HEART DISEASE, HEART AT TACK & STROKE HOSPITAL INCOME POLICY from UNITED TEACHER ASSOCIATES INSURANCE COMPANY (UTA) The U.S. facts 1 are... Cardiovascular disease is the No. 1 killer of American men and women. 1.2 million people have a heart attack each year. 400,000 to 460,000 die from heart attacks in an emergency room or before reaching a hospital. 50% of men and 64% of women who die suddenly of coronary heart disease had no previous symptoms. Coronary heart disease causes 1 out of every 2.6 deaths. 6,813,000 vascular and cardiac surgeries were performed in 2002 and are predicted to rise. OR.ITC-HT96 11/9/10
HEART DISEASE IS THE NUMBER 1 KILLER OF AMERICANS 1 Approximate leading causes of death per year: 1. Cardiovascular Disease 927,448 2. Cancer 557,271 3. Chronic Lower Respiratory Diseases 124,816 1,000,000 927,448 Leading Causes of Death * Includes heart disease, heart attack and stroke About every 34 seconds, an American will die due to cardiovascular disease Of the total inpatient cardiovascular operations and procedures performed, 44 percent are on people under age 65 Number of Deaths 800,000 600,000 400,000 200,000 557,271 124,816 73,249 Average age of heart transplant recipients: 21% ages 35-49 47% ages 50-64 0 Total Cardiovascular Diseases Cancer Chronic Lower Respiratory Diseases Diabetes Mellitus FACT... In 2005 the overall estimated cost for Cardiovascular Disease totaled $393.5 billion. $241.9 billion (62%) was for direct medical expenses, but more than one-third of this amount, $151.6 billion (38%), was for non-medical expenses (lost productivity due to morbidity and mortality). MEDICAL VS NON-MEDICAL EXPENSES MEDICAL EXPENSES Doctor Nurse Drugs & Medicine Daily Hospital Room Charge Surgery NON-MEDICAL EXPENSES Loss of income Family member loss of income On-going fixed costs such as rent or mortgage, groceries, utility bills, etc. Insurance deductibles & co-payments Direct Medical Costs 62% How would you pay for out-of-pocket heart expenses? Major Medical, HMO, Medicare, Medicaid, Use your own assets, Rely on your family? TRANSFER THE RISK TO UTA Indirect Costs 38% Travel & hotel expenses Child Care expenses Home Care during treatments Non-Covered Experimental Treatments Source: 1 American Heart Association Heart Disease and Stroke Statistics 2005. These facts represent the U.S. population, are presented for information only, and do not imply coverage provided under the policy or endorsement of the American Heart Association.
HEART DISEASE, HEART ATTACK & STROKE HOSPITAL INCOME POLICY Benefi ts and options designed to make a difference for you and your family HOSPITAL CONFINEMENT Pays the daily Hospital Confinement Benefit amount selected. Choose from Plan A or Plan B with no lifetime maximum. 1st - 45th Day 46th Day & thereafter $300 per day $400 per day 1st - 45th Day 46th Day & thereafter $150 per day $200 per day SURGICAL Pays actual charges not to exceed the amount shown in the Surgical Schedule for the plan selected. $5,000 Surgical max per operation $2,500 Surgical max per operation ANESTHESIA Pays actual charges not to exceed 25% of the surgical fee. 25% 25% GOVERNMENT HOSPITAL Pays the Government Hospital Benefit Amount for each day of confinement, in lieu of all other benefits. $200 per day $100 per day AMBULANCE Pays actual charges, not to exceed the amount for the plan selected, of a licensed or professional ambulance company for ground or air transportation to or from the hospital. INSURED TRANSPORTATION & LODGING Pays actual charges, not to exceed the amount for the plan selected, for transportation by common carrier to the nearest hospital for specially prescribed treatment not available locally for the insured person. The lodging benefit will not exceed 30 days per calendar year. $500 per confinement $80 per day $250 per confinement $40 per day FAMILY TRANSPORTATION & LODGING Pays actual charges, not to exceed the amount for the plan selected, for a family member to accompany the insured to the nearest hospital for specially prescribed treatment not available locally for the insured person. The lodging benefit will not exceed 30 days per calendar year. $500 per confinement $80 per day $250 per confinement $40 per day SECOND & THIRD OPINIONS Pays actual charges, not to exceed the amount for the plan selected, for a second surgical opinion. If the second opinion contradicts the first physician s opinion, pays actual charges, not to exceed the amount for the plan selected for a third surgical opinion. $200 per operation $100 per operation
BLOOD, PLASMA & PLATELETS Pays actual charges, not to exceed the amount for the plan selected, for cross matching, transfusions, processing and procurement, and administration of treatment. DRUGS & MEDICINE Pays actual charges for drugs and medicine received in the hospital (as outpatient in West Virginia) not to exceed the amount for the plan selected. $50 per day $25 per day NURSING SERVICES Pays actual charges for services of a private duty nurse, not to exceed the amount for the plan selected. Benefit is limited to a number of days equal to the number of days of hospital confinement. $100 per day $50 per day ATTENDING PHYSICIAN Pays actual charges for inpatient visits, not to exceed the amount for the plan selected. The number of visits will not exceed the number of days of hospital confinement. $50 per day $25 per day PHYSIOTHERAPY Pays actual charges for the services of a registered physiotherapist, not to exceed the amount for the plan selected. $100 per day $50 per day HEART TRANSPLANT Pays actual charges for implantation of a natural or artificial heart, including but not limited to the replacement heart, surgeon s fees, fees of all assistants and technicians, operating and recovery room charges, anesthesia services and supplies and all special equipment and surgical supplies. The benefit is limited to a lifetime maximum of $100,000 per insured. $100,000 lifetime max $100,000 lifetime max ELECTROCARDIOGRAM Pays actual charges for electrocardiogram while hospital confined, not to exceed the amount for the plan selected. OXYGEN Pays actual charges for oxygen and related equipment while hospital confined, not to exceed the amount for the plan selected. AT-HOME NURSING Pays actual charges for each day of at-home nursing for a number of days equal to the number of days of hospital confinement not to exceed the amount for the plan selected. $100 per day $50 per day DIAGNOSTIC TESTS Pays actual charges for diagnostic tests, not to exceed the amount for the plan selected. $1,000 lifetime max $500 lifetime max AMBULATORY SURGICAL CENTER Pays all of the above benefits, if applicable, also qualify for payment if services are rendered in an Ambulatory Surgical Center. $500 per day $250 per day HMO BENEFIT If covered under an HMO, We will pay the daily benefit for the plan selected, in lieu of all other benefits. $400 per day $200 per day. DURABLE MEDICAL EQUIPMENT Pays actual charges for the rental of Durable Medical Equipment, not to exceed the benefit for the plan selected. $2,000 $1,000 HOSPICE Pays the actual charges not to exceed the benefit amount for the plan selected while confined in a hospice or at home and receiving hospice care. The Hospice benefit is payable for a number of days equal to the number of days of hospital confinement. $60 per day $30 per day HEART TREATMENT POLICY
OUTSTANDING POLICY FEATURES We pay in addition to any other insurance you may have! Guaranteed Renewable for life! The premium is the same for smokers and non-smokers Premiums do not increase just because you move into a higher age bracket! RIDERS Available for extra premium INTENSIVE CARE UNIT BENEFIT RIDER* Rider Form Series RD-10204-ICU-OR The optional Intensive Care Unit Benefit Rider pays for Intensive Care or Cardiac Intensive Care. When any covered person is confined to an intensive care unit as a result of any injury or sickness, we will pay the ICU charges not to exceed the maximum daily benefit amount You select $600.00 per day or $300.00 per day for confinement in Hospital Intensive Care Unit or Cardiac Intensive Care Unit. Coverage is from the first day for any accident and for any sickness not to exceed 30 days for each period of confinement. Benefits are reduced to one half of the listed ICU Benefit Amount shown on the policy schedule for covered persons prior to attainment of age 1 and after attainment of age 65. FIRST DIAGNOSIS CANCER BENEFIT RIDER* Rider Form Series RD-10401-FDC Pays Maximum Benefit Amount Due In Cash As Listed In The Policy Schedule $10,000 - $50,000 On First Diagnosis Of Internal Cancer Or Malignant Melanoma. You can select the Lump Sum Payment benefit that best fits Your needs: $50,000 $40,000 $30,000 $25,000 $20,000 $10,000 * The optional riders described above are available upon payment of extra premium.
THIS IS A LIMITED BENEFIT - SPECIFIED DISEASE POLICY 10 -DAY RIGHT TO EXAMINE POLICY: You have 10 days to review the policy after You receive it. If for any reason You are not satisfied, You may return it to us for a full refund of the premium You paid. RENEWABILITY CONDITIONS: The policy is guaranteed renewable. Premium rates may be changed on a class or state basis. CANCELLATION: You may cancel this policy at any time by written notice delivered or mailed to Us, prior to its renewal date or expiration date. We shall refund to You, the pro-rata portion of such premiums paid for any period beyond the end of the policy month in which the cancellation occurred. Cancellation shall be without prejudice to any claim originating prior to the effective date of cancellation. If this is a Single Parent Plan or an Individual Plan, upon the death of the Insured, the coverage ceases. We will refund the pro-rata portion of any premium paid. If this is a Family Plan, upon the death of the Insured, the coverage will be changed to a Single Parent Plan. The Insured s spouse will become the Insured. POLICY LIMITATIONS AND EXCLUSIONS: This policy provides benefits only for loss resulting exclusively from Heart Attack, Heart Disease or Stroke, as defined in this policy. It does not cover: 1. any other disease or sickness; 2. injuries; 3. any disease or incapacity that has been caused, complicated, worsened, or affected by Heart Attack, Heart Disease or Stroke or as a result of treatment for Heart Attack, Heart Disease or Stroke; 4. care and treatment received outside the United States; 5. treatment not approved by a Physician as medically necessary; 6. experimental treatment; or 7. hospital confinement or expenses that are incurred prior to the end of the Waiting Period regardless of the date of first positive diagnosis. The Heart Disease, Heart Attack & Stroke Hospital Income Policy and the First Diagnosis Cancer Benefit Rider contains a 30-day waiting period which means that no benefits are available until the policy has been in force at least 30 days from the effective date shown in the policy schedule. Any advice, treatment, or expenses incurred for Heart Attack, Heart Disease, or Stroke within the Waiting Period will not be covered. Benefits for a Pre-Existing Condition will be excluded for two (2) years from the Effective Date of the policy. A PREEXISTING CONDITION means a Heart Attack or Heart Disease for which diagnosis, advice or treatment is given within the five (5) years prior to the Effective Date of the policy. Policy Form Series: HT-960601-UTA