Plan Highlights
- Members and their spouses are eligible for coverage regardless of age if you have not been diagnosed with, treated for, or advised of cancer (except skin cancer) within the five years prior to your effective date of coverage. Dependent children under age 19, 25 if a full-time student (in Utah up to age 26)
- Two options to choose from: Standard and High:
|
Benefit Amount
|
Standard
Option |
High
Option |
|
Cash Payment upon First Occurrence
|
$1,000
|
$1,500
|
|
Hospital Benefit (First 60 Days)
|
$100/day
|
$150/day
|
| Hospital Benefit (Over 60 days) |
$250/day |
$375/day |
| Outpatient Treatment |
$100/day |
$150/day |
| Hospice Care (Maximum 180 days) |
$100/day |
$150/day |
| ICU Benefit (Maximum 15 days) |
$100/day |
$150/day |
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. Your dependents under age 19, 25 if a full time student (in Utah up to age 26), are also eligible provided they meet the health requirements. (This Plan is not available to residents of AZ, CT, GA, MA, ME, NJ, NY, OR, SC, SD, VT and WA.)
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. You’ll receive $1,000 under the Standard Option or $1,500 under the High Option upon the first occurrence to 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 or $150 per day under the High 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
Intensive Care Benefits
Under the Standard Option, an additional $100 per day will be payable if the confinement is in an Intensive Care Unit. An additional $150 per day will be payable under the High Option if the confinement is in an Intensive Care Unit. The maximum benefit period will be 15 days.
Extended Hospital Confinement Days 61+
Beginning on the 61st day of hospitalization, your daily benefit increases to $250 per day under the Standard Option or $375 per day under the High Option.
Outpatient Care
As an outpatient receiving therapy and treatment for cancer (including chemotherapy), you'll be paid $100 per day under the Standard Option or $150 under the High Option to help you meet ongoing costs.
Hospice Care
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. The High Option pays you $150 per day up to $27,000.
Economical Rates Regardless of Age
Semiannual premiums are surprisingly affordable and are the same regardless of your age or that of your insured dependents:
| |
Standard
Option |
High
Option |
|
Member
|
$ 41.70
|
$ 61.50
|
|
Member & Family**
|
$ 78.00
|
$ 115.00
|
** 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.
*** under age 26 in Utah.
Select Annual Billing or Electronic Funds Transfer (EFT) to avoid a $2.00 billing fee.
Effective Date of Coverage
Coverage becomes effective on the date 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.
Exclusions
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 (except as specified for cancer), expenses you are not legally obligated to pay or those charged only because you have insurance or treatment or services performed outside the United States.
Pre-existing 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 pre-existing 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.
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 be sent 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 Monumental Life Insurance Company to the Trustee.
"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!
Important Notice to Persons on Medicare
This policy or certificate duplicates some Medicare Benefits.
This is Not a Medicare Supplement Insurance Policy
This policy or certificate provides limited benefits, if you meet the policy conditions, for hospital and medical expenses only when you are treated for one of the specific diseases or health conditions listed in the policy or certificate. It does not pay your Medicare deductibles or coinsurance and is not a substitute for a Medicare supplement insurance policy.
This policy or certificate duplicates Medicare benefits when it pays: hospital or medical expenses up to the maximum stated in the policy. Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services (regardless of the reason you need them). These include:
- hospitalization
- physician services
- hospice
- other approved items and services
Before You Buy This Policy
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 insurance, contact your state insurance department or state senior insurance counseling program.
This information is for illustrative purposes only and is not a contract. It is intended to provide a general overview of the services described. Remember that only the policy can provide the actual description of services, terms, conditions and exclusions.
3732759
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 Group Insurance Program.
3. Mail the completed Application with your check to:
Administrator, ASME Group Insurance Program
12421 Meredith Drive
Urbandale, IA 50306