Short Term Medical

Plan 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. 

Benefits


The insurance described herein is a temporary medical insurance plan. This plan covers eligible expenses caused by an illness or injury and incurred from any doctor or any hospital within the USA.

How Coverage Works

  • All eligible expenses are applied toward the deductible.
  • Once the deductible has been fulfilled, the policy will cover 100% up to $1,000,000.

The Short Term Medical plan is set up to be as simple as possible - No co-pay & No coinsurance. 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 deductible.

Eligible Expenses

  • Hospital Expenses: All medically necessary expenses while hospitalized including:
  • Hospital room and board limited to semi-private daily rate,
  • Hospital intensive care unit,
  • Emergency room care,
  • Outpatient surgery,
  • Diagnostic services,
  • Supplies and therapy.
  • Physician Services: All medically necessary expenses for treatment including:
  • Physician services consisting of home, office, and hospital visits,
  • Other medical care and treatment,
  • Diagnostic services,
  • Supplies and therapy.

Skilled Nursing Facilities: Skilled Nursing Facility room and board, provided confinement begins within 30 days following a Medically Necessary Hospital confinement of 3 days or longer.

Home Health Care: All medically necessary expenses if hospitalization would have been required if Home Health Care was not provided and the care is provided in accordance with a written plan established, approved and followed by a physician.

Ambulance Services Expenses: Ground ambulance service from Your temporary residence to and from a Hospital.

Prescription Drugs: Outpatient prescription medications covered up to a maximum of $500.

$25,000 Accidental Death: $50,000 if accidental death occurs while riding as a passenger of a common carrier.

Retro Date* (pre-existing conditions): This unique feature will allow you to receive follow-up treatment for covered accidents or sicknesses that occurred in prior policies. The retro date allows the insured to re-apply for coverage and have up to 11 months of protection without a new pre-existing condition being applied in subsequent policies. If more than 11 months is purchased a new pre-existing condition exclusion will apply.

Sports & Activities Included

Included Sports or Activities - Sports or Activities included in Your coverage. Participation in the following sports or activities are covered at no additional premium and without the need for prior declaration, when participating on a recreational and non professional basis during the term of insurance. Any involvement in these sports and/or activities is subject to your compliance with local laws and regulations and the use of recommended safety equipment (including but not limited to helmet, harness, knee and/or elbow pads).

  • Aerobics
  • Archery
  • Baseball
  • Basketball
  • Badminton
  • Banana boating
  • Body boarding (boogie boarding) up to 10 foot waves
  • Canoeing/kayaking/rafting (grade 1 only)
  • Cross country running
  • Curling
  • Cycling (street)
  • Deep sea fishing
  • Elephant riding
  • Fencing
  • Fishing
  • Go karting
  • Golf
  • Hot air ballooning (organized pleasure rides only)
  • Indoor climbing (on climbing wall)
  • Jet boating
  • Paint balling/war games (wearing eye protection)
  • Parasailing (over water)
  • Rowing
  • Running (non-competitive and not marathon)
  • Sailing/yachting (if qualified or accompanied by a qualified person and no racing)
  • Snorkeling
  • Soccer
  • Spear fishing up to 30 feet (without tanks)
  • Swimming
  • Swimming with dolphins
  • Table tennis
  • Tennis
  • Trampolining
  • Trap shooting
  • Trekking/hiking (without the need for climbing equipment) up to 10,000 feet above sea level
  • Tug of war
  • Volleyball
  • Zorbing/hydro zorbing/sphering

Included Sports or Activities does not include:

1. any sport and/or activity not listed above, or 2. any activity you do as a high school athlete, college athlete, semiprofessional athlete, professional athlete, or in a race, or 3. any activity carried out against local warnings or advice, or 4. any activity if it is not carried out in a safe way, or 5. any activity if you act irresponsibly or put yourself in needless danger.

Hazardous Sports & Activities Optional Rider

Optional Hazardous Sports or Activities Rider - Hazardous Sports or Activities are the following list of activities which are considered to be more than a standard risk. This optional rider will provide up to $250,000 for eligible expenses incurred by participation in the following:

  • Bungee Jumping
  • Driving/Riding a motor scooter
  • Hang Gliding
  • Horseback Riding (no jumping)
  • Hiking/Trekking (without the need for climbing equipment) up to 20,000 feet above sea level
  • Jet Skiing
  • Mountaineering up to 10,000 feet
  • Paragliding
  • Roller skating/ inline skating
  • Scuba diving (up to depth of 60 feet if PADI or equivalent qualified or accompanied by qualified instructor and not diving alone)
  • Skydiving with an instructor
  • Snow Skiing/ Snowboarding (excluding back country and helicopter skiing/boarding)
  • Snowmobiling (trail riding only)
  • Surfing up to 10 foot waves
  • Tree canopy tours / Zip lining / repelling
  • Wake Boarding
  • Waterskiing
  • White Water Rafting / canoeing /kayaking (grades 2-4 only).
  • Windsurfing

Optional Hazardous Sports or Activities Does Not Include:

1. any sport and/or activity not listed in the Optional Hazardous Sports and Activities Rider description, or 2. any activity you do as a high school athlete, college athlete, semi-professional athlete, professional athlete, or in a race, or 3. any activity carried out against local warnings or advice, or 4. any activity if it is not carried out in a safe way, or 5. any activity if you act irresponsibly or put yourself in needless danger.

Pre-existing Conditions Limitations

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 attention 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.

Limitations

  • The maximum Eligible Expense for room and board charges for an intensive care unit is three times the Provider’s semi-private room rate.
  • The maximum Eligible Expense for outpatient prescription medication(s) is $500.00 in the aggregate and for a maximum prescribed period of ninety (90) days for any one prescription.
  • PPO network discounts are only applicable to Eligible Expenses as defined in this wording. If benefits are not payable, You will be billed by the Provider at the full non-discounted rate.