Secure STM - Underwritten by Standard Security Life Insurance Company of NY Rated A- Excellent by AM Best

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Short Term Health Insurance
Frequently Asked Questions
What is Short Term Insurance?
Secure Short term health insurance is designed to provide low cost medical coverage on a temporary basis. Ideal if you are between jobs, a temporary or seasonal worker, a college student or recent graduate, in a waiting period, while between permanent health plans or as a low cost alternative to COBRA insurance.
How long can I be covered?
The Secure STM Short term health coverage is available for as little as 30 days and you can keep it for up to 6 months. You can also choose the single payment option for your temporary coverage and receive a premium discount.
When does coverage begin?
Your Secure STM short term coverage can begin as early as the next day. You can also select a later date of up to 60 days.
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Secure STM - Affordable Short Term Health Insurance
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Secure STM is available in all states Except
CT, MA, NJ, NY, ND, VT, WA
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Secure STM - Short Term Medical plan is available in most states. The short term coverage includes a $2,000,000 lifetime maximum per person. The deductible options range from $1,000 to $5,000. Other options are available such as a Prescription copay plan and the Secure STM also includes the STM Enhancement Series discount plan.

Secure STM Short Term Health Insurance features include

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Pays up to $2,000,000 Lifetime Maximum per Covered Person

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Choice of Coverage Periods - 30 days to 12 months or the exact number of days

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Use any doctor or hospital. Save out of pocket expenses by using a network provider

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Choice of Deductibles - $1,000, $2,500 or $5,000

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Coinsurance options - The Insurance company pays 80% or 50% of $10,000 or $20,000 (depending on the state) and then 100% up to the policy limits of $2,000,000

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Choose a monthly plan or receive a discount when choosing the single payment option

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$50 Office Visits Copay- The $50 copay applies to the physician’s consultation charge. After you pay $50, the plan pays 100 percent of the consultation charge balance with no deductible.

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Child Only Coverage is available - the minimum age is two years old

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Physician Office Visits, inpatient, outpatient, x-rays, labs, surgery, transplants, inpatient prescriptions, hospital room and boar and more...

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Free Look Period ensures your satisfaction with a 10-day money back guarantee

Secure STM Short Term Coverage is ideal for those who are

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Between jobs or laid off

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Waiting for employer benefits,

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Part-time or temporary employees

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College Student or recently graduated

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Finding COBRA insurance unaffordable

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Without adequate health insurance

       

Underwritten by: Standard Security Life Insurance Company of NY

Standard Security Life Insurance Company of NY

 

  • Secure STM - Short Term Health Insurance
  • Secure STM Plan Details

The Secure STM Short term health insurance plan is designed to provide low cost medical coverage on a temporary basis.  Ideal if your between jobs, lay off, a college student or recent graduate, in a waiting period, while between permanent health plans or as a low cost short term health insurance alternative to COBRA or traditional health coverage. Secure STM Short term coverage is available for as little as 30 days and you can keep it for up to 6 months.  You can also choose the exact number of days and save 20% when choosing the single payment option. Compare all of the short term health insurance plans to find the plan that fits your needs with the lowest cost..

Secure STM - How are benefits covered?

Secure STM pays benefits for each covered person in the following manner (subject to specific benefit limits):
1. You are responsible for eligible expenses until the deductible is satisfied. Choose from four options: $1,000, $2,500 or $5,000 (maximum of 3 deductibles per family)
2. For most covered services, Secure STM then pays 80% or 50% of the next $10,000 or $20,000 (depending on your state) of covered expenses
3. After this, Secure STM pays 100% of covered expenses up to your Coverage Period maximum of $2,000,000 per covered person

Who qualifies for the Secure STM plan?

Secure STM Short-Term Medical is to those under the age of 65, their spouses under 65 and eligible dependents under age 26 who can answer 'no' to the health questions on the application. Child-only coverage is available for ages 2 through 18.

What medical expenses are covered?

After satisfying the deductible amount you’ve selected, Secure STM will pay the coinsurance you’ve selected for covered expenses, up to a maximum of $2,000,000 per insured person per coverage period.*
The Benefits are limited to the usual, reasonable and customary charge for a covered expense.

    • Physician services for treatment and diagnosis
    • Emergency room, outpatient hospital or ambulatory surgical center charges
    • Surgeon services in the hospital or ambulatory surgical center
    • Services when a doctor administers anesthetics up to 20 percent of the primary surgeon’s covered charges w Assistant surgeon and surgeon’s assistant services up to 20 percent of the primary surgeon’s covered charges
    • Ground ambulance services up to $500 per occurrence
    • Air ambulance services up to $1,000 per occurrence
    • Organ, tissue or bone marrow transplants up to a $150,000 coverage period maximum
    • Acquired Immune Deficiency Syndrome (AIDS) up to a $10,000 coverage period maximum. This AIDS maximum of $10,000 per coverage period does not apply to policies/certificates issued to residents of AZ, CA, DC, ID, MD, ME, MO, NH, NC or ND. The maximum benefit in KS is $75,000 per coverage period.
    • Blood or blood plasma and their administration, if not replaced
    • Mammography, Pap smear and prostate antigen test (covered at specific age intervals; not subject to deductible) w X-ray exams, laboratory tests and analysis
    • Oxygen, casts, non-dental splints, crutches, non-orthodontic braces, radiation and chemotherapy services and equipment rental Inpatient covered expenses
    • Room and board, doctor visits and general nursing care up to the most common average semi-private room rate
    • Intensive care or specialized care unit up to three times the average semi-private room rate
    • Prescription drugs administered while hospital confined


 

 

 

 

 

 

 

 

 

 

 

 

 

 

Private Health Care Systems (PHCS) PPO Network?

In addition to your insurance plan, you’ll also enjoy discounts provided through nationwide access to one of the premier PPOs through Private HealthCare Systems (PHCS). PHCS provides you with the opportunity to reduce your expenses for provider and facility services. The program is voluntary, so there is no penalty for not using a PHCS participating provider; but you can reduce your out-of-pocket medical expenses by using the program. Simply call PHCS at 1-800-678-7427 or visit PHCS on the web at www.phcs.com to verify that your doctor or hospital is part of the PHCS Healthy Directions Network. At the time of service present your Short Term Medical Insurance Identification Card with the PHCS logo on it and your provider will bill you at the reduced network rate for services if applicable.*
*PHCS and Lab Card Select are not affiliated with the Standard Security Life Insurance Company of New York nor are they a part of the Secure Lite STM insurance plan.

Is there a pre-existing condition limitation?

Secure STM will not provide benefits for any loss caused by or resulting from a pre-existing condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered persons effective date of coverage; or symptoms existed within the 5-years immediately prior to the covered persons effective date of coverage which would cause a reasonable person to seek diagnosis, care or treatment. The pre-existing condition limitation may vary by state.

What is the usual, reasonable and customary charge?

Usual, Reasonable and Customary means with respect to fees or charges, fees for medical services or supplies which are usually charged by the provider for the service or supply given and the average charge for the service or supply in the locality in which the service or supply is received; whichever is less, or with respect to treatment or medical services, treatment which is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as Usual, Reasonable and Customary for services and supplies; we may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies.

What are my Secure STM payment options?

Choose from two convenient payment options.

  • You can pay for coverage in monthly payments for up to 6 months at a time. We accept monthly payments by check, money order, credit card or automatic bank withdrawal. If you select this option, and your need for insurance ends before your coverage period ends, you can cancel at any time throughwritten notification to our Policy Service Department.

  • The single payment option is ideal if you know the exact number of days coverage is needed. This option has a special reduced rate and you only pay for the coverage you need through one, single payment. You can pay in full for any number of days, from a minimum of 30 days to a maximum of 180 days of coverage by check, money order or credit card or ACH online.

Your subsequent monthly credit card/ach premium deductions will occur based upon the effective date of coverage. If your coverage effective date is the 1st - 14th, your premium will be deducted on the 1st of the month. If your coverage effective date is the 15th - 31st, your premium will be deducted on the 15th of the month.

How can I save money and maximize my benefits?

Through the Secure STM plan, you have access to discounted medical services through two national Preferred Provider Networks (PPOs): ACS and MultiPlan. The network providers have agreed to provide their services at a negotiated fee and pass these discounts on to you. While you have the flexibility to choose any health care provider, the discounts available through network providers for covered services will help to lower your out-of-pocket cost. The discount will be reflected in your final bill and you will not owe the network providers for the difference between their retail rate and the negotiated fee. You will still be responsible for paying your share of the covered expenses, including any deductible, copay and coinsurance. Your coinsurance amount will be based upon the negotiated fee.
Using a network provider is voluntary. If you are unable to find a network provider, we will attempt to negotiate a discount for you from your provider. While we can’t guarantee the outcome, if we successfully obtain a discount it will be passed on to you.

To search for a health care provider or facility, please visit the Web sites listed below. At the time of services, simply present your identification card to the network provider.

ACS is a comprehensive network of 2,500 ancillary service providers at over 25,000 sites, representing providers of outpatient services, including lab and diagnostic testing, except physicians. www.anci-care.com

MultiPlan is one of the nation’s largest networks with more than 500,000 members in 50 states, including physicians, and inpatient and outpatient facilities. www.multiplan.com or 888-342-7427.
ACS and MultiPlan are not affiliated with Standard Security Life Insurance Company of New York, nor are they part of this insurance plan.

When does my coverage start?

Your coverage will begin as early as the day following online submission. You can request a later effective date, but no more than 60 days after the application date. All coverage is subject to approval of your application and payment of the first premium.

How long will STM coverage last?

Secure STM is specifically designed to fill temporary insurance needs and coverage stops at the end of the period applied for. Depending on the payment option you select, Secure STM offers coverage for one to 6 months.**

Can I continue coverage?

If your need for temporary health insurance continues, you may apply for another Secure STM plan.* Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not continuous and any condition incurred during the last coverage period will be excluded as a pre-existing condition.
*Some states may restrict re-application to another STM coverage period.

Is there an extension of benefits after the plan terminates?

If a member, or insured dependent is receiving benefits for a hospital confinement on the date that the certificate of insurance terminates (for other than nonpayment of premium), benefits will continue in accordance with the terms of the certificate of insurance for as long as that confinement remains. However, in no event will coverage continue beyond the end of 90 days following the date the coverage terminates when the insured becomes eligible for other coverage for the same conditions or the maximum benefits have been reached. Benefits payable are subject to a new deductible amount and satisfaction of coinsurance limit.

Is there a free-look period?

If you are not completely satisfied with this coverage, and you have not filed a claim, you may return the Certificate of Insurance within 10 days and receive a premium refund. Enrollment and Administrative fees are non-refundable.

Do I need pre-certification?

You must notify the pre-certification service 10 days prior to a non-emergency hospital admission or surgery and 48 hours (or as soon as reasonably possible) following an emergency admission to the hospital for pre-certification of admission. Failure to pre-certify will result in a benefit reduction of 50%. Pre-certification is not a guarantee of benefits.

What is the enhancement series*?

In addition to offering you an association-endorsed short-term medical plan, CA provides additional consumer benefits and services you can use to stay healthy and reduce your medical expenses. These benefits include:

  • *The Communicating for America (CA) Healthy Lifestyle Enhancement Series is not an insurance benefit, nor is it affiliated with Standard Security Life Insurance Company of New York, nor is it a part of the STM insurance plan. The Enhancement Series is not available to residents in the states where the CA membership is not required.

Who is the Insurance Company?

The Secure STM is insured by Standard Security Life Insurance Company of New York (Standard Security), a member of the IHC Group. Standard Security is rated A- (Excellent) by A.M. Best Company, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations to their insureds.

Secure STM - Short Term Health Insurance 02202012