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Here are answers to the most frequently asked questions about the Assurant Temporary / Short Term Health Insurance plan. Your questions are important to us! If you don't find the answers
you are looking for covered below, please call or e-mail
us and we will be happy to help you.
General information
Q. What is Temporary Health insurance?
A. Temporary Health Insurance is short term health insurance
designed to protect you from an unexpected illness or injury when you are
between permanent health plans.
Q. Are there co-payments with this plan?
A. There are no co-pays with our six-month plan. Our
twelve-month plan* has co-pays of $150 per each emergency room visit and $500
per each inpatient hospital stay.
* The twelve-month Short Term Medical plan is
not available in all states.
This Web site will only provide you with the ability
to purchase plans available in your area.
Q. How long a time period may I purchase Short
Term Health coverage?
A. The minimum amount of coverage you can purchase
is 30 days. The maximum amount of coverage is 185 days for a policy with a
six-month maximum duration, and 365 days for a policy with a twelve-month
maximum duration.*
* The twelve-month Short Term
Health
plan is
not available in all states.
This Web site will only provide you with the ability
to purchase plans available in your area.
Q. When does my coverage begin?
A. If you are submitting your application by:
Internet using a credit card or auto bank debit - 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, the earliest your coverage can begin is at 12:01 a.m. on March 17th.
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,and your effective date
will be March 17.
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, the plan
date will be the later of a) your requested date or b) two days prior to the
date the application was received by Assurant Health.)
Coverage will take effect provided the following conditions are met:
- Your completed application and full premium
payment are received by Assurant Insurance Company, and,
- Your answers on the application are complete
and meet the requirements for acceptance.
Q. Can I change my deductible?
A. No. Deductible changes cannot be made after your
plan is issued.
Q. Can I add or remove family members?
A. No. To add or remove family members, a new policy
would need to be issued.
Q. What is the definition of a pre-existing
condition?
A. A pre-existing condition is an illness or injury
for which the covered person received medical treatment or advice from a
physician within the 5 year* period immediately preceding the covered person's
effective date; or that produced signs or symptoms within the 5 year* period
immediately preceding the covered person's effective date.
* May vary by state.
Pre-authorization service
Q. Does this plan require pre-authorization?
A. Yes. Temporary Health Insurance requires authorization
prior to receiving certain services. The identification card you receive with
your policy provides a toll-free number for easy access to this service. The
authorization process must be followed in its entirety to receive maximum
benefits. The policy explains the authorization process in detail.
Authorization is required in advance of:
- All hospital or skilled nursing facility
admissions
- Outpatient or day surgeries
- Rehabilitation programs
- Home health care
- Physical medicine/Chiropractic care
- Transplants
The number to call for pre-authorization is
1-800-800-2412. The Short Term Medical identification card, which is
attached to a copy of the insurance contract, also lists the pre-authorization
phone number.
Payment information
Q. Are there any additional fees due in addition to the premiums?
A. Yes. In most cases, there is a one-time, non-refundable $20 application fee
with each policy.
Q. What is the difference between monthly and single payment plans?
A. If you know exactly how long you will need temporary health insurance, for
example, it will be 90 days before your employer's group insurance starts, then
you can save money by paying for your policy in one lump sum. If you are
uncertain how long you will need coverage, you have the option of paying as you
go - month by month.
Q. If I choose the monthly payment option, how will I be billed?
A. If you make your initial payment by:
- Automatic credit card debit - each
month, your premium payments will be debited automatically from the credit
card you provided with your initial payment. Your card will be debited each
month until you have reached a total of six or twelve months of coverage,
depending on the policy you purchase*. If your temporary need ends prior to
the 6th or twelfth month, call us at 1-800-800-5453 and we will stop the
automatic credit card debit. (Please note: 7 days advance notice is
required to ensure future credit card charges are stopped.)
- Auto bank debit (checking or savings) -
your initial premium payment will be automatically debited from the
account number provided. You will receive coupons via the U.S. Postal
Service for all subsequent payments. Each month, mail your check along with
the coupon to Assurant Health. Each coupon pays for an additional 30 days of
coverage. Note: No lapse notices are sent.
- Check - you will receive payment
coupons via the U.S. Postal Service for all subsequent payments. Each month,
mail your check along with the coupon to Assurant Health. Each coupon pays for
an additional 30 days of coverage. Note: No lapse notices are sent.
* The twelve-month Short Term Medical plan is not available in all states. This
Web site will only provide you with the ability to purchase plans available in
your area.
Q. Can I pay my premium by credit card?
A. Yes. We accept Visa and MasterCard. If you select the single payment
option, your entire premium can be billed to your credit card. If you select the
monthly payment option, your premium payments will be automatically
debited each month from the credit card you provide until you have reached six
or twelve months of coverage, depending on the policy you purchase*. If your
temporary need ends prior to the sixth or twelfth month, call us at
1-800-800-5453 and we will stop the automatic debit. (Please note: 7 days
advance notice is required to ensure future credit card charges are stopped.)
* The twelve-month Short Term Health plan is not available in all states. This Web site will only provide you with the ability to purchase plans available in
your area.
Benefits
Q. Can I choose my doctors and hospitals or are there PPO and HMO options
available?
A. This plan is not an HMO or PPO. You have the freedom to select the doctors
and hospitals you use.
For Additional Savings* - You can reduce your medical bills by using 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. At the time of service , present your medical identification
card with the PHCS logo on it and your provider will bill you at the reduced
network rate for services.
* Not applicable in Rhode Island.
Q. Are prescription drugs covered?
A. Yes. A prescription drug is one that is prescribed by a physician and payment
is subject to deductible and coinsurance amounts for an illness or injury that
occurs while a policy is in force. There is no drug card.
Q. Does the Short Term Medical plan cover routine dental and optical
expenses?
A. No. This plan is designed to protect you in the event of an illness or injury
and is not meant to cover non-injury related dental and optical care.
Q. Will a routine checkup be covered?
A. No. This plan is designed to protect you in the event of an illness or injury
and is not meant to cover routine exams and preventive care. Short Term Medical
is for temporary coverage only and therefore does not include most of the
benefits a permanent heath plans offer.
Q. Is there a waiting period for benefits?
A. If you purchase a twelve-month plan* and your requested effective date is
within three (3) days of applying for coverage, a waiting period of up to three
(3) days for sickness benefits may apply. This waiting period will be clearly
indicated on your benefit summary. Benefits for injuries are covered as of the
effective date of your policy.
* The twelve-month Short Term Medical plan is not available in all states. This
Web site will only provide you with the ability to purchase plans available in
your area.
Purchasing an Additional Short Term Health Insurance Plan*
Assurant Health 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:
- No claims were incurred under a previous
Assurant Short Term Health plan .
- There has been no significant change in your
health.
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 Assurant 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.
* Varies by state.
Federal reform legislation
The following Q&A's regard federal legislation. *State reform legislation
may vary.
Q. Are Short Term Medical plans affected by the Federal Health Insurance
Portability and Accountability Act (HIPAA) of 1996?
A. No. Under HIPAA, short term limited duration policies are generally exempt
from this legislation. This means that when issuing a Short Term Medical policy,
insurance carriers do not have to: guarantee renewability, guarantee issue or
waive the pre-existing condition limitation for federally eligible individuals.*
Q. Is a Short Term Medical plan considered "creditable coverage"
under HIPAA?
A. Under HIPAA, Short Term Medical coverage is generally considered creditable
coverage to help satisfy any pre-existing condition period.* Previous creditable
coverage includes:
- A group health plan
- Health insurance coverage
- Part A or Part B of title XVIII of the Social
Security Act (Medicare)
- Title XIX of the Social Security Act, other
than coverage consisting solely of benefits under section 1928 (Medicaid)
- Chapter 55 of title 10, United States Code (Champus)
- A medical care program of the Indian Health
Service or of a tribal organization
- A state health benefits risk pool
- A health plan offered under chapter 89 of
title 5, United States code (Federal Employee Health Benefit Plan)
- A public health plan (as defined in
regulations)
- A health benefit plan under section 5(e) of
the Peace Corps Act
* Consult your state for specific rights and requirements.
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