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Temporary Health Insurance: Frequently Asked Questions
Assurant Health is the brand name used for products underwritten and issued by Time Insurance Company.
Your questions are important to us! If any of your questions are not addressed within the following topics, please call or e-mail us and we will promptly provide you with the answers.
General information
Q. How much short term health insurance coverage can I have?
A. Length of coverage periods must be a minimum of 30 days and can be a maximum of 365* days.
* Varies by state. To get personalized information based on where you live, click here.
Q. When does my interim health insurance coverage begin?
A. If you are submitting your application by:
Internet using a credit card or auto bank debit - The earliest your interim insurance coverage can begin is the day following transmission, if all other eligibility criteria have been met. For example, if you submit your application online on March 16th, the earliest your coverage can begin is at 12:01 a.m. on March 17th.
All transmissions take place and are recorded based on the time and date in the Central Time Zone. For example, if you submit your application on-line at or after 10:00 p.m. on March 15th from a location in the Pacific Time Zone, the time of the transmission will be at or after 12:00 a.m. Central Time. The transmission date of your application will be March 16th.
Mail and writing a check - The earliest that your short term insurance coverage can begin is the day following the U.S. Postal Service postmark, if all other eligibility criteria have been met. (If the envelope containing your application is not postmarked by the U.S. Post Office or if the postmark is not legible, the plan date will be the later of a) your requested date or b) one day prior to the date the application was received by Assurant Health Insurance Company.)
Temporary insurance coverage will take effect provided the following conditions are met:
- Your completed application and full premium payment are received by Assurant Health Insurance Company, and,
- Your answers on the application are complete and meet the requirements for acceptance.
Q. Can I backdate a Short Term Medical Insurance plan?
A. No. Backdating is not allowed. When completing an application, please follow these steps:
- Complete the application before the desired effective date.
- Make your payment before the desired effective date and include it with the application.
- When mailing the application to Assurant Health Insurance Company, the postmark on the envelope containing the application must on or before the requested effective date.
Q. Can I change my deductible?
A. Deductible changes cannot be made after your health insurance plan is issued.
Q. What is the definition of a pre-existing condition?
A. A pre-existing condition is defined as an illness or injury for which the covered person received medical treatment or advice from a physician within the 5-year* period immediately preceding the covered person's effective date; or that produced signs or symptoms within the 5-year* period immediately preceding the covered person's effective date.
* Varies by state. To get personalized information based on where you live, click here.
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Pre-authorization
Q. Does this plan require pre-authorization?
A. Yes. Short Term Medical requires authorization prior to receiving certain services. The identification card you receive with your interim insurance policy provides a toll-free number for easy access to this service. The authorization process must be followed in its entirety to receive maximum benefits. The contract explains the authorization process in detail.
Authorization is required in advance of:
- All hospital or skilled nursing facility admissions
- Outpatient or day surgeries
- Rehabilitation programs
- Home health care
- Physical medicine/Chiropractic care
- Transplants
The number to call for preauthorization is 1-800-800-2412. The Short Term Medical identification card, which is attached to the insurance contract, also lists the preauthorization phone number.
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Payment information
Q. If I select the monthly payment option, how will I be billed?
A. If you select the monthly payment option and pay your initial payment by:
- Automatic credit card or bank account debit - each month, your premium payments will be debited automatically from the account number you provided with your initial payment. Your account will be debited each month until you have reached a total of 12 months of coverage. If your temporary need ends prior to the 12th month, simply call 1-800-800-5453 and we will stop the automatic debit. (Please note: 7 days advance notice is required to ensure future debits are stopped.)
- Check - you will receive a sheet of payment coupons via the U.S. Postal Service for all subsequent payments. Each month, mail your check along with the coupon to Assurant Health. Each coupon pays for an additional 30 days of coverage. Note: No lapse notices are sent.
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Benefits
Q. Do I have the option to select my doctors and hospitals or are there PPO and HMO options available?
A. This plan is not an HMO or PPO. There are no restrictions on which doctors you may see. You have the freedom to select the doctors and hospitals of your choice.
For Additional Savings* - You can reduce your medical bills by using the doctors and hospitals participating in PHCS Healthy Directions. Simply call PHCS at 1-800-357-6847 or visit them on the web at www.phcs.com to verify that your doctor or hospital is part of the PHCS Network. When using the web, click on "Find a Provider", then "Start New Search." Under Step #2, choose Healthy Directions/Access Advantage from the drop down menu. At the time of service, present your medical identification card with the PHCS logo on it and your provider will bill you at the reduced network rate for services.
* Not applicable in Rhode Island.
Q. Does the Short Term Medical plan include a dental and optical benefit?
A. No. This plan is designed to protect you in the event of an illness or injury and is not meant to cover non-accident related dental and optical care.
Q. Is there a drug card?
A. No. However, prescription drugs are covered under the plan. Prescription drugs require the written prescription of a physician and payment is subject to deductible and coinsurance amounts.
Q. Will a routine checkup be covered?
A. No. This plan is designed to protect you in the event of an illness or injury and is not meant to cover routine exams and preventive care. Short Term Medical is for temporary coverage only and therefore does not include most of the benefits a permanent heath insurance plan offers.
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Obtaining an Additional Short Term Medical plan
Our Short Term Medical plan is not renewable.
However, if your temporary need continues beyond your policy period, you may apply for a new plan under the following circumstances:
- No claims were incurred under a previous Short Term Medical plan.
- There has been no significant change in your health.
Generally, any previous or current health condition or symptom will be considered a pre-existing medical condition that will not be covered under a new plan. There is no continuous coverage between plans – therefore, your new plan will not provide benefits for any condition or symptom which began during a previous plan. In addition, no benefits are available for any period in which you are not covered by a Short Term Medical plan.
To obtain an additional plan, you must complete a new enrollment form. If the enrollment form is approved, a new gap insurance plan will be issued.
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Federal reform legislation
Note: The following Q&A's are regarding federal legislation.
Q. Are Short Term Medical plans affected by the Federal Health Insurance Portability and Accountability Act (HIPAA) of 1996?
A. No. Under HIPAA, short term limited duration policies are generally exempt from this legislation.* This means that when issuing a Short Term Medical policy, insurance carriers do not have to: guarantee renewability, guarantee issue or waive the pre-existing condition limitation for federally eligible individuals.
* May vary by state. To get personalized information based on where you live, click here.
Q. Is a Short Term Medical plan considered "creditable coverage" under HIPAA?
A. Under HIPAA, Short Term Medical coverage is generally considered creditable coverage to help satisfy any pre-existing condition period.* Previous creditable coverage includes:
- A group health plan
- Health insurance coverage
- Part A or Part B of title XVIII of the Social Security Act (Medicare)
- Title XIX of the Social Security Act, other than coverage consisting solely of benefits under section 1928 (Medicaid)
- Chapter 55 of title 10, United States Code (Champus)
- A medical care program of the Indian Health Service or of a tribal organization
- A state health benefits risk pool
- A health plan offered under chapter 89 of title 5, United States code (Federal Employee Health Benefit Plan)
- A public health plan (as defined in regulations)
- A health benefit plan under section 5(e) of the Peace Corps Act
* State reform legislation may vary; consult your state for specific rights and requirements. |