Detail

Plan Administrator: Petersen International Underwriters | AM Best Rating: A-"Excellent" | Underwriter: Lloyd’s of London

The insurance described herein is a temporary major medical insurance plan for individuals up to age 64. Coverage has a maximum term length of 3 Months. Eligible expenses caused by an illness or injury and incurred from any doctor or any hospital within the USA will be reimbursed to you.

This plan is not Affordable Care Act (ACA) compliant. This coverage is available in Arizona, California, Connecticut, Georgia, Illinois, Minnesota and Texas.

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Policy Maximum and deductible are per person, per policy period. There is a choice of $100, $250, $500, $1,000, $2,500, $5,000, or $10,000 deductibles. The earliest effective date is the day after the application is submitted. Short Term Medical coverage offers the longest term length with a maximum policy period of 3 Months. The low monthly premiums of the Short Term Medical plan enable anyone to get quality healthcare.

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  • Any expense which You are not legally obligated to pay.
  • Services which are not Medically Necessary or are not furnished by and under supervision of a Physician.
  • Expenses for services and supplies for which You are entitled to benefits, services or reimbursement through the Veterans’ Administration, Workers’ Compensation insurance, any private health plan or from any other source except Medicaid.
  • Out of Network expenses in excess of UCR.
  • Intentional self-inflicted injuries while sane or insane.
  • Treatment for alcoholism, drug addiction, allergies, and/or Mental or Nervous Disorders and all related symptoms and side effects.
  • Rest cures, quarantine or isolation.
  • Cosmetic surgery unless necessitated by an accidental Injury.
  • Dental exams, dental x-rays and general dental care except as a result of an accidental Injury.
  • Eye glasses or eye examinations.
  • Hearing aids or hearing examinations.
  • General or routine examinations.
  • Injuries or Sicknesses sustained from participation in Hazardous Sports and Activities.*
  • Pregnancy and pregnancy-related conditions including but not limited to fertility, pre-natal care, childbirth, miscarriage, abortion or postpartum conditions.
  • Injuries or Illnesses due to War or any Act of War whether declared or undeclared.*
  • Injuries or Illnesses due to Terrorism or any Act of Terrorism whether declared or undeclared.*
  • Injuries or Illnesses due to an Act of Terrorism involving the use or release of any nuclear weapon or device or chemical or biological agent, regardless of any contributory cause(s).
  • Injuries or Illnesses sustained while committing a criminal or felonious act.
  • Expenses incurred for or resulting from pain which is not supported by medical diagnosis.
  • Cataract surgery.
  • Any elective surgery, including but not limited to complications of previous elective or cosmetic surgeries.
  • Custodial Care.
  • Expenses for supplies and services that were not incurred within the USA.
  • Pre-existing conditions.
  • *This exclusion can be removed if the appropriate additional premium has been paid and the optional benefit is indicated on the Schedule or attached by an endorsement.

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Pre-existing Condition means a condition caused or contributed to by a Sickness or Injury for which medical advice, diagnosis, care or treatment, including the use of prescription medication, including but not limited to ongoing conditions(s), was recommended by or received from a licensed health care practitioner, and/or any symptom(s) and/or any condition(s) which would have caused a reasonably prudent person to seek medical atten- tion during the twelve (12) months immediately preceding the Retro Date of the insurance described in this Certificate, whether disclosed or not on Your application or online enrollment.

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The First Health Network has providers in all 50 states. The network has more than 5,000 hospitals, over 90,000 ancillary facilities, and over 1 million health care professional service locations in the network. To locate a provider please use the following information: Provider Search – 800-226-5116 or Provider Look-Up Website – www.doctorsearchnow.com.

You may receive diagnosis and treatment of your Sickness or Injury from a Provider within the PPO Network, at your option. To find a Provider within the PPO Network please review the information on Your identification card. By utilizing the PPO network You may receive discounts and savings for any incurred Eligible Expenses. Utilizing the PPO network is not required and it does not guarantee that benefits will be payable or that the Provider will bill Us directly. You have the option to see any Provider whether they are in network or out of network.

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