Insurance Type | Short Term Medical Insurance |
Insurance Provider | Standard Life |
Plan Type | PPO |
Deductible | $5,000 |
Coinsurance | 30% after deductible |
Coverage Max | $1,000,000 |
Application Fee | $0 |
Plan Type | Short Term Medical Insurance |
Office Visit for Primary Doctor | During your coverage period, you can make an unlimited number of Doctor Office and Urgent Care visits for a predictable $50 dollar copay per visit, not subject to deductible or coinsurance, up to a maximum benefit of $2000 per coverage period. |
Office Visit for Specialist | During your coverage period, you can make an unlimited number of Doctor Office and Urgent Care visits for a predictable $50 dollar copay per visit, not subject to deductible or coinsurance, up to a maximum benefit of $2000 per coverage period. |
Coinsurance | 30% after deductible |
Annual Deductible | Individual: $5,000.00Family: $15,000.00 |
Separate Prescription Drugs Deductible | |
Prescription Drugs | Generic: Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided Brand Name: Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided Non-formulary: Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided |
Annual Out-of-Pocket Limit | Individual: $11,000.00Family: $33,000.00 |
Does Out-of-Pocket Limit include deductible? | Yes |
Lifetime Maximum | $1,000,000.00 |
Out-of-Network Coverage | Yes |
Out of Country Coverage | None |
Physicians | |
Primary Care Physician (PCP) Required | No |
Specialist Referrals Required | No |
Preventive Care Coverage | |
Periodic Health Exam | Yes |
Periodic OB-GYN Exam | No |
OB-GYN Exam Conditions | N/A |
Well Baby Care | No |
Prescription Drug Coverage | |
Generic Prescription Drugs | Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided |
Brand Prescription Drugs | Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided |
Non-Formulary Prescription Drugs Coverage | Inpatient: Coinsurance + Deductible Outpatient: Not Covered, discount card provided |
Separate Prescription Drugs Deductible | |
Hospital Services Coverage | |
Emergency Room | 30% Coinsurance after deductible |
Outpatient Lab/X-Ray | 30% Coinsurance after deductible |
Outpatient Surgery | 30% Coinsurance after deductible |
Hospitalization | 30% Coinsurance after deductible |
Maternity Coverage | |
Pre & Postnatal Office Visit | Not Covered |
Labor & Delivery Hospital Stay | Not Covered |
Additional Coverage | |
Chiropractic Coverage | Covered except: spinal manipulation or adjustment |
Mental Health Coverage | Inpatient: $100 maximum per day, 31 day maximum per Coverage Period; Outpatient: $50 maximum per visit, 10 visit maximum per Coverage Period. |
What medical expenses are covered?
The following benefits are for the Insured and each Covered Dependent subject to the plan Deductible, Additional Deductibles, Coinsurance Percentage, Stop Loss Amount and Maximum Limit per Coverage Period. Benefits are limited to the Reasonable and Customary charge for each Covered Eligible Expense, in addition to any specific limits stated in the policy.
Note: This is a brief description of the plan benefits, which may vary by state.
Loss caused by, contributed to or resulting from the following is excluded or otherwise limited as specified:
This exclusion does not apply to a newborn or newly adopted child who is added to coverage in accordance with PART II – ELIGIBILITY AND EFFECTIVE DATE OF INSURANCE.
Why Short-Term Medical (STM)?
Short-Term Medical pays benefits like a major medical insurance plan, but for a predetermined length of time. You can select from a wide range of deductible and coinsurance options to tailor a plan to fit their lifestyle needs and budget.
How do I figure out what I need and where do I start?
First, Select Your Benefit Period and Payment Method
Single Payment
This option is ideal if you know the exact number of days you need coverage. The minimum number of days you may apply for coverage is 30 days. Pay now for the number of days you will need STM coverage. We accept payment by Visa, MasterCard, or Bank Draft.
Monthly Pay
You can select coverage up to 3 months. This plan is "pay as you go" which gives you the flexibility to continue coverage for as long as it is needed, or you can stop payments to discontinue the plan once your temporary need ends. We accept automatic monthly payments by Visa, MasterCard, or Bank Draft.
Then, based on your lifestyle needs and budget, select one from each of the following:
Deductible: $500, $1,000, $2,500, $5,000, $7,500, $10,000
The selected deductible must be paid by each Covered Person before Coinsurance benefits are payable. After 3 individuals meet their deductible, the deductible is deemed satisfied for any remaining covered individuals
Coinsurance Percentage: In-Network plan 80/20, 70/30 (Out-of-Network is 20% less)
Your selection of a Coinsurance Percentage represents the percent of covered eligible expenses that we pay and that you pay, after the deductible has been satisfied up to the Stop Loss Amount
Stop Loss Amount: $10,000 or $20,000
Once you've reached your Stop Loss Amount selected, we pay 100%* up to the Maximum Limit per Coverage Period. For example, if your coinsurance is 80/20, you pay 20% of the next $10,000 in covered charges ($2,000 out-of-pocket plus deductible). Then we pay at 100% up to the Maximum Limit per Coverage Period.
*Subject to Reasonable and Customary Charges.
What medical expenses are covered?
The following benefits are for the Insured and each Covered Dependent subject to the plan Deductible, Additional Deductibles, Coinsurance Percentage, Stop Loss Amount and Maximum Limit per Coverage Period. Benefits are limited to the Reasonable and Customary charge for each Covered Eligible Expense, in addition to any specific limits stated in the policy.
Note: This is a brief description of the plan benefits, which may vary by state.
Does the plan require Pre-Certification?
All Inpatient hospitalizations and procedures done at an Outpatient Surgery Facility must be pre-certified. Standard Life and Accident's professional review organization must be contacted as soon as possible before the expense is to be incurred. If the Covered Person does not comply with the Pre-certification requirements as stated in the insurance certificate, the Eligible Medical Expenses will be reduced by 50%.
How does Reasonable and Customary affect my benefits?
We may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies in order to determine the amount that should be considered as Reasonable and Customary for services and supplies.
The policy defines Reasonable and Customary charges as the lesser of the following:
All benefits are limited to Reasonable and Customary charges.
What if I change my mind after I purchase the STM Coverage?
If you are not 100% satisfied with your coverage, and you have not already used any of your insurance benefits, return the certification to us within 10 days of receipt. Coverage will be cancelled as of the effective date and your plan cost will be returned. No questions asked!
What is the Pre-Existing Conditions Limitation?
Charges resulting directly or indirectly from a condition for which a Covered Person received medical treatment, diagnosis, care or advice within the 60* month period immediately preceding such person's Certificate Effective Date. A Pre-Existing condition includes conditions that produced any symptoms which would have caused a reasonable prudent person to seek diagnosis, care or treatment within the 60* month period.*varies by state
Additionally, if you request a Certificate Effective Date that is within 3 days of the date of enrollment, then you will only be entitled to receive benefits for:
Who is eligible to apply for this insurance?
Select STM is available to members and their spouses, who are between 18 and 64 years old and their dependent unmarried children under 26 years old; and can answer "No" to all of the questions in the application for insurance. Child-only coverage is available for ages 0-25 (adult rates apply to anyone 18 or older).
When does the STM coverage terminate?
Coverage under the Policy will cease at 12:01 a.m. for a Covered Person, based on the time zone in the place where the Insured resides, on the earliest of the following:
Premium | Plan Name | Deductible | |
---|---|---|---|
from $57 | ![]() | $5,000.00 | Select |
from $58 | ![]() | $5,000.00 | Select |
from $121 | ![]() | $5,000.00 | Select |
from $126 | ![]() | $5,000.00 | Select |
from $126 | ![]() | $5,000.00 | Select |
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.