The Short Term Medical (STM) Insurance plan is provided by HCC Life and offers affordable temporary health insurance to protect you and your family. You should consider purchasing the STM plam if you are concerned about protecting yourself from the potentially high medical costs associated with an unexpected accident or sickness.
With the STM plan you're in control. You get to choose your deductible, coinsurance, maximum coverage amount, and the exact length of coverage. You also have the freedom to receive treatment from doctors and hospitals of your choice without incurring out-of-network penalties. The STM plan gives you peace of mind by relieving some of your financial worry in the event of an unexpected medical condition.
The STM plan is ideal for:
- Individuals waiting on approval of major medical coverage
- Individuals transitioning between jobs
- College students or recent graduates
- Individuals no longer eligible on parents' policy due to age or status
- Individuals looking for an affordable substitute for COBRA
- New employees waiting for group coverage to begin
- Individuals not yet eligible for Medicare coverage
How Coverage Works
Policy 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.
Choice of Policy Options
Length of coverage
Up to 6 or 11 months
$250, $500, $1,000, $2,500, $5,000, or $7,500
80% or 50% of the next $5,000 of eligible expenses
Coverage Period Maximum
$1 million or $2 million
The STM plan covers the following expenses:
After you satisfy your deductible, The STM plan 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
The STM plan does not cover:
The STM plan does not cover: pre-existing conditions* (including those not inquired about on the enrollment form); preventive or wellness doctor visits; dental or optical treatments; routine physical exams; normal pregnancy or childbirth; well child care; interscholastic and intercollegiate sports injuries; over-the-counter medications and outpatient prescription drugs; expenses incurred outside the United States, its possessions or territories, or Canada.
The following conditions are also excluded: varicose veins, substance abuse and alcoholism, chronic fatigue or pain disorders, and allergies, except for emergency treatment of allergic reactions. Expenses during the first 6 months after the effective date are excluded 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 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 The STM plan is purchased. This exclusion does not apply to a newborn or newly adopted child who is added to coverage.
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 for detailed information about these and other policy exclusions and limitations. Benefits, provisions, limitations and exclusions may vary by state.
The STM plan Eligibility
You are eligible to enroll in The STM plan if you are age 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 age 25 may also be included as a covered dependent if enrolled full-time in an accredited school or college. Eligibility for children ages 19 through 25 may vary by state.
Coverage Effective Date
For enrollment forms 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 enrollment form provided payment has been received. For enrollment forms submitted by mail, your effective date is 12:01am* on the postmark date of your completed enrollment form 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 enrollment form.
*Times expressed are based on the geographical area where the certificate holder resides.
Free Look Period
If you are not 100% satisfied with The STM plan, return the certificate along with a written request for cancellation to HCC Life within 10 days of receipt. 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 Policy
The STM plan is not renewable, but if your temporary insurance need continues beyond the coverage period purchased, you may apply for a new policy as long as you have not had more than two The STM plan policies during the past 12 months. Additional purchase may not be available in some states.
About the Insurer
The STM plan is underwritten and administered 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).
Consumer Benefits of America
In most states, The STM plan is available only to members of the Consumer Benefits of America Association (CBA). Membership in the association will entitle you to discounts of up to 40% off regular retail prices on many short-term and long-term prescription drugs. Discounts are available from over 59,000 participating pharmacy providers nationwide or by mail service. When membership is required, association fees are assessed at the time of application; enrollment in the association is automatic upon payment of the correct premium and all applicable fees. New members will receive details about membership benefits with their STM plan insurance documents.