Healthcare Expense Lifestyle Protection

Transcription

1 Marketed by Healthcare Expense Lifestyle Protection FOCUS ON RECOVERY, NOT EXPENSES Indemnity Insurance ADH03-14 (R. 9-14) Insurance Coverage underwritten by Guarantee Trust Life Insurance Company

2 Platinum s Healthcare Expense Life pays cash directly to you when yo $ $ Hospital Confinement Lump Sum Benefit Available in 4 levels - Benefits Up to 2,000 $500 $1,000 $1,500 Did you know? The average length of a hospital inpatient stay is 4.8 days. 1 Accident-Only Emergency Room Benefit 500 $200 $300 $400 Pays a lump sum benefit for hospital confinement due to a covered accident or sickness (must be admitted 18 hours). Benefit available once per period of confinement. PLUS $100/DAY Hospital Confinement Benefit paid in addition to Lump Sum Benefit Maximum of 30 Days per period of confinement. Ability to increase Hospital confinement benefit 15% every 3 years to age 80 regardless of your health through the Guaranteed Purchase Option. Premiums are based on your age at the time of increase and you must not skip 3 increase options. Pregnancy does not count as a covered event, but hospitalizations associated with certain complications of pregnancy are covered. Benefit pays a lump sum for ER visits due to accidental cause. May be paid up to 4 days per person, per year. Benefit NOT payable for Urgent Care Clinics or Convenient Care Centers. Accidents will happen... More than 200,000 children under 14 are treated for playgroundrelated injuries each year. 2 1 Source: 1 Source: 2 Source: 2 Source:

3 style Protection Indemnity Insurance u need it most. Wellness Benefit Healthy Lifestyle $50 per person/calendar year Pays for a physical examination by a Doctor or for participating in programs promoting a healthy lifestyle, such as a gym or health club membership. Benefit payment is limited to once per Calendar Year per Covered Person (over the age of seventeen). Health and Wellness Benefit $100 per person/calendar year This benefit pays for diagnostic tests, such as mammograms, ultrasounds, MRIs & x-rays, and many blood tests. Benefit payment is limited to once per Calendar Year per Covered Person. Alternative Care Benefit $50 per person/visit Alternative Care is limited to yoga, meditation, relaxation techniques, Tai-Chi, acupuncture, therapeutic massage, and nutritional counseling. Pays for alternative care prescribed by a doctor. Limited to once per month for a maximum of 24 visits. Doctor Office Visit Benefit Pays for a doctor s office visit each day that a covered person visits or receives treatment from a doctor due to a covered injury or sickness. Up to $100 per covered person $25 per day, per covered person, limited to 4 days annually per person. Benefit is payable for urgent care clinics or convenient care centers. Policy Advantages Guaranteed Renewable Your Platinum plan will continue as long as you pay your premiums as agreed. Premiums do not increase with age Premiums can only be increased on a class basis by state. Assured Payments We will pay what is indicated in your plan, regardless of what other insurance you may have. No Lifetime Maximum The benefits listed have no lifetime maximum unless otherwise stated in your policy. Insurance Coverage underwritten by Guarantee Trust Life Insurance Company Did you know? In 2010, the aggregate cost for all hospital stays was $375.9 billion; the average cost per stay was $9, Source:

4 How HELP Works: You receive cash to use as you see fit.* Benefits may be payable for each person covered by your policy. There is no lifetime limit on the hospital confinement benefit.** The family policy covers dependents to age 26. *You may assign benefits to a hospital. **There are lifetime limits to other benefits. Annual Benefit Example*** Primary Insured Age Premium Primary Insured Healthy Lifestyle Health & Wellness Dr. Visits Accident-Only (e.g. physical) (e.g. common diagnostic tests) max. 4/person/year Emergency Room $50 $100 $25/per Spouse Dependents 18+ Dependents 17 and under TOTALS N/A = GRAND TOTAL ANNUAL BENEFIT ***Example assumes eligibility for all listed benefits. See limitations and exclusions. Premium payable for the base policy and riders. No one expects a stay in the hospital. If the unexpected does occur, most of us usually assume our major medical insurance will cover our expenses. Unfortunately, no matter how brief the stay, even the best health insurance policies will likely leave us with a bill. Add to that often overlooked, out-of-pocket expenses such as transportation, meals for family members, child care or lost wages Platinum s hospital confinement indemnity policy can HELP.

5 $ Cancer, Heart Attack / Stroke Lump Sum Benefit Benefits Up to 20,000 $5,000 $10,000 $15,000 First Diagnosis Lump Sum Cancer* Benefit: Pays an indemnity benefit when a Covered Person is first diagnosed as having Internal Cancer. 25% of lump sum is paid for Cancer in Situ. This benefit is not payable for Basal Cell Skin Cancer. Heart Attack / Stroke Lump Sum Benefit: Pays an indemnity benefit when a Covered Person is first diagnosed as having a heart attack or stroke. Limited Coronary Angioplasty or Bypass Benefit: Pays an indemnity benefit of 10% of lump sum benefit selected when a Covered Person undergoes Coronary Angioplasty or Bypass without a heart attack or stroke diagnosed. If lump sum is paid due to heart attack or stroke, 10% is not paid in addition. This benefit is not payable if the Coronary Angioplasty or Bypass is performed as a direct result of a Heart Attack which immediately preceded the procedure. Did you know... 60% of the cost of cancer is nonmedical and is not paid for by major medical insurance. 1 85% of those who suffer a heart attack will survive it. 2 35% of the overall costs of strokes are indirect costs, and consequently not paid for by medical insurance. 3 Reoccurence Benefits Cancer Reoccurrence: Reoccurrence of cancer, whether it is a previously diagnosed cancer or newly diagnosed cancer, is covered provided that the insured has been cancerfree and did not have treatment for cancer during the 365 days prior to the subsequent diagnosis of cancer. The lump sum benefit payable varies with the year of reoccurrence as shown in this graph: Heart Attack / Stroke Reoccurrence: After 365 days have passed following payment of the indemnity benefit for a heart attack or stroke, lump sum benefits for a subsequent heart attack or stroke are payable subject to the schedule shown in this graph: 10% 25% 50% Number of Full Years Elapsed 100% 0 Years 1 Year 2-3 Years 4 Years 5 Years % of First Diagnosis Benefit *Cancer and First Diagnosis of Cancer are defined in your policy 1 Source: American Cancer Society, Cancer Facts & Figures 2010 pg 3 2 Source: American Heart Association, Circulation, Heart Disease and Stroke Statistics, 2010 Update, pg. e87 3 Source: American Heart Association Circulation, Heart Attack and Stroke Statistics 2010 Update, pg. e206

6 Toll Free Our Customer Service Specialists are friendly, knowledgeable and licensed! If you have a question, please call us. LIMITATIONS AND EXCLUSIONS PLEASE SEE YOUR INSURANCE CONTRACT FOR SPECIFIC DETAILS. THE EXCLUSIONS AND LIMITATIONS LISTED BELOW ARE TYPICAL, BUT YOUR STATE MAY HAVE SLIGHT DIFFERENCES. THIS POLICY IS A LIMITED BENEFIT INSURANCE PROVIDING HOSPITAL INDEMNITY BENEFITS. Waiting Period: The policy and most riders have a 30 day waiting period before benefits can be paid. The Wellness Benefit Rider has a 90 day waiting period and the Emergency Room for Accidents Benefit Rider has no waiting period. The waiting period begins on the policy/rider(s) effective date. Cancer, Heart Attack or Stroke will not be a covered condition when advice or treatment is received prior to the policy s effective date or within the waiting period, or tissue is extracted prior to the policy s effective date or within the waiting period, and such advice, treatment, or tissue extraction results in the Diagnosis of Cancer, Heart Attack or Stroke. Hospital Confinement Indemnity Coverage: The benefits under this policy are subject to pre-existing condition limitations. A pre-existing condition is a sickness or injury, disclosed or not disclosed on the application, for which medical care, treatment, diagnosis or advice was received or recommended within the 6 month period immediately prior to your effective date of coverage under this policy; or the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care or treatment within the 6 months prior to your effective date of coverage under this policy. Treatment includes the taking of prescription drugs or medicines. Pre-existing conditions are not covered unless the loss begins more than 6 months after your effective date of coverage. This policy/rider does not pay benefits for (1) treatment, services or supplies which: (a) are not medically necessary; (b) are determined by us to be experimental/investigational in nature; (c) are received without charge or legal obligation pay (except for a U.S. Government Hospital); (d) would not routinely be paid in the absence of insurance; (e) are received from any immediate family member; (f) are received outside the United States (continental and Hawaii); (2) expenses incurred as a result of loss due to war, or any action of war declared or undeclared; active service in the armed forces of any country (for an individual plan, if you notify us of such active duty, we will refund any premium paid for which no coverage is provided as a result of this exception); (3) expenses incurred as a result of committing or attempting to commit an assault or felony or participating in a riot or civil commotion; (4) injury or sickness arising out of or in the course of employment and which is payable under any Workers Compensation or Occupational Disease Act or Law; (5) cosmetic or elective surgery other than: (a) reconstructive surgery incidental to or following surgery resulting from trauma, infection, or other diseases of the involved part; or (b) reconstructive surgery because of a congenital disease or anomaly; (6) any accident caused by the participation in any activity or event, including the operation of a vehicle, while under the influence of a controlled substance (unless administered by a Doctor or taken according to the Doctor s instructions) or while intoxicated (intoxicated means that condition as defined by the law of the jurisdiction in which the accident occurred); (7) loss due to voluntarily using any drug, narcotic or controlled substance, unless as prescribed by a Doctor; (8) pregnancy, except for complications of pregnancy; any pregnancy of a dependent child, including hospital confinement rendered to her child after birth; or hospital confinement due to any covered person giving birth within the first nine (9) months after the effective date of this policy as a result of a normal pregnancy, including Cesarean. Newborns are not covered at time of birth. Cancer and Heart Attack & Stroke Lump Sum Benefits: Cancer does not include pre-malignant tumors or polyps; or carcinoid of the appendix. This rider does not pay benefits for non-malignant skin cancer (such as basal or squamous cell). This policy does not constitute comprehensive health insurance coverage (often referred to as major medical coverage ) and this policy does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. This brochure is designed as a marketing aid and is not to be construed as a contract for Hospital Indemnity Insurance or other benefits described herein. It provides a brief description of the important features of policy form version(s) G1350, and rider form (versions) RG13LSH, RG13ER, RG13DO, RG13WR, RG13CLSR, and RG13HSLS. Marketed by Platinum Building, 137 Main Street, Dubuque IA Fax: For customer assistance, call Rated A+ with the Better Business Bureau Knowledgeable licensed customer service available to help you No automated phones real people providing real service Guarantee Trust Life Insurance Co Milwaukee Avenue Glenview, IL Located in Glenview, Illinois Founded in 1936 Mutual Legal Reserve Company