Even the best health insurance plan doesn't cover all the costs of hospitalization or medical care. Major medical plans typically pay 80% and only after you've paid an annual deductible. And that 's just for expenses they cover. What about the cost of private hospital rooms, private duty nursing, and in-hospital physician's visits? Many plans either limit or exclude these expenses altogether.

What's more, many insurance plans pay only 80% of "reasonable and customary" fees; you pay 20%. And if a doctor charges more than what the insurance company deems appropriate, you could wind up paying more than 20%.

And, what about the hidden costs associated with a hospital stay...those personal expenses your family incurs if you're hospitalized...things like travel, lodging, meals, housekeeping expenses, etc.

In short, until you get all the bills you just don't know how much you'll have to pay out of your own pocket. And with medical costs continually rising, having a little extra protection can give you a lot more peace of mind.

That’s why APSIT is sponsoring a Hospital Indemnity Insurance Plan...
Here are some of the features:

• Daily benefits ranging from $50 to $150
• Benefits from the first day of covered hospitalization for up to 2 years
• Double benefits for cancer or intensive care confinements¹
• Coverage for your spouse and children
• Guaranteed acceptance for all eligible members and dependents²
• Plus there are some special benefits you won’t find in just any hospital insurance plan:
  • Skilled nursing facility confinements benefit
  • Home convalescent benefit

In addition, there are limited benefits for alcohol and substance abuse confinements. And when you consider that our plan is underwritten by New York Life, one of the largest and most respected insurance companies in the world, you have a package that's hard to beat.

¹ For insured individuals under age 65.
²Benefits for pre-existing conditions may be limited; see "Exclusions and Limitations."

Here's How It Works

You choose the daily benefit for you and your spouse - $50, $75, $100 or $150. You may also cover your unmarried dependent children under 23 for either $30 or $50 a day. (Note: Under the APSIT Plan the total Daily Benefit Amount that you apply for, together with any other coverage that you may have (Individual or Group Plan) may not exceed $300 a day. Also, you must be insured in order to cover your dependents.)

If you or one of your insured dependents are hospitalized for a covered condition, you’ll receive daily benefits from the first day up to two years for each confinement. What’s more, while you or an insured dependent are in an intensive care unit, or hospitalized for cancer, the daily benefits are doubled, as long as the confinement began before age 65.

These benefits are payable in addition to any other hospital or medical coverage, including Medicare. And you can have benefits paid directly to you, or assigned to your doctor or hospital.

By having benefits paid directly to you, you have more control over how to use your benefit dollars. For example, you might want to use the cash to pay for housekeeping expenses, or to supplement a reduced income that results from a hospitalization.

Best of all, as a member of one of the associations participating in APSIT, you’re guaranteed acceptance as long as you’re under age 65³. Although coverage for pre-existing illness or injuries is limited, neither you nor an eligible family member can be refused insurance on the basis of your medical history. That means no complicated application to fill out or physical exam to take. What could be easier?

³ Your spouse under age 65 and dependent children under age 23 are also guaranteed acceptance. If both you and your spouse are eligible members, each may apply as a member, but may not duplicate coverage by applying as dependants of each other. Only one member may request coverage for your eligible children.

Plus, More Benefits For Extra Protection

Nursing Homes aren’t just for the elderly. Individuals of all ages may need skilled nursing care outside of a hospital while recovering from an acute illness or injury. Yet many medical plans don't pay benefits for skilled nursing or home convalescent care. Thanks to APSIT, you can have the protection you may need to bridge the gap between full hospitalization and full recovery.

Skilled Nursing Facility Benefit — If after a covered hospital confinement of at least five days, (that began before age 65) you're totally disabled as defined in the policy, and enter a skilled nursing facility within seven days, the APSIT plan pays 50% of the daily hospital benefit for up to one year. This benefit is also available to your covered dependents.

Home Convalescent Benefit — If after a covered hospital confinement of at least 10 days, (that began before age 65) you're totally disabled as defined in the policy, and recovering at home, this plan pays 50% of your daily hospital benefit for as long as you're totally disabled, up to 30 days, or the length of the prior hospital stay, whichever comes first. This benefit is also available to your covered dependents.

All Premiums are based upon members attained age at issue and at renewal. Rates increase as the member attains a new age bracket.

Premium rates shown are current and may be changed by New York Life on any premium due date and on any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds under the Group Policy. For example, a class of insureds is a group of people with the same age and gender. Future Benefits are subject to change by agreement between New York Life and APSIT.

⁴Semi-annual premiums are one-half the annual premium, plus an administrative fee of 50 cents.
⁵Shown for renewal purposes only

Term Of Coverage

Your coverage will go into effect on the earliest of the 1st or the 15th of the month following approval of your application, provided you are performing your normal activities on that day and your premium is paid in a timely manner.

Dependant coverage will begin on the date you become covered or, the earlier of the 1st or the 15th of the month following approval of your application to add your dependents, provided they are performing their normal activities on that day and their premium is paid in a timely manner.

Your coverage under this plan will remain in force as long as:

• The group policy is in effect;
• Your premiums are paid when due; and
• You're an active member of a participating association of APSIT.

Your dependents' insurance remains in force as long as your coverage is in effect, premiums are paid when due, and they remain eligible dependants.

Exclusions And Limitations

Benefits are provided only for confinements which begin while insured and which are recommended by a doctor as medically necessary to treat a sickness or accident. Benefits are not provided for confinements resulting from: war or military service; self-inflicted injuries, suicide or it's attempt (while sane or insane); normal pregnancy or childbirth⁶; or pre-existing conditions as defined below.

Benefits for confinements due to mental, nervous or emotional disorders are limited to 365 days in your lifetime. Benefits for confinement due to alcoholism, chemical or drug dependency are limited to 45 days in a 12-month period.

The maximum benefit payable for any one day of covered confinement is two times the daily benefit amount.
⁶Confinements for pregnancy or childbirth are covered in Massachusetts and California.

Missouri Residents: The exclusion for confinements due to suicide or self-inflicted injuries is not applicable to confinements due to an attempted suicide while insane.

Pre-existing Condition Limitation - Any illness or injury, diagnosed or undiagnosed, for which medical care or treatment was received or recommended during the 12-month⁷ period before the effective date of coverage is a pre-existing condition. This policy does not cover confinements for pre-existing conditions until 12 months after the last treatment or care was rendered, or 24 months⁸ after the effective date of coverage, whichever is sooner. All other conditions are covered immediately.

⁷6 months in Montana
⁸12 months in Colorado

Coordination With Other Plans Limitation

The daily benefits payable under this Plan will be coordinated with any hospital indemnity benefits paid or payable under any other Hospital Indemnity Policy that you may have in force. As a result of this coordination, the daily benefits payable under this Plan may be reduced.

Definitions

Confinement — a period that begins on the date a covered person is admitted to the hospital. Subsequent confinements for the same or related causes are part of the same confinement period, unless separated by 12 months or more.

Hospital — an institution that primarily and continuously provides medical care and treatment of sick and injured people on an inpatient basis; operates facilities for medical and surgical diagnosis and treatment by or under the supervision of a staff of legally qualified physicians; and provides 24-hour-a-day nursing service by or under the supervision of registered graduate nurses. Hospital also means an institution that is state licensed or approved as a residential treatment center for the treatment of alcoholism, chemical dependency or drug addiction. Hospital does not mean any institution, or part thereof that is used primarily as a clinic; as a nursing home, convalescent home, or skilled nursing facility; as a place for rest, custodial care, or for the aged.

Skilled Nursing Facility — is an institution that primarily and continuously provides skilled nursing care, and related services, to people recuperating from sickness or injury on an inpatient basis; maintains a daily medical record of each patient; has established policies, developed and executed by a professional group, including at least one legally qualified physician, and at least one registered professional nurse; provides adequate procedures for the administration of drugs; provides each patient with a planned program of medical care by or under the supervision of a physician; and has a qualified physician available to furnish medical care in case of emergency. Skilled Nursing Facility does not mean a hospital, rest home for the aged, or a place for custodial care; or a place for the care of drug addicts, alcoholics, or the mentally ill.

Here's How To Apply

1. Only eligible members may apply for coverage. Request application materials 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 New York Life.

Your application is subject to underwriting approval by New York Life.

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

APSIT offers a full complement of insurance products from New York Life. Ask your Plan Administrator for information on the Group Term Life (standard plan), 10 Year Level Term, Personal Accident, Disability Income, and Hospital Indemnity Benefit Plans.

Coverage under this plan is generally available to residents of the United States and Canada (except Quebec). Coverage may not be available in some states – call the Plan Administrator for availability.

Notice to Florida Residents: Ken Friedman (an employee of Herbert V. Friedman, Inc.) is a licensed Agent for service to residents of Florida.

This website provides a general description of the insurance plan offered and is not a contract. Complete terms, conditions, definitions, limitations, exclusions and renewability are detailed in Group Policy G-29069-0 -Policy Form GMR (in Texas Policy Form GMR-FACE/G-29069-0) issued to the Trustees of the American Physical Society Insurance Trust (APSIT). Insured Members are provided a Certificate of Insurance which details their coverage.