- Members and their spouses are eligible for coverage regardless of age (under age 65 in CA) if you have not been diagnosed with, treated for, or advised of cancer (except skin cancer) within the five years, 12 months in TX, 2 years in GA, and 6 months in CA prior to your effective date of coverage. Dependent children under age 19, 25 if a full-time student.
|Cash Payment upon First Occurrence
|Hospital Benefit (First 60 Days)
|Hospital Benefit (Over 60 days)
|Hospice Care (Maximum 180 days)
|Wellness Care (Maximum benefit)
Coverage For You and Your Family
As an ASME member, you are eligible for this insurance regardless of your age provided you have not been diagnosed with, treated for, or advised of cancer (except skin cancer) within five years prior to the effective date of coverage (12 months in TX, 2 years in GA and 6 months in CA). Your dependents under age 19, 25 if a full time student, are also eligible provided they meet the health requirements. (This Plan is not available to residents of AK, CO, CT, IL, IN, LA, MA, MI, MN, MT, MS, NC, NE, NV, NH, NJ, NM, NY, OR, TN, SD, UT, VT, WA and WY). Not available in California age 65 and over.
FIRST OCCURRENCE IS COVERED
Benefits begin on the first day cancer is positively diagnosed, provided your policy has been in force for 30 days prior to diagnosis except in: AZ, MO, OK, TX and WI. You’ll receive $9,000 under the Standard Option upon the first occurrence that may help you pay for initial expenses. (First occurrence benefit does not pertain to skin cancer and will be paid only once during your lifetime.)
Hospital Confinement Days 1-60
For the first through 60th day of a covered hospitalization, you will receive $100 per day under the Standard Option. The benefit will be paid subject to the following conditions:
- the Covered Person is Hospital Confined
- the Confinement must be caused by Cancer
- the Confinement begins while insurance under the Policy and Rider are in force for the Covered Person
Wellness Care Benefits
Paid for 6 screening tests/exams, up to $120 Maximum Benefit under the Standard Option.
Extended Hospital Confinement Days 61+
Beginning on the 61st day of hospitalization, your daily benefit increases to $250 per day under the Standard Option.
As an outpatient receiving therapy and treatment for cancer (including chemotherapy), you'll be paid $100 per day under the Standard Option to help you meet ongoing costs.
If hospice care should be required, the Standard Option can pay $100 per day for a maximum of 180 days, up to $18,000, to help meet the special needs of you and your family.
COMPETITIVE RATES REGARDLESS OF AGE
Semiannual premiums are surprisingly competitively-priced and are the same regardless of your age or that of your insured dependents:
|Member & Family**
If applicable, an additional $2 billing fee (n/a in KS) will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment options.
Your Payment Options:
Please note: You may also have the option of paying your premiums once a year (annually), twice a year (semi-annually), or four times a year (quarterly). If you pay your premiums monthly, quarterly or semi-annually, the total amount of premiums and/or administration fees that you pay in a year may be higher than if you make one annual payment. If you are interested in learning more about these payment options, please refer to your fulfillment package for details.
** Family coverage includes the covered member, spouse and dependent children (unmarried children under age 19; or, under age 25 if enrolled as full-time students) of the covered member. This plan is underwritten by Transamerica Premier Life Insurance Company. Transamerica Premier Life has the right to change premiums on any premium due date with 31 days notice to the insured. Premiums may also change if the group master policy changes.
Effective Date of Coverage
Coverage becomes effective on the first day of the month following acceptance by the administrator of the application and the first premium payment, provided you or any dependent to be covered is not hospital confined.
This policy only pays benefits for medical care or treatment resulting from cancer, and recommended and approved or performed by a physician. The policy does not cover injury or sickness (other than cancer), or treatment or services performed outside the United States.
Preexisting Condition Limitation
A cancer for which treatment has been received before the covered person has been insured for 30 days from his effective date of coverage will be considered a preexisting condition (except in AZ, MN, MO, TX, WI and WY). We will, however, make payments for this cancer if the covered person incurs expenses after his or her insurance has been in effect for 12 months.
Termination of Coverage
Coverage ends if: the Master Policy is terminated; the member is no longer a member of his/her association; or the insured fails to pay the appropriate premium. Dependent’s coverage ends when member’s coverage ends, its premiums are not paid, the Master Policy is terminated, or on the premium due date coinciding with or next following the date the dependent ceases to be eligible. Transamerica Premier Life Insurance Company has the right to change premiums on any premium due date with 31 days notice to the insured. Premiums may also change if the group master policy changes.
How to File a Claim
To file a claim, call or write to the administrator for claim forms.
Certificate of Insurance
When you become insured, you will receive a Certificate of Insurance summarizing your benefits under the Plan.
This information is only a brief description of the principal provisions and features of the Plan. The complete terms and conditions are set forth in the policy issued by Transamerica Premier Life Insurance Company to the Trustee.
Transamerica Premier Life Insurance Company has the right to change rates on any premium due date with 31 days advanced notice to the insured. Rates may also change at any time if the terms of the group master policy are changed.
"30–Day Free Look"
When you become insured you will be sent a Certificate of Insurance summarizing your insurance coverage. If you are not completely satisfied with the terms of your Certificate, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will receive a full refund--no questions asked! THIS IS A CANCER ONLY POLICY.
IMPORTANT NOTICE TO PERSONS ON MEDICARE
THIS INSURANCE DUPLICATES SOME MEDICARE BENEFITS
This is not a Medicare Supplement Insurance
This insurance pays a fixed amount, regardless of your expenses, if you meet the policy conditions, for one of the specific diseases or health conditions named in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
This insurance duplicates Medicare benefits because Medicare generally pays for most of the expenses for the diagnosis and treatment of the specific conditions or diagnoses named in the policy.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
- physician services
- outpatient prescription drugs if you are enrolled in Medicare Part D
- other approved items and services
Before You Buy This Insurance
- Check the coverage in all health insurance policies you already have.
- For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
- For Help in understanding your health insurance, contact you state insurance department or state health insurance assistance program.
HOW TO APPLY
Get Quicker, Easier Service When You Apply
Before you request coverage, you must be a member in good standing of ASME . Please wait until your application for membership is accepted before initiating your insurance requests. If you have any questions regarding membership, see the ASME home page.
1. Refer to the Plan description for benefits and premium cost as you fill out the Application Form.
2. Make a check payable for the total amount of the premium due to: Administrator, ASME Insurance Program.
3. Mail the completed Application with your check to:
Administrator, ASME Insurance Program
P.O. Box 10374
Urbandale, IA 50306-8812
This is a supplemental health insurance plan that requires you to have major medical coverage, Medicare, or other health coverage that meets "minimum essential coverage" as defined by the Affordable Care Act.