$1,000,000 Catastrophe Major Medical Insurance Plan A Group Health Insurance Plan That Pays In Excess Of What Your Major Medical Or Hospitalization Insurance - Or Even Medicare - May Not Pay!
 

Available Regardless Of Age!

Whatever Your Age...You Need This Coverage

Today, the cost of a serious illness or injury is often far beyond the benefits provided by the average health insurance policy. Rising hospital and nursing home costs, escalating doctor's fees, expensive medicines, home health care costs, specialized surgical procedures and new equipment can push your expenses far over the limit your basic insurance was ever designed to handle.

What if you were suddenly stricken by long-term sickness or serious injury requiring major surgery or even an extensive recuperation period? In addition to a hospital stay, you may need to enter a nursing or convalescent home. Who would pay THOSE bills?

Even though your basic health insurance policy may have a large LIFETIME maximum benefit, benefits may be restricted PER YEAR as to what will and will not be covered.

For your own financial security and peace of mind, you need the $1,000,000 Catastrophe Major Medical Insurance Plan...to take over when your basic coverage (including Medicare) runs short. And that's exactly how this plan has been designed - as supplemental health coverage.

For this reason, the Plan includes your choice of a $25,000 or $50,000 deductible (or the amount paid by your basic health insurance if higher)...important also in keeping your cost as economical as possible. Once this deductible is reached, the Catastrophe Major Medical Insurance Plan takes over to cover up to 100% of the Plan's eligible expenses (during the calendar year) up to a maximum of $1,000,000 in benefits while insured.

$1,000,000 Maximum Benefit!

You Cannot Be Turned Down Because Of Age

All members and/or spouses are eligible to apply regardless of age. Unmarried dependent children from birth to 19 years of age (25 if attending school full-time) are also eligible. You must be able to perform the normal activities (as defined by the policy) of a person of like age, sex or retired status on the date insurance is to take effect. If you are not, the insurance will take effect on the day you resume such activities. Your coverage will remain in force as long as your premiums are paid when due, the Group Policy remains in force and you continue to be an eligible member or dependent.

Pays up to 100% of all reasonable and customary eligible expenses after your deductible:

  • All hospital charges including daily, semi-private room and board - up to $400 per day
  • All intensive care facility charges up to $800 per day
  • Services of a physician for medical care treatment whether in a hospital, at home or in the office
  • Anesthetics and the administration thereof
  • Blood and plasma, artificial limbs or eyes, surgical dressings, casts, splints, trusses, braces or crutches, oxygen and rental of equipment to administer oxygen, rental of a wheelchair or hospital-type bed, rental of an iron lung or other mechanical equipment for the treatment of respiratory paralysis, rental of other mechanical equipment for medical or surgical treatment
  • Treatment to natural teeth injured by a non-job related accident
  • Drugs and medicines requiring written prescription
  • Ambulance service up to $2,000 per calendar year
  • Mental, nervous or emotional disorders, alcoholism or drug addiction treated in a hospital are covered, but not to exceed $25,000, while insured
  • Private duty nursing services up to $300 per day, $30,000 per calendar year

Convalescent Home Benefits

Anyone at any age may require long-term convalescent or custodial care in a nursing home. That's why this is an extremely important benefit to you - a benefit that is either not included or is limited in most health insurance plans.

If an insured person becomes confined as an inpatient in a convalescent home facility, the Plan pays $300 per week for room, board, general nursing care services and supplies. Coverage is up to a maximum of $46,800, while insured. Confinement must be prescribed by an attending physician within 14 days of hospitalization.

Home Health Care Benefits

The Plan will pay the reasonable and customary charges for covered home health care treatment up to 100 visits in any one calendar year. These services must be approved by a physician and provided by a certified home health care agency. Each visit by a member of a home health care team will be considered as one home health care visit. Four hours of such home health aide visits will be considered one visit.

Hospice Care

The Plan also pays for up to 210 consecutive days of confinement in a hospice and charges for five bereavement counseling visits to the family of the terminally ill person.

Survivor's Coverage

Coverage continues for dependents of a deceased member as long as the dependents meet the normal eligibility requirements, premiums continue to be paid at the adjusted rates depending on the survivor's age, and the group policy remains in force.

Coordination Of Benefits

The benefits of this Plan will be paid after benefits paid by any group or government insurance and insured has to avoid duplicate benefit payments. However, this provision does not prevent insureds from collecting up to 100% of their allowable expenses.

Here's More About The Plan...

Your Deductible

The $1,000,000 Catastrophe Major Medical Insurance Plan is designed to help provide coverage for the extraordinary expenses not covered by your present health insurance. For this reason, the Plan offers a calendar-year deductible. All reasonable and customary eligible expenses count toward your deductible in full. The deductible is the greater of the benefits paid under the insured's basic insurance plan or the selected deductible. The member may select either a $25,000 or $50,000 deductible amount. Each insured has 24 consecutive months to accumulate the deductible.

Common Disaster Provision

If more than one insured family member is injured in the same accident, only one deductible needs to be satisfied.

Required Basic Health Insurance

The required basic Plan is a health insurance plan which provides a minimum of 70 days of full coverage for in-hospital confinements or a major medical plan with a lifetime maximum of not less than $50,000, co-insurance of not less than 80% and a deductible of not more than $1,000. In order to be eligible for this Catastrophe Major Medical Plan, you must have a basic health insurance policy providing at least this minimum benefit. At claim time, if you do not have basic insurance equal to these benefits, any charges incurred during the first 70 days of each hospital confinement will not be covered.

Benefit Period

A Benefit Period starts on the day you incur the first charge towards your deductible, and will end the earlier of:

  • The date 12 consecutive months have elapsed during which no charge was incurred for the injury or sickness, or
  • the expiration of three years from the date the first charge was incurred, or
  • the Maximum Lifetime Benefit Amount of $1,000,000 has been paid.

Pre-existing Condition Limitation

All covered accidents and sickness which originate after the effective date of insurance are covered immediately. Pre-existing conditions are not covered until 12 consecutive months from the policy's effective date have passed without treatment or medical advice for such a condition; or the insured has been covered under the policy for two years. A pre-existing condition is any condition for which medical advice or treatment has been received during the past 12-month period prior to the day insurance went into force.

What's Not Covered

Exclusions: Benefits are not paid for loss caused by or resulting from any one or more of the following: intentionally self-inflicted injuries, suicide or any attempt thereat; hearing aids; dental treatment; eye examinations or glasses, or the fitting thereof, except to the extent that any of them are necessary for the repair or alleviation of damages caused solely by accident covered under this policy, or necessitated by congenital defects; any treatment or service furnished by a member of the Insured's family, employer or employee of such employer; results from a war or act of war or intentionally self-inflicted injury. A complete list of Exclusions is contained in the Certificate of Insurance.

Semi-Annual Premiums
$1,000,000 Catastrophe Major Medical Insurance Plan
$25,000 Deductible
Age Member Only Member & Spouse Member & Child(ren) Member, Spouse &
Child(ren)
Under 40 $86.80 $172.80 $244.80 $331.20
40-49 $115.20 $230.40 $259.20 $374.40
50-59 $201.60 $403.20 $302.40 $504.00
60-64 $266.40 $532.80 $352.80 $619.20
65-69 $244.80 $489.60 $309.60 $544.40
70-74 $288.00 $576.00 $352.80 $640.80
75+ $338.40 $676.80 $403.20 $741.60
 
$50,000 Deductible
Age Member Only Member & Spouse Member & Child(ren) Member, Spouse &
Child(ren)
Under 40 $60.48 $120.96 $171.36 $231.84
40-49 $80.64 $161.28 $181.44 $262.08
50-59 $141.12 $282.24 $211.68 $352.80
60-64 $186.48 $372.96 $246.96 $433.44
65-69 $171.36 $342.72 $216.72 $388.08
70-74 $201.60 $403.20 $246.96 $448.56
75+ $236.88 $473.76 $282.24 $519.12

NOTE: All premiums - including those for spouse - are based on applicants age when insurance becomes effective and on applicant's attained age on renewal dates. Although you will never be singled out for an increase in premium, the insurance company reserves the right to increase premiums on a class-wide basis.

Here's How To Apply

  1. Only eligible members may apply for coverage. Request enrollment material from the Plan Administrator at the following address:

       Herbert V. Friedman, Inc.
       119 North Park Avenue
       Rockville Centre, New York 11570
       1-800-272-1637
       E-mail: apsit@hvfinc.com

  2. Complete the application answering all questions fully. Please make sure you date and sign the application (all signatures must be original).

  3. Return the completed application to the Plan Administrator.

  4. Do not send money. You will be billed after your application is approved by THE UNITED STATES LIFE Insurance Company.

Your application is subject to approval by THE UNITED STATES LIFE Insurance Company.

Each member participating in the plan will receive a Certificate of Insurance describing the exact coverage and benefits purchased.

If you have any questions regarding the plan, application or claims, contact the Plan Administrator.

30-Day Guarantee

When you receive your Certificate of Insurance, read it over carefully...show it to a trusted advisor or friend. If the $1,000,000 Catastrophe Major Medical Insurance Plan is less than what you had expected, just mail your Certificate back to the Insurance Administrator within 30 days of receipt. Your coverage will be voided and your money will be promptly refunded.

No questions asked! Your satisfaction is guaranteed 100%.

This is a brief summary and is subject to the terms, conditions and limitations of Group Policy No. E-200,073. Your Certificate of Insurance will detail the benefits and provisions of the Group Policy.
This plan may not be available in all states.

For Assistance and Information please contact the Plan Administrator:

Herbert V. Friedman, Inc.
119 North Park Avenue
Rockville Centre, NY 11570-4179
516-764-0050

Underwritten by: THE UNITED STATES LIFE Insurance Company
An American General Company

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