Coverage Information for Short Term Health Insurance

Important Information

This plan does not provide benefits for pre-existing conditions, work related conditions, and preventive care.  If you or a dependent have an existing health condition, you may want to consult with your independent insurance agent prior to changing or purchasing health/medical insurance coverage

Insurance fraud is a crime.  Any person who, with intent to defraud or knowingly facilitates a fraud against an insurer, submits an application or files a claim containing false, deceptive and/or incomplete information is subject to civil and criminal prosecution.

This website provides general information about the American Health Shield – Short Term Medical insurance plan.  It is not a contract.  The complete terms, provisions and conditions or coverage are described in the Policy or Certificate issued by The Chesapeake Life Insurance Company to approved applicants.  Plan benefits, limitations and exclusions vary by state.

This plan of insurance plan is not currently available to residents of:

GA, ID, KS, MD, MA, ME, ND, NH, NJ, NY, OR, RI, SD, UT, VT.

This plan of insurance, under Policy Form STP-01 and STP-IND-01, is underwritten by The Chesapeake Life Insurance Company Oklahoma City, OK.  The Policy and Certificates issued under it, will be deemed amended to conform to the minimum requirements of the laws of the state in which coverage is issued.

Covered Medical Expense Highlights

The American Health Shield – Short Term Medical provides benefits for Covered Medical Expenses related to covered Injury or Sickness, which are:  1) not in excess of Usual and Customary Charges; 2) not in excess of a maximum benefit amount; 3) made for services and supplies which are a Medical Necessity and listed as Covered Medical Expenses in the Policy or Certificate issued by The Chesapeake Life Insurance Company. 

Covered Medical Expenses and Benefits vary be state. Detailed information about these and additional Covered Medical Expenses is listed in the Policy or Certificate issued by The Chesapeake Life Insurance Company to approved applicants.

Note - Usual and Customary Charges means the lesser of: 1) the actual charge; 2) what the provider would accept for the same service or supply in the absence of insurance; or 3) the reasonable charge as determined by The Chesapeake Life Insurance Company, based on factors such as: a) the most common charge for the same or comparable service or supply in a community similar to where the service or supply is furnished; b) the amount of resources expended to deliver the treatment rendered; c) charging protocols and billing practices generally accepted by the medical community or specialty groups; or d) inflation trends by geographic region.

Limitation & Exclusion Highlights

Unless specifically listed as a Covered Expense in the Policy or Certificate (or as may be provided by an Endorsement attached to the Policy or Certificate), no benefit will be paid for loss or expense caused by, contribution to, or resulting from:

A Pre-existing Condition, defined as: 1) the existing of symptoms within the 12 months immediately prior to the Insured’s Effective Date or, 2) any condition which originates, is diagnosed, treated, or recommended for treatment or for which medication was prescribed or recommended within the 12 months immediately prior to the Insured’s Effective Date; 2. Charges in excess of Usual and Customary Charges; 3 Addiction, alcoholism and codependency; 4. Congenital conditions; 5. Circumcision; 6. Cosmetic procedures, except cosmetic surgery required to correct an Injury for which benefits are otherwise payable under this plan; 7. Custodial care or rehabilitation care service and supplies; 8. Dental treatment, except for accidental Injury to sound, natural teeth; 9. Elective abortion; 10. Expenses incurred outside of the United States, its possessions, territories or Canada; 11. Hearing examinations, hearing aids, eye exams, glasses or contacts; 12. Injury caused by, contributed to, or resulting from the use of alcohol, intoxicants, hallucinogenic, illegal drugs, or any drugs or medications that are not taken in the dosage or for the purpose prescribed by the Insured Person’s Physician; 13. Injury or Sickness for which benefits are paid or payable under any Worker’s Compensation or Occupational Disease Law or Act, or similar legislation; 14. Injury or Sickness to the extent that benefits are paid by Medicare or any other government law or program (except Medicaid); or medical coverage under any automobile insurance; 15. Mental Illness and behavioral problems; 16. Normal pregnancy, maternity services or supplies; 17. Organ transplants; 18. Participation in a riot or civil disorder; commission of or attempt to commit a felony or fighting; 19. Reproductive/infertility services; 20. Routine and/or screening physical examinations, testing, or treatment; 21. Services rendered or supplies purchased from your immediately family; 22. Skydiving, parachuting, hang gliding, glider flying, parasailing, sail planning, bungee jumping, or flight in any kind of aircraft (except while riding as a passenger on a regularly scheduled flight of a commercial airline); 23. Sleep disorders, supplies, treatment, or testing related to sleep disorders; 24. Suicide or attempted suicide while sane or insane; 25. Intentionally self-inflicted Injury; 26. Treatment in a Government hospital, unless there is legal obligation for the Insured Person to pay for such treatment; 27. Treatment or removal or repair of tonsils or adenoids, except for a Medical Emergency; 28. Sclerotherapy for veins or the extremities; 29. Service supplies or treatment of acne, acupuncture, allergy (including testing); 30. Nasal, sinus surgery, deviated nasal septum, skeletal irregularities of jaws; 31. Breast reduction or augmentation; 32. Weight management services; 33. War or any act of war, declared or undeclared; or while in the armed forces of any country.

Plan limitations and exclusions vary by state. Detailed information about plan limitations and exclusions are listed in the Policy or Certificate issued by The Chesapeake Life Insurance Company to approved applicants.

 

 

 

SHORT TERM HEALTH INSURANCE QUOTES