received via mail by Fortis Insurance
Company. |
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Choose From Two Convenient Payment
Options
Fortis Insurance Company
makes paying for your policy easy by offering two convenient payment
options.
Single Payment Option: Ideal
if you know the exact number of days coverage is needed. The minimum number of
days you may apply for is 30. The maximum is 185 days (for the six month plan)
or 365 days (for the 12 month plan).
Monthly Payment
Option Ideal if you are unsure how long you need coverage. This "pay as
you go" option gives you the flexibility to continue coverage for as long as
it's needed (up to 185 days with the six month plan or 365 days with the 12
month plan) or simply stop payments and discontinue the plan once your
temporary need ends. |
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If you pay
your initial 35 day premium by MasterCard, VISA or
automatic charge to checking account, each additional 30 days of
coverage will be automatically charged to your account for up to 185 days (for
the six month plan) or 365 days (for the 12 month plan). If your temporary need
ends prior to this date, simply call 1-800-800-5453 and we will stop the
automatic account charge. |
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Note: Seven days advance notice is required to ensure future
account charges are stopped. |
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If you pay
your initial 35 day premium by check or Discover
Card, Fortis Insurance Company will send you a sheet of payment
coupons shortly after you receive your certificate. Each coupon is for an
additional 30 days of coverage. |
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Authorization
Fortis
Insurance Company uses an authorization service which ensures that you and your
family receive the most appropriate and cost effective care available. The
authorization process must be followed in its entirety to receive maximum
benefits. This process is explained in detail for you in the certificate.
Benefits for unauthorized services of otherwise covered expenses will be
reduced. No benefits will be paid for a transplant if the procedure was not
authorized prior to the beginning of the donor search and
selection. |
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Purchasing an Additional Short Term Medical
Plan
Fortis Insurance
Company's Short Term Medical plans are not renewable.
However, if
your temporary need continues beyond your policy period, you may apply for a
new plan under the following circumstances: |
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No claims
were incurred under a previous Fortis Short Term Medical plan. |
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There has
been no significant change in your health. |
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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. There is no continuous coverage between plans—therefore your new
plan will not provide benefits for any condition or symptom which began during
a previous plan. In addition, no benefits are available for any period in which
you are not covered by a Fortis Short Term Medical plan.
To obtain an
additional plan, you must complete a new enrollment form. If the enrollment
form is approved, a new plan will be issued. |
Apply Now!
Applying for Short Term Medical is as easy as 1-2-3! |
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1. |
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Calculate
the premium for the coverage of your choice. Refer to the Premium. |
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2. |
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Complete
all information, sign and date the enrollment form. |
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Detach the
enrollment form, insert it in the envelope with your payment and mail it to
your agent. (If you are view the forms on the internet, then print our the
forms and then fill them in. Otherwise you can obtain a form from your
agent.) |
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Check or Money Orders should be made payable to: Fortis
Insurance Company.
If you have any questions, please contact Stockstill and
Associates, at: 281-476-9063 or call Fortis Insurance Company at:
1-800-800-5453. |
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