Hospital Income and Short Term Recovery Insurance Plan
All about your valuable member benefit
As you probably know, Medicare is generous in what it pays for. But, it was never designed to cover everything. Home recovery care, including home nursing service, physical and occupation therapy, speech therapy, companion care, home health care, and homemaker services, are frequently not fully covered by Medicare. That’s why ASME negotiated this benefit for you.
EXCLUSIVELY available to ASME members age 65+
This benefit is not available to the general public. You’d be hard pressed to find it on your own in the general marketplace. This plan was designed for retired members and their spouses age 65 and over enrolled in Medicare to help pay for home recovery expenses Medicare doesn’t cover.
How your Recovery Plan works
The ASME Short Term Recovery Insurance Plan (Recovery Plan) has two parts: a Hospital Income/Skilled Nursing Benefit and a separate Home Recovery Care Benefit.
Hospital Cash Benefits
With the Recovery Plan Hospital Benefit, you’d collect $750.00 once you’re admitted to a Hospital or a Skilled Nursing Facility as an Inpatient for at least one day for a covered sickness or injury – regardless if you need home recovery care. Benefits are paid directly to you or to anyone you designate.
And, if you find you need longer Hospital care, you’d collect an additional $500.00 after 14 days in the Hospital. Another $200.00 after 30 days in the Hospital! That’s up to $1,450.00 in cash benefits you could get paid to use toward your recovery care.
Home Recovery Cash Benefits
The Association Home Recovery Care Benefit pays you $200.00 in cash benefits for each day (from the very first day) you incur a covered Home Recovery Care Expense. Benefits are paid up to 40 days per year (maximum 20 days per occurrence). That’s up to $8,000.00* in lump sum cash benefits paid directly to you, or anyone you may assign, to help you with your recovery expenses.
And this benefit would be paid in addition to any other insurance coverage you may have.
When your Home Recovery benefits kick in
You’d get paid cash benefits when your doctor says you need care in your home after a Hospital stay, and Medicare approves the home recovery care your doctor recommends. That’s all there is to it.
Why you should consider this coverage
When you recover from an Injury, surgery or Sickness, you’ll want to stay independent and in better control of your care. With a backup plan like the Recovery Plan, you may be able to better afford the care you want.
The Association Recovery Plan helps put you in charge of your care. And with this plan, you have protection to help you confidently make the home recovery care choices you want.
Affordable group rates
This plan was carefully created so you can get benefits that you may need. Affordable monthly rates start at $19.95. That’s less than a dollar a day. Check out how affordable your rate is:
||Member or Spouse
For your convenience, you’ll be billed quarterly. You cannot be singled out for a rate increase. Rates and/or benefits may be changed on a class-wide basis. Rates are based on your attained age and increase as you enter a new age category.
*At age 80 the home recovery care benefit would reduce to an annual maximum of 20 days or $4,000.00 for covered services.
Keep your coverage as long as you want
Your protection starts as soon as the first day of the month after we receive your Confirmation Form and first premium payment. Then, you can keep your Recovery Plan as long as you want. Your coverage won’t end due to age. As long as the Master Policy remains in force, you only need to pay your premiums when due and remain an ASME member to keep your protection. A member’s spouse’s coverage ends when the member’s does, the Master Policy terminates, and when premiums are not paid. Your spouse can not be legally separated or divorced from you.
We’ll send you an official Recovery Plan Certificate of Insurance. Take up to 30 days to decide if the plan is right for you. If you like what you see, pay your premium. If not, let us know and we’ll cancel your enrollment. No questions asked.
Pre-Existing Conditions Limitation
A Pre-Existing Condition means any Injury or Sickness, diagnosed or undiagnosed, for which medical care is received by a covered person within the 6–month period prior to the covered person’s effective date of insurance. Conditions prior to effective date: During the first 6 months of a covered person’s insurance, losses incurred for Pre-Existing Conditions are not covered. This will not apply to loss that the covered person incurs after being free of medical care for the condition for a 6–month period (ending any time on or after his or her effective date).
Exclusions and Limitations
This Plan does not cover intentionally self–inflicted injuries, suicide or attempted suicide, whether sane or insane (while sane in Missouri and Colorado). Any loss caused or contributed to by war or act of war, whether war is declared or not, pregnancy or childbirth, except Complications of Pregnancy.
A Hospital or a Skilled Nursing Facility does not mean any institution or part thereof used principally as a rest home, a home for the aged, or a place for custodial care; or a place for the care of drug addicts, alcoholics, or the mentally ill.
Confined or Confinement means being an inpatient in a Hospital due to Sickness or Injury.
Periods of Confinement in a Hospital separated by less than 90 days and due to the same or related causes are considered part of the same period of Confinement.
This Plan Is underwritten by Harford Life and Accident Insurance Company, Hartford, CT 06155.
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
Policy Form #SRP–1151 A (HLA) (5421)
This limited health benefit plan (1) does not constitute major medical coverage, and (2) does not satisfy the individual mandate of the Affordable Care Act (ACA) because the coverage does not meet the requirements of minimum essential coverage.
Important Notice To Persons On Medicare
This Insurance Duplicates Some Medicare Benefits
This is not Medicare Supplement Insurance
This insurance pays a fixed dollar amount, regardless of your expenses, for each day you
meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and
is not a substitute for Medicare Supplement Insurance.
This insurance duplicates Medicare benefits when:
- any expenses or services covered by the policy are also covered by Medicare.
Medicare generally pays for most or all of these expenses.
Medicate pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
- physician services
- 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 your state insurance department or state senior insurance counseling program.
Printed in U.S.A.