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Hospital, Medical, Surgical Insurance*
Hospital, Medical, Surgical Insurance from Physicians Mutual Insurance Company is designed to help cover gaps in your existing coverage … or to help provide limited protection if you find the cost of major medical coverage too expensive. When you receive a covered service, this limited-benefit coverage can pay you a fixed amount of cash you can use to help pay additional or unexpected medical bills.
This important coverage can work together with health insurance you may already have to give you more complete coverage. Or it can work by itself if major medical health insurance is simply not in your budget.
* In Idaho, this is a Limited Hospital Confinement Indemnity Policy; in Texas, this is Hospital Confinement Indemnity Coverage; in Virginia, this is a Hospital Confinement Indemnity Policy
Coverage Can Include:
Preventive care treatments
Emergency room visits
Outpatient lab work
Home health care
Benefits & Features:
No deductible — Help reduce your out-of-pocket costs
Benefits can stand alone or work hand-in-hand with other coverage — Tailor an insurance policy to help fit your needs
Freedom to go to any covered doctor or hospital you want — Go anywhere in the United States
Coverage renewed each year — Simply continue to pay your premiums
Full benefits for the entire family — Everyone can receive the same benefits, regardless of age
Easy to apply — Just answer a few health questions to determine your eligibility
Your satisfaction is guaranteed — Return your insurance policy within 31 days for a full refund of any premium paid … you have nothing to lose
Time Saver: Our supplemental Hospital, Medical, Surgical Insurance can offer coverage for the services you are likely to use the most — all at a price that can easily fit your budget. Compare your plan options now and see how easy it is to tailor an insurance policy that's best for you.
We're Here to Help
Get a free quote now for Hospital, Medical, Surgical Insurance, our most complete coverage for the services you may use the most. It's fast, easy and secure.
For more details about our other supplemental health insurance options, talk with one of our friendly insurance advisors.
Give us a call at 1-888-932-7642.
This product and offer are not available in all states. Please contact us to see what coverage may be available in your area.
Important Disclosure Information
Insurance Policy Kind: P643 (GA: P643GA; ID: P643ID; OK: P643OK; TN: P643TN; TX: P643TX)
P643 Hospital, Medical, Surgical Insurance
What Is Limited or Not Covered:
This is a limited-benefit hospital, medical, surgical insurance policy. Benefits are not paid for loss that occurs before your insurance policy/rider is in force. Benefits are not payable for loss as the result of an intentionally self-inflicted injury; any loss due to an act of declared or undeclared war; loss for care or treatment received outside of the fifty (50) United States and the District of Columbia; loss for injury sustained while under the influence of alcohol or any controlled substance, drug, hallucinogen, or narcotic not taken on the advice of, and in accordance with the direction of, a physician; drug or alcohol abuse; loss due to services for dental examination or treatment (including x-rays); loss due to services for vision examination or correction; loss due to which the contributing cause was the commission of or attempt to commit a felony or being engaged in an illegal occupation; and confinement due to mental or nervous disorder, unless resulting from organic disease, including Alzheimer's. Benefits are not paid for loss due to confinement or services rendered in a Veteran's Administration (V.A.) or any other hospital owned or operated by the federal government, unless the covered person has a legal liability to pay for such confinement or services. Benefits are not payable for services provided by a family member unless the family member is: a physician; a regular employee of the organization providing the service or care; and receives no compensation other than the normal compensation for employees in his/her job category. Benefits are not payable for confinement in a clinic, convalescent home or rest home, home for the aged or assisted living facility or unit, nursing home facility or unit or skilled nursing, intermediate care, extended care or custodial care facility or unit; a domiciliary, housing or residential facility or unit; a hospice unit, alcohol, drug or substance abuse treatment facility or unit.
Benefits are not paid for pre-existing conditions if loss begins within 12 months after the effective date. A pre-existing condition is a medical condition that required treatment or advice or caused symptoms that ordinarily would have required treatment or advice within two years before the effective date. Pregnancy is a pre-existing condition if the pregnancy was diagnosed before the effective date. Complications of pregnancy will be treated the same way as any other medical condition.
Preventive care benefits begin after a 180-day waiting period, following the insurance policy effective date and is payable once per year.
Home health care must be for the care and treatment of a sickness or injury where hospital confinement would have been otherwise required, be provided under a physician's plan of home health care, and begin within 14 days after a consecutive three-day covered hospital confinement. There is a maximum limit of 50 days per calendar year.
The following are not considered complications of pregnancy: false labor; occasional spotting; physician prescribed rest cure during the pregnancy; morning sickness; pre-eclampsia; hyperemesis gravidarum; or post partum depression, psychosis or any other mental disease or disorder; or similar conditions associated with the management of a difficult pregnancy not constituting a nosologically distinct complication of pregnancy.
Hospital confinement must be an inpatient admission for a period of at least 24 hours. Hospital confinement does not include an observation or recovery room or any other room of a hospital used for patient observation and recovery following an outpatient treatment in a hospital, even if stay exceeds 24 hours unless the stay is considered to be an inpatient admission by the hospital. Hospital confinements less than 30 days apart are considered to be one hospital confinement. The hospital confinement benefit reduces by 50% for confinement due to normal pregnancy/childbirth. Optional Intensive Care Benefit Rider: intensive care confinement is payable only once for any one hospital confinement and must continue for a period of at least 24 hours.
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