![]() |
|
|
|
|
|
![]() |
|
|
The first step in protecting yourself and your family from costs associated with cancer treatment, is to review the coverage provided in the Cancer Policy Certificate. The cancer insurance consists of basic cancer coverage, including scheduled benefits for hospital stays, extended care and cancer treatments. Plus, there are additional benefits that are included with your policy and they are the wellness benefit rider and the cancer initial diagnosis level benefit rider. You can choose to enhance your coverage by adding the optional intensive care rider, which pays an additional amount each day you are confined in an intensive care unit for a covered accident or sickness. |
|
|
Below is a detailed description of coverage's, if you have questions Contact US |
| Benefits Added to Base Policy | |
| Wellness Benefit Rider (WBR3 - 3 units) | |
| Pays benefit of amount shown each year for each covered person for one of the following cancer screening tests: Bone Marrow Testing; CA15-3 (blood test for breast cancer); CA125 (blood test for ovarian cancer); CEA (blood test for colon cancer); chest X-ray; colonoscopy; flexible sigmoidoscopy; hemocult stool analysis; mammography, including breast ultrasound; Pap smear, including Thin Prep Pap Test; PSA (blood test for prostate cancer); Serum Protein Electrophoresis (test for myeloma); or biopsy for skin cancer. This benefit is payable only once for each covered person each calendar year. This benefit is paid regardless of the result of the test(s). |
$75/year |
| Cancer Initial Diagnosis Level Benefit Rider (CLR1 - 4 units) | |
| Pays a one-time benefit of amount shown for each covered person,when a covered person is diagnosed for the first time ever as having cancer (other than skin cancer).The first diagnosis must occur after the waiting period and is payable only once for each covered person. | One time benefit of $2,000 |
| Hospitalization-Related Benefits | |
| Hospital Confinement | |
| Amount shown each day for each day a covered person is admitted to and confined as an inpatient in a hospital. Maximum 70 days per each period of continuous hospital confinement. | $200/day Max. 70 days |
| Inpatient Drugs and Medicine | |
| In-hospital charges up to amount shown for each day of continuous hospital confinement. | $10/day |
| Physician’s Attendance | |
| Charges up to the amount shown each day for a visit by a physician during a covered hospital confinement. Limited to one visit a day by one physician. | $30/day |
| Ambulance | |
| Charges up to amount shown for each continuous hospital confinement for transportation by a licensed ambulance service or a hospital owned ambulance for transporting a covered person. | $200 |
| Family Member Lodging and Transportation | |
| Pays the following benefits for one adult member of the covered person’s family to be near the covered person, when a covered person is confined in a non-local hospital for specialized treatment. Lodging – Cost of a single room up to amount shown, in a motel, hotel, or other accommodations acceptable to us. This benefit is payable up to 60 days for each continuous hospital confinement. Transportation – Cost of round trip coach fare on common carrier, or amount shown for each mile up to 700 miles personal vehicle allowance for each continuous hospital confinement. We do not pay the Family Member Transportation benefit if the personal vehicle transportation benefit is paid under the Non-Local Transportation benefit, when the family member lives in the same city or town as the covered person. | Lodging up to $100/day Transportation cost of round trip coach fare or $0.40/mile personal auto |
| Non-Local Transportation | |
| Cost of round trip coach fare by common carrier or amount shown for each mile up to 700 miles for round trip personal vehicle transportation for treatment at a hospital (inpatient or outpatient), Radiation Therapy Center, Chemotherapy or Oncology Clinic, or any other specialized freestanding treatment center nearest to the covered person’s home provided, the same or similar treatment cannot be obtained locally." on-local" means a round trip of more than 70 miles from the covered person’s home to the nearest treatment facility. Does not cover transportation for someone to accompany or visit the person receiving treatment; or visits to physician’s office/clinic for services other than actual treatment. | Cost of round trip coach fare or $0.40/mile personal auto |
| Private Duty Nursing Services | |
| Charges up to amount shown each day while hospital confined. Must be required and authorized by the attending physician. Nursing services in a facility other than a hospital are not covered. | $100/day |
| Government or Charity Hospital | |
| Amount shown each day in lieu of all other benefits in the policy when confined to a hospital operated by or for the U.S. Government (including the Veteran’s Administration) or a hospital that does not charge for the services it provides (charity). | $100/day |
| Extended Care Benefits | |
| Hospice Care | |
| One of the following is paid if a covered person has been diagnosed by a physician as terminally ill and the attending physician has approved services. Payable only if home care services or admission to a freestanding hospice care center occurs within 14 days after a period of inpatient hospital confinement. Freestanding Hospice Care Center – Charges up to amount shown each day for confinement in a licensed freestanding hospice care center. Benefits payable for hospice care centers that are designated areas of hospitals will be paid the same as inpatient hospital confinement; or Hospice Care Team – Charges up to amount shown for each visit, limited to 1 visit a day, for home care services by a hospice care team. Home care services are hospice services provided in the patient's home. Food services or meals other than dietary counseling, services related to well-baby care, services provided by volunteers or support for the family after the death of the covered person are not covered. | $100/day or $100/visit |
| Extended Care Facility | |
| Charges up to amount shown each day for each day a covered person is confined in an extended care facility. Confinement period is limited to the number of days of previous continuous hospital confinement. Confinement must begin within 14 days after hospital confinement and must be at the direction of the attending physician. | $100/day |
| Extended Benefits | |
| If continuous hospital confinement for the treatment of cancer or a specified disease lasts more than 70 days, the policy pays the actual hospital charges up to amount shown for each day. Begins on the 71st day until discharge. Paid in addition to any other benefits paid prior to the 71st day, and paid in lieu of all other benefits after the 70th day. | $100/day |
| At Home Nursing | |
| Charges up to amount shown each day for private nursing care and attendance by a nurse at home. Must be required and authorized by the attending physician and must begin within 14 days after confinement as an inpatient in a hospital. Limited to the number of days that the Hospital Confinement benefit is paid. | $100/day |
| Other Cancer Treatment Benefits | |
| Surgery | |
| Surgeon's fee not to exceed amount shown in the Schedule of Operations in the policy. Two or more procedures done at the same time through one incision is considered one operation; pays the amount shown in the Schedule of Operations for the one operation with the largest benefit. The Surgeon’s charge for reconstructive breast surgery and stem cell transplants are among the many surgeries covered under this benefit. Outpatient surgery is paid at 150% of the scheduled benefit. Assistant and co-surgeons are not covered. | $3,000 Max. will vary according to surgery |
| Second Surgical Opinion | |
| Charges up to amount shown. Must be incurred after diagnosis and before surgery. | $200 |
| Anesthesia | |
| Charges of an anesthetist not to exceed 25% of the amount paid for surgery. The maximum benefit paid for skin cancer is $100. | 25% of surgery or $100 if skin cancer |
| Ambulatory Surgical Center | |
| Charges up to amount shown each day when surgery is performed at an Ambulatory Surgical Center. | $250/day |
| Physical or Speech Therapy | |
| Charges up to amount shown each day for restoration of normal body function. | $25/day |
| Prosthesis | |
| Charges up to maximum shown for each prosthetic device prescribed as a direct result of surgery for cancer or specified disease treatment and which requires surgical implantation. Limited to $2,000 for each covered person, for each amputation. | $2,000 |
| Radiation Therapy, Radio-Active Isotopes Therapy, Chemotherapy and Immunotherapy | |
| Charges up to maximum shown each 12 month period beginning with the first day of benefit under this provision for covered treatment techniques used for modification or destruction of cancerous tissue. | $10,000/12 mos. |
| Blood, Plasma and Platelets | |
| Charges up to maximum shown for each 12 month period beginning with the first day of benefits under this provision for blood, plasma, and platelets (including transfusions and administration charges); processing and procurement costs; and cross-matching. Donor replaced blood is not covered. | $10,000/12 mos. |
| Outpatient Lodging | |
| Cost, up to maximum shown, of single room in a motel, hotel, or other accommodations acceptable to us. Covered person must be receiving radiation or chemotherapy treatment on an outpatient basis. Limited to maximum shown for each 12 month period beginning with the first day of benefit under this provision. Outpatient treatment must be received at a treatment facility more than 100 miles from the covered person's home. Must be authorized by the attending physician and cannot be obtained locally. | $100/day; Max. of $4,000/12 month period |
| Skin Cancer | |
| Charges for removal of skin cancer up to amount shown when a physician who is not a pathologist diagnoses it. If more than one skin cancer is removed at the same time, the amount payable is the amount shown for each additional skin cancer removed. Skin cancers diagnosed by a pathologist are eligible for other policy benefits. | $120 for first removal, and $60 each additional at same time |
| New or Experimental Treatment | |
| Charges up to maximum shown for each 12 month period beginning with the first day of treatment under this provision when the attending physician judges such treatment necessary and no other generally accepted treatment produces superior results in the opinion of the attending physician. 2 | $10,000/12 mos. |
| OPTIONAL BENEFIT | |
| Hospital Intensive Care Rider (ICR2) | |
| $300/day or $600/day ($150/day or $300/day at the covered person’s age 70 and above) for each day of confinement in a hospital intensive care unit. Begins with the first day of admission and pays up to 45 days. For time periods less than a day (24 hours), a pro-rata share of the daily benefit is paid. Benefit reduces to 50% at age 70.• The hospital intensive care rider is not disease specific and pays a benefit for covered confinement in a hospital intensive care unit for any covered illness or accident from the very first day of confinement.• Charges for ambulance transportation to a hospital for admission to an intensive care unit for a covered confinement; this benefit is not paid if the base policy covers the ambulance. • We do not pay any benefits under this rider for hospital intensive care unit confinements due to cancer or a specified disease for 2 years from the rider date, if cancer or a specified disease is diagnosed after the rider date and prior to the end of the waiting period. • No benefits are paid if confinement is due to an attempted suicide or intentional self-inflicted injury; or intoxication or being under the influence of drugs not prescribed by a physician; or alcoholism or drug addiction. Benefits are not paid under this rider for continuous hospital intensive care unit confinements that occur during hospitalization that begins before the rider date. Children born within 10 months of the rider date are not covered for any continuous hospital intensive care unit confinement benefit that occurs or begins during the first 30 days of such child's life. | $300
a day
or $600 a day |
|
Copyright © 2003, SAS, Inc. All Rights Reserved. Privacy Policy |