Short Term Student Medical Insurance

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Short Term Student Insurance

How STM Medical Coverage Works

Plan benefits are subject to the deductible and coinsurance with the exception of visits to an urgent care center. The deductible is waived when you receive care at an urgent care center, and instead you pay a $50 copay, after which coinsurance applies. An urgent care center means a facility separate from a hospital emergency department where patients can be immediately treated for injury or sickness on a walk-in basis without an appointment. Limits apply to all benefits. Please see the certificate for a complete listing of benefits, limits, and exclusions.

Choice of Plan Options
Length of Coverage	Up to 6 or 12 months Purchase in full or make monthly payments
Deductible Amount you pay toward covered expenses before the plan pays benefits	$250, $500, $1,000, $2,500, $5,000, or $7,500 A maximum of 3 deductibles is required per family
Coinsurance Percentage of eligible expenses the plan pays after the deductible	80% or 50% of the next $5,000 of eligible expenses
Coverage Period Maximum The maximum amount the plan pays	$1 million or $2 million

STM covers the following expenses:

After you satisfy your deductible, STM will begin paying eligible expenses according to the coinsurance you select and up to the coverage period maximum that you choose. Benefits are based on Usual and Customary charges of the geographical area in which charges are incurred.

Inpatient and outpatient charges made by a hospital, including inpatient prescription drugs
Charges incurred at an urgent care center after a $50 copay
Charges made by a physician, surgeon, radiologist, anesthesiologist, and any other medical specialist to whom the physician has referred the case
Charges made for dressings, sutures, casts or other supplies prescribed by the attending physician or specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices for repeat use at home
Charges for diagnostic testing using radiology, ultrasonographic or laboratory services
Charges for oxygen and other gases and anesthetics and their administration
Charges made by a licensed extended care facility upon direct transfer from an acute care hospital
Emergency local ambulance transport in connection with injury or sickness resulting in inpatient hospitalization
Expenses related to complications of pregnancy
Charges for physical therapy that is prescribed in advance by a physician in relation to a covered injury or sickness

STM Eligibility

You are eligible to apply for STM if you are aged 2 through 64 and you meet the following requirements:

you are not pregnant or, if requesting dependent coverage, not an expectant father or planning on adopting;
you will not be covered under other medical insurance at time of requested effective date;
you are not a member of the armed forces of any country, state or international organization, other than on reserve duty for 30 days or less; and
you are able to answer “no” to the medical questions on the application.

Your spouse under age 65 and dependents under age 19 are also eligible for coverage, provided they meet the same requirements. Unmarried children under the age of 25 may also be included as a covered dependent if enrolled full-time in an accredited school or college.

Coverage Effective Date

For applications received online, by e-mail, or by fax, your coverage becomes effective at 12:01am* on the date following the date we receive your completed application provided payment has been received. For applications submitted by mail, your effective date is 12:01am* on the postmark date of your completed application or 12:01am* on the requested effective date, whichever is later, provided payment has been received. Your requested effective date must be within 45 days from the date you signed the application form.

*Times expressed are based on the geographical area where the certificate holder resides.

Free Look Period

If you are not 100% satisfied with STM, return the certificate to HCC Life within 10 days of receipt with a written request for cancellation. Coverage will be cancelled as of the effective date. No questions asked! After the 10 day free look, the premiums will not be refunded. The administrative fee is non-refundable.

Purchasing an Additional Plan

STM is not renewable, but if your temporary insurance need continues beyond the coverage period purchased, you may apply for a new plan as long as you have not had more than two Short Term Medical Plans during the past 12 months. Additional purchase may not be available in some states.

STM excludes coverage for pre-existing conditions. Pre-existing refers to conditions for which you received medical treatment, diagnosis, care, or advice within a specific number of months immediately preceding your effective date. The pre-ex period will vary depending on the state in which STM is purchased. Any subsequent plan purchased is subject to the same provision; therefore, any condition or symptom prior to the effective date of the subsequent plan, even if covered on the preceding plan, will not be covered.

About the Insurer

STM is insured by HCC Life Insurance Company, which has been an industry leader in medical stop loss and excess lines coverage for more than 30 years. HCC Life, an Indiana domiciled insurer, has offices in Atlanta, Boston, Dallas, Indianapolis & Minneapolis and writes over $750 million dollars in premium annually. HCC Life Insurance Company is rated an A+ (Superior) for financial strength by A.M. Best Company ratings services. All of HCC Life products are backed by the financial stability of our parent company, HCC Insurance Holdings, Inc. (NYSE: HCC).

HCC Life HealthCare Options, a division of HCC Life Insurance Company, offers STM. Headquartered in Indianapolis, Indiana, HCC Life HealthCare Options has a team of claims specialists, medical professionals and service representatives available 24 hours a day, 7 days a week to answer your questions and respond to your needs promptly and compassionately.

Consumer Benefits of America

The Short Term Medical Plan is available only to members of the Consumer Benefits of America Association. Membership in the association will entitle you to discounts of up to 40% off regular retail prices on most short-term and long-term prescription drugs. Discounts are available from over 63,000 participating pharmacy providers nationwide or by mail service. If you are not already a member, enrollment in the association is easy. Details about this membership benefit accompany your STM insurance documents.

Plan Exclusions

Although the Short Term Medical Insurance plan provides great coverage, there are exclusions to coverage - and the main exclusions are listed below:

Services related to pregnancy, except for complications of pregnancy, or conception
Weight modification, cosmetic surgery, and treatment of varicose veins
Dental, vision and hearing exams and treatment
Routine physical exams, preventative care, and immunizations unless mandated by applicable state law. Refer to certificate of coverage upon issue
Substance abuse and alcoholism
Speech, occupational, and sleep therapy as well as acupuncture and holistic care of any nature
Organ or tissue transplants
Spinal manipulation or adjustment
Chronic fatigue or pain disorders
Allergies, except for emergency treatment of allergic reactions
Treatment of joints, spine, bones or connective tissue, unless related to a covered injury
Over-the-counter medications and outpatient prescription drugs
Charges that are not incurred during the coverage period
Experimental or investigational services
Services that are not medically necessary or which exceed usual and customary charges
Expenses during the first 6 months after the effective date for (subject to all other coverage provisions, including the pre-existing condition limitation): a. Total or partial hysterectomy, unless it is medically necessary due to a diagnosis of carcinoma; b. Tonsillectomy; c. Adenoidectomy; d. Repair of deviated nasal septum or any type of surgery involving the sinus; e. Myringotomy; f. Tympanotomy; g. Herniorraphy; or h. Cholecystectomy

Pre-existing Conditions

Amigo Medical excludes coverage for pre-existing conditions. Pre-existing refers to conditions for which you received medical treatment, diagnosis, care, or advice within a specific number of months immediately preceding your effective date. The pre-ex period is mandated by each state and will vary depending on the state in which Amigo Medical is purchased. This exclusion does not apply to a newborn or newly adopted child who is added to coverage.

Waiting Period

When coverage is purchased within 3 days of the effective date, you will only be entitled to receive benefits for sicknesses that begin, by occurrence of symptoms and/or receipt of treatment, at least 72 hours following the effective date. This waiting period does not affect benefits for injuries.

This is a partial list of exclusions and limitations. Please see the Certificate of Insurance for detailed information about these and other plan exclusions and limitations. Benefits, provisions, limitations and exclusions may vary by state.

Please learn more about the Student Short Term Medical Insurance plan:

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