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FAQs
Here are answers to the most frequently asked questions about our Short Term Medical insurance plan.
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General Information
Q. For how long a time period may I purchase Short Term Medical coverage?
A. Short Term Medical insurance can be purchased for one month (30 days) up to 12 months (360 days). Coverage up to 12 months (360 days) is not available in all states. This Web site will only provide you with the ability to purchase the length of coverage available in your state.
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Q. When does my coverage begin?
A. It depends on how you pay for your policy:
- Credit card or auto bank debit — the earliest your coverage can begin is the day after you submit your application online. For example, if you submit your application online March 16, the earliest your coverage can begin is 12:01 a.m. on March 17. All submissions take place and are recorded based on Central time.
- Check — if you submit your application online and pay by check, the effective date of coverage you requested will be honored provided your full premium payment is received at Assurant Health within 10 days of submission of your application. If your check is not received within 10 days, a new application will need to be completed and a new effective date requested.
Q. What is the age range for coverage?
A. Eligible persons must be between the age of 30 days and 64 years, 11 months. To be considered dependents, children must be younger than 18 or 24 if a full-time student.*
* May vary by state.
Q. What is a pre-existing condition?
A. A pre-existing condition is a medical condition due to sickness or injury for which you received medical treatment or advice during the five-year period immediately prior to your Short Term Medical effective date, regardless of whether the condition was diagnosed or not; or that produced signs or symptoms within the five-year period immediately prior to your Short Term Medical effective date. The signs or symptoms either must have allowed one knowledgeable in medicine to diagnose the disorder or would have compelled a reasonable person to seek diagnosis or treatment.
If you have a pre-existing condition, treatment for that condition will be excluded from your Short Term Medical plan.
This definition varies by state.
Q. Can I change my deductible after my policy is issued?
A. No. To change your deductible, a new policy would need to be issued.
Q. Can I add or remove family members after my policy is issued?
A. No. To add or remove family members, a new policy would need to be issued.
Q. What does "lifetime maximum" mean?
A. Lifetime maximum is the maximum amount the plan will pay toward medical bills for each covered person.
Q. Does this plan require preauthorization for services?
A. Yes.* This plan requires authorization prior to receiving certain services. The identification card you receive with your 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 policy 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 800-800-2412. The Short Term Medical identification card, which is attached to a copy of the insurance contract, also lists the preauthorization phone number.
* Not applicable in California, Idaho, Missouri and North Carolina.
Q. Where do I mail a claim?
A. Claims can be faxed to 414-224-0472 or mailed to Assurant Health, P.O. Box 981602, El Paso, TX 79998.
Q. How do I cancel my coverage?
A. You can cancel your coverage by:
- Phone: 800-800-5453
- Fax: 414-299-6533
- Mail: Assurant Health, P.O. Box 3175, Milwaukee, WI 53201-3175
Q. If my temporary need continues, can I get another Short Term Medical policy?
A. Short Term Medical insurance is not renewable. When your plan expires, you can apply for another plan if your temporary need continues and you are still eligible.* The new plan will not provide benefits for any condition or symptom that began during the previous plan.
Note: Short Term Medical plans are designed for people who have a temporary insurance need. One of our Individual Medical plans may be more appropriate if you have an ongoing need for medical coverage.
* Varies by state.
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Benefits
Q. Can I choose my own doctors and hospitals?
A. You have the freedom to pick your own doctors and hospitals — without worrying about out-of-network costs. When you need medical care, you have the option to save an average of 20-35% on your medical bills by using the doctors and hospitals in a designated health care network in your area. The specifics on which network will save you the most will be provided in your policy packet.
Not applicable in Rhode Island.
Q. Are prescription drugs covered?
A. Prescription drugs are covered for an accident or illness that is incurred while the policy is in force. The cost for covered prescription drugs will be applied to the plan deductible and coinsurance and will be paid at 100% once the plan deductible and coinsurance amounts have been met. A prescription drug is one that is prescribed by a physician.
Q. Do Short Term Medical plans cover routine dental and optical expenses?
A. No. Plans are designed to protect you in the event of an illness or accident and are not meant to cover non-injury related dental or optical care.
Q. Will a routine checkup be covered?
A. No. Short Term Medical insurance is designed to protect you in the event of an illness or accident and does not cover routine exams or preventive care.
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Payment Information
Q. Are there any other fees due in addition to the premium?
A. There is a one-time, nonrefundable application fee with each policy.
Q. What is the difference between the monthly and single payment options?
A. If you know the exact number of days coverage is needed, you can save 20% when you choose the single payment option and make a one-time, up-front payment. For example, if you know you have a 90-day waiting period before you're eligible for health benefits through your employer, this payment option is ideal. Note: Refunds are not available after the 10-day free look period.*
If you want flexibility or are unsure how long coverage is needed, you can pay as you go with the monthly payment option. Then simply contact us to stop payments and discontinue the plan once your temporary need ends.
* Varies by state.
Q. If I choose the monthly payment option, how will I be billed?
A. If you make your initial payment by:
- Automatic credit card or bank debit — your first payment and all subsequent monthly payments will be automatically debited from the credit card or checking/savings account information provided. Your first payment will be debited on the day you submit your application. Subsequent monthly payments will be debited starting 30 days after your requested effective date and will continue every 30 days until you have reached a total of 180 or 360 days of coverage (depending on the plan you selected). If your temporary need ends early, simply call 800-800-5453 or e-mail us and we will stop the automatic credit card debit of future payments. Note: Seven 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 with the coupon to Assurant Health. Each coupon pays for an additional 30 days of coverage. Note: No lapse notices are sent.
Coverage up to 12 months (360 days) is not available in all states. This Web site will only provide you with the ability to purchase the length of coverage available in your state.
Q. Can I get a premium refund?
A. We stand behind our products! If you aren't completely satisfied with your Short Term Medical plan, you may return the policy and ID cards within 10 days of delivery and receive a premium refund, no questions asked. The one-time application fee is not refundable. After 10 days, premiums are not refundable.*
Simply put your refund request in writing and fax it to 414-299-6217 or mail it to: Assurant Health, P.O. Box 3175, Milwaukee, WI 53201-3175.
* Varies by state.
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Federal Reform 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.*
* State reform legislation may vary. Consult your state for specific rights and requirements.
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.
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