Hospital Indemnity Details

Aarp offers a variety of insurance products, one of which is an Indemnity Insurance product. This type of policy will cover your medical bills and lost earnings if you are hurt in an accident, become ill with a covered illness or disease, or die. It also covers the cost to replace property that is damaged due to theft or vandalism. The AARP Indemnity Insurance policies can be purchased individually or as part of our comprehensive packages for seniors. AARP has been providing quality life insurance coverage since 1958 when they were founded by retired employees from General Motors Corporation who wanted to offer affordable group benefits for retirees through their retiree organization called the American Association of Retired Persons (AARP).

This knowledge will help you understand better the details of the aarp indemnity insurance before you start filling it out.

QuestionAnswer
Form NameAarp Indemnity Insurance
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesaarp group hospital plan, aarp indemnity plan, hospital indemnity plans for individuals, hospital indemnity plans

Form Preview Example

AARP Hospital Indemnity Plans

Definitions

Hospital–AHospitalmustbeproperlylicensedasaHospital anditmustprovideorganizedfacilitiesfor,ormakeprovisionsfor, majorsurgeryanddiagnosis.Itmusthaveregisteredorgraduate nursesproviding24-hournursingserviceandhavelicensed physiciansalwaysoncall.InUtah,aHospitalisaninstitutionwhich providesmedicalcareandtreatmentforsuchinjuredpersonsandis dulylicensedbytheStateofUtahandisoperatingwithinthescope ofthatlicense.Althoughconfinementinaskillednursingcareunit isspecificallyexcluded,theHospitalStaybenefitwillbepaidforup toanadditional20daysinaskillednursingfacilityorskilled nursingcareunitaslongasthestayimmediatelyfollowsacovered HospitalStay,skillednursingcareisprovided,andthefacilityor unitisapprovedforpaymentbyMedicareoroperatedpursuantto statelawtoprovideskillednursingcare.

PeriodofHospitalStay–APeriodofHospitalStayisthetotal numberofdaysofallsuccessiveHospitalStaysforthesame orrelatedcauses.HospitalStays,whichareseparatedbymorethan 6months,orthosewhichareduetounrelatedcauses,arenotpartof thesameperiodofHospitalStay.SuccessiveHospitalStaysforthe sameorrelatedcauseswhichbeginrespectivelybeforeandafterthe firstdayofthemonthinwhichyoubecomeage65arenotpartof thesameperiodofHospitalStay.

HospitalStay–AHospitalStayisthecontinuousperiodoftime thatbeginsonthedayyouenteraHospitalasaninpatientandends whenyouhavebeendischargedfromaHospital(orskillednursing facility/unitofthesameHospital)foratleast24hours.

AmbulatorySurgicalCenter–AnAmbulatorySurgical Centermustbelicensedasanambulatorysurgicalcenterbythe stateinwhichitislocated;orbeafreestandingfacility,otherthan aphysician’soffice,wheresurgicalanddiagnosticservicesare providedonanambulatorybasisandhaswrittenagreementswith localhospitalsfortheimmediateacceptanceofpatientswho developcomplicationsorrequirepost-operativeconfinement.

OutpatientObservationCareBenefit–IfOutpatient ObservationCareisrequired,abenefitwillbepaidequaltothe applicableHospitalStayBenefit.Benefitswillbepaidwhen OutpatientObservationCareisdonebyaHospitalonthe Hospital’spremisestoprovidetheuseofabedandperiodic monitoringtoevaluatethepatient’sconditiontodeterminethe needforaninpatientsubmission.Thebenefitwillbepaidwhen allofthefollowingconditionsaremet:(1)thecareisMedically Necessary;(2)medicaladvice,testsortreatmentarereceived whileconfinedinaHospitalonanoutpatientbasisforatleast

12hours;and(3)aroomcharge(otherthananinpatientroom andboardcharge)isincurred.Confinementinanemergency roomorinanoutpatientsurgicalunitisnotconsideredOutpatient ObservationCare.BenefitsforOutpatientObservationCarewill bebasedontheamountpayableforthefirstdayofaninpatient hospitalconfinementasdeterminedbytheScheduleofBenefits. Nomorethan2daysofHospitalStaybenefitswillbepayable duringanyoneperiodofOutpatientObservationCare.

What is Not Covered

• Stays, visits, or care which are not needed to treat a sickness

Confinementinaninstitutionorunitthereofwhichprimarily

 

or injury (or dental conditions, in Florida) are not covered.

 

providestreatmentforsubstanceabuse.

• Stays that start, or care received, within three months after

Staysorcareforcosmeticsurgeryperformedmainlytochange

 

theeffectivedateifcausedbyorresultingfromapre-existing

 

aperson’sappearance.

 

condition. (Apre-existing condition is any injury or sickness

Staysorserviceforwhichnochargewouldbemadetoyou

 

[or dental condition, in Florida] for which you received

 

intheabsenceofinsurance.

 

medical advice or treatment during the six months prior to

Medicalexpensesincurredpriortotheeffectivedateorin

 

the effective date.) Note: If you are replacing your current

 

 

conjunctionwithastaywhichbeganpriortotheeffectivedate.

 

supplementalhealthinsuranceplanwithanAARPHospital

 

 

Outpatientsurgicalcareprovidedinaphysician’soffice.

 

IndemnityPlan,thisexclusionwillnotapplytoyou.

OutpatientsurgicalcarereceivedoutsidetheUnitedStates

Staysthatbeginbeforetheinsuranceeffectivedate.

 

anditspossessions.

Illnessorinjuryduetofutureactsofwar,evenifthewaris

 

Staysorservicescaused,whollyorpartly,byintentionally

 

notdeclared.

 

self-inflictedinjury,orattemptedsuicide,whilesaneorinsane.

 

 

 

Thereisalifetimelimitof190daysofbenefitpaymentsfor

HospitalStaysduetomental,psychoneuroticorpersonality disorders.(ForConnecticutResidentsonly:Thereisalimitof 60daysofbenefitpaymentspercalendaryearforHospital Staysduetomental,psychoneuroticorpersonalitydisorders.)

Confinement is not covered if the primary purpose of the confinement is to provide any of the following types ofcare:

(a)care of the type provided in a clinic, rest home, convalescent home, home for the aged or assisted living center;

(b)skilled nursing care (except as otherwise expressly covered under the Plan); (c) intermediate care, extended care or custodial care; (d) residential care or care of the type provided in a domiciliary unit; (e) care of the type provided in a hospice; (f) care of the type provided in an ambulatory surgical center or dialysis center; (g) care consisting primarily of scheduled classes, training, education and/or recreation. Such confinement is not coveredeven when the facility or unit in which such care is provided is part of the Hospital.

OnceyoureceiveyourCertificateofInsurance,readitoverintheprivacyofyourownhomeasitdetailsthefulllimitations andprovisionsofthePlan. Ifyouarenotcompletelysatisfiedwithyourcoverage,justreturnyourCertificatetoUnitedHealthcare InsuranceCompanywithin30daysofreceivingit.Yourinsurancewillbecanceled,andUnitedHealthcareInsuranceCompany willtreattheCertificateasifithadneverbeenissued.

TheseAARPHospitalIndemnityInsurancePlanscarrytheAARPnameandUnitedHealthcarepaysaroyaltyfee toAARPforuseoftheAARPintellectualproperty.AmountspaidareusedforthegeneralpurposesofAARPand itsmembers.NeitherAARPnoritsaffiliateistheinsurer.

BA25044ST(7-10)

AARPdoesnotrecommendhealthrelatedproducts,services,insuranceorprograms.Youarestronglyencouragedtoevaluateyourneeds.

AARPanditsaffiliatearenotinsuranceagenciesorcarriersanddonotemployorendorseinsuranceagents,brokers,producers,

representativesoradvisors.

InsuredbyUnitedHealthcareInsuranceCompany,Horsham,PA(UnitedHealthcareInsuranceCompanyofNewYork,Islandia,NY forNewYorkresidents). PolicyFormNumberGRP79171GPS-1(G-36000-2). AARPHospitalIndemnityInsurancePlansprovide supplementalhealthinsurancebenefitsandarenotMedicaresupplementormajormedicalplans. Allplansmaynotbeavailablein yourstate/area.

Thisisasolicitationofinsurance. Anagent/producermaycontactyou.

Tohelppreventthepossibilityofbecomingover-insured,youmaynotbeenrolledatanytimeinmorethanonePlanofthistype throughUnitedHealthcareInsuranceCompany.

AsanAARPmember,age50orover,orthespouseofamember(forCAresidents,anAARPmember,age50-64,orthespouseof amemberunderage65),youareeligiblefortheAARPGroupHospitalIndemnityPlan.ThesePlanspayindemnitybenefitsina statedamountforhospitalizationandOutpatientSurgicalCare,regardlessofexpensesincurred. Onlyonebenefitperdayispayable. IfyourequireaHospitalStay(orIntensiveCareUnitStay)andOutpatientSurgeryonthesameday,youwillreceivethehigher benefitpayment. BenefitswillbepaidwhenyoureceivecoveredOutpatientSurgeryperformedbyaphysicianinaHospitaloperating roomorAmbulatorySurgicalCenter. Benefitswillbepaidforamaximumofonevisitperday.AARPHospitalIndemnityPlanspay benefitsregardlessofanyotherhealthinsuranceyoumayhave.

Benefitschangeatage65. Forbenefitinformationforthoseage65orolder,pleaseseetheenclosedmaterials.

Age65andoverbenefitsapplytocoveredHospitalStaysbeginning,orcoveredOutpatientsurgeryreceivedonorafterthefirstdayof

themonthinwhichyouturn65.

Thispackagedescribessupplementalhospitalindemnityinsuranceplans,butisnotacontract,policy,orinsurancecertificate.Pleaseread yourCertificateofInsurance,uponreceipt,forplanbenefits,definitions,exclusions,andlimitations.

YourcoveragecannotbecanceledwhiletheGroupPolicyremainsinforceunlessyoufailtomakeyourpaymentswhendue. Benefitsandcostsvarydependingupontheplanselected. Ratesaresubjecttochange.Anyratechangewillapplytoallmembersof thesameclassinsuredunderyourPlanwhoresideinyourstate.

IfyouarecoveredunderMedicaid,yougenerallydonotneedthisPlanandshouldnotenrollsince,insuchcase,benefitspayableunderthe

Planmaybepaidtoyourhealthcareprovider,asrequiredbylaw.

ThePolicyFormNo.GRP79171GPS-1(GPS-36000-2)isissuedintheDistrictofColumbiatotheTrusteesoftheAARPInsurancePlan.

PlanRD:GH1144(inFlorida,GH1156),PlanRE:GH1145(inFlorida,GH1157),PlanRF:GH1138(inFlorida,GH1142). PlanRG:GH1146(inFlorida,GH1158),PlanRH:GH1139(inFlorida,GH1143),PlanRI:GH1147(inFlorida,GH1159).

TheAARPInsurancePlan(“Trust”)isatrustthatholdsthemastergroupinsurancepolicyissuedbyUnitedHealthcare.Participants areissuedcertificatesofinsurancebyUnitedHealthcareunderthemastergroupinsurancepolicy.Thebenefitsofparticipatinginan insuranceprogramcarryingtheAARPnamearesolelytherighttoreceivetheinsurancecoverageandancillaryservicesprovidedby theprograminwhichyouparticipate.NeithertheTrustnorAARPprovideinsuranceorguaranteethebenefitsofferedbytheinsurer. PremiumsarecollectedfromyouonbehalfofthetrusteesoftheTrust.ThesepremiumsareusedtopayexpensesincurredbytheTrust inconnectionwiththeinsuranceprogramsandtopaytheinsurancecompanyforyourinsurancecoverage.Incomeearnedfromthe investmentofpremiumswhileondepositwiththeTrustispaidtoAARPandusedforthegeneralpurposesofAARPanditsmembers.

IMPORTANTNOTICETOPERSONSONMEDICARE

THISINSURANCEDUPLICATESSOMEMEDICAREBENEFITS

ThisisnotMedicareSupplementInsurance

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.

ThisinsuranceduplicatesMedicarebenefitswhen:

any expenses or services covered by the policy are also covered by Medicare

Medicaregenerallypaysformostoralloftheseexpenses.

Medicarepaysextensivebenefitsformedicallynecessaryservicesregardlessofthereasonyouneedthem.

Theseinclude:

hospitalization

hospice

• other approved items and services

physician services

outpatient prescription drugs if you are enrolled in Medicare PartD

BeforeYouBuyThisInsurance

Check the coverage in allhealth insurance policies you already have.

For more information about Medicare and Medicare Supplement insurance, review the GuidetoHealthInsuranceforPeople withMedicare, available from the insurance company.

Forhelpinunderstandingyourhealthinsurance,contactyourstateinsurancedepartmentorstatehealthinsuranceprogram[SHIP].

NAIC 1995

State-Specific Information

ImportantInformationforMinnesotaResidents:

This is a supplemental hospital indemnity plan, and does not meet the requirements of a Minnesota qualified plan.You may only enroll for this coverage if you are currently covered under a Minnesota qualified plan (the front page of the certificate or policy of a qualified plan is labeled as such) or a health maintenance plan.

NorthCarolina:ThePlan(s)contain(s)anexclusionforpre-existingconditions.Yourcoveragewillstopif: youarenolongeraneligiblemember(orspouseofamember)ofAARP;youfailtopaytherequiredmonthly paymentsdue;ortheGroupPolicyisterminated.

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