Healthy individuals between
the ages of 15 days and age 64 and 11 months, who have a temporary insurance need.
Dependent children through
age 20 (age 24 if full-time student) may be covered as dependents on their partent's plan.
Foreign residents living in
the U.S. for at least one year with proof of an Alien Registration Receipt Card, Green Card, Visa, or other
appropriate documentation.
When does coverage
begin?
Your effective date of coverage will begin on the later of:
1) 12:01 a.m. the day after your requested policy date; or
2) 12:01 a.m. the day after the postmark date affixed by the
U.S. Post Office, provided the following conditions are met:
Your application and the full
premium payment are received by your agent or Fortis
Health;
Your answers on the
application are complete and meet the requirements for
acceptance.
First: You pay deductible for
each covered person.
Then: Once the deductible is
satisfied, Fortis Health pays either 80% or 50% of the next $5,000 of cobered expenses, depending on the rate
of payment you selected. You pay the remaining 20% or 50%.
Thereafter: Fortis Health
pays 100% of remaining covered expenses up to the plan maximum of $2 million for each covered person.
The single payment option is
ideal if you know the exact number of days coverage is needed. The mimimum number of days you may apply for is
30 and the maximum is 185.
The monthly payment option is
ideal if you are unsure how long you need coverage. This "pay as you go" option gives you the
flexibility to continue coverage for as long as it's needed (up to 185 days) or stop payments and
discontinue the plan once your temporary need ends. You make an intitial premium
payment of 35 days. Then, shortly after you receive your contract, Fortis Insurance
Company will send you a sheet of payment coupons. Each coupon pays for an additional 30
days of coverage.
Money Back Guarantee! If you
are not 100 percent satisfied with the plan, you may return the contract within 10 days of delivery for a
full refund. No questions asked!
Fortis Health uses an
authorization service which ensures that you and your
family receive the most appropriate and cost effective care
available. The authorization process must be followed in its entirety to receive maxzimum
benefits. This process is explained in detail for you in the contract. Benefits for
unauthorized services of otherwise covered expenses will be reduced. No benefits will be paid for a
transplant if the procedure was not authorized prior to the beginning of the donor
search and selection.
Short Term Medical from
Fortis Health does not cover pre-existing conditions. A pre-existing condition is defined as one that a
covered person has had signs or symptoms of, or medical treatment or advice for, within
the last five years (except in certain states where this exclusion may be limited by
law). Although pre-existing conditions are not covered, people with certain medical conditions
shuld not be offered Short Term
Medical coverage.
There are two types of
pre-existing conditions - those diagnosed by a doctor
and those that produce symptoms, but have not been diagnosed. It
needs to be determined if either of these situations are present by asking questions
regarding health history.
If you need help in
determining a pre-existing condition, please contact the
Short Term Medical department at 1-800-800-5453
Fortis Health's Short Term
Medical plan is non-renewable. However, if your
temporary need continues beyond your policy period, you may apply for
one additional plan under the following circumstances:
No claims were incurred
under a previous Short Term Medical plan;
There has been no
significant change in health;
The total periods of
coverage do not exceed a total of 185 days out of
any 365 day period, you may apply for one additional plan.
To obtain a second plan, you
must complete a new application. If a second application
is approved, a new plan will be issued.
Please NOTE: There is no
continuous coverage between the original and second
plan. Any condition or symptom which may have occurred under
the first plan will be treated as a pre-existing condition under the second plan and
therefore will not be covered.
A third plan can be issued
ONLY on an exception basis by calling Fortis Health's
Short Term Medical department at 1-800-800-5453.
If claims were incurred on
either of the first two plans, a third plan CANNOT be
written.
Any conditions that manifest themselves during a
preceding plan period will be considered pre-existing in subsequent plan periods and will not be
a covered expense (unless continuity applies).
Coverage will continue in
force for the full benefit period. There is no provision
for a premium refund. There is a "10 day free look"
provision in which your client can return the policy for a full refund within 10 days of receipt
of their plan.
Full premium is required with
the application. If insufficient premium is received,
you will have 10 days to obtain a check or signed
authorization to charge the correct amount on VISA, MasterCard or Discover for the balance due.
When a credit card payment is
rejected by the lending institution, the policy will be deemed void. If a check is sent to cover the premium, a
current effective date will be issued using the postmark date of the envelope in which
the check is sent.
Your effective date of coverage will begin on the later of: