Frequently Asked Questions About Short-Term Medical Insurance

STM Basics

What is short-term medical insurance?

Short-term medical insurance (STM) is a quick, temporary insurance solution that protects you and your family from the financial hardships caused by unexpected major medical expenses during a gap in coverage.

STM plans last for as few as 30 days or as many as 6 months. STM offers protection until you secure a permanent major medical plan; it is not meant to be a long-term solution.

Who needs STM?

STM meets the temporary insurance needs of those laid off or between jobs and looking for a COBRA alternative, new graduates, part-time or seasonal employees, those who have been recently divorced, and new hires in waiting periods, to name a few. To find out which plan best fits your situation and budget, click here

What does STM cover?

STM usually covers a range of physician services, surgery, outpatient and inpatient care. In addition, policyholders can often choose their own doctors and hospitals without restrictions, although there may be financial incentives for using in-network providers. Plans typically will not cover routine office visits, preventive care or preexisting conditions, so be sure to check the policy’s list of exclusions.

Click here for a free, no-obligation quote and find the plan that fits your needs.

Who provides this type of coverage?

The STM plans offered on healthedeals.com are administered by IHC Health Solutions and underwritten by Standard Security Life Insurance Company of New York; both are members of The IHC Group.

Does STM include dental and vision benefits?

No. STM is temporary major medical coverage. Dental and vision benefits must be purchased separately.

Is STM considered creditable coverage?

Our plans do offer a certificate of creditable coverage, which should help with future applications for major medical plans. However, it is up to your new carrier whether or not they will accept the certificate. If you have a break in coverage that exceeds 63 days, your certificate is no longer valid.

Applying and Purchasing STM

How do I apply for a plan?

STM plans are easy to shop for and purchase online. Click here to get a free quote and compare plans, then apply and buy with within minutes.

Who qualifies for STM through IHC Health Solutions?

IHC Health Solution’s short-term medical plans are available to all members of Communicating for America* who are between the age of 18 and 64, their spouses and dependent children under age 19 (or under age 25 if a full-time student). All applying for coverage must be able to answer “no” to all medical history questions on the application. Child-only coverage is available for ages 2 through 18.

* CA membership does not apply to residents in ID, IN, KS, LA, ME, MD, MN, MT, ND, NH, NV, or SD

Can I insure only my child?

Yes. Child-only coverage is available for ages 2 through 18.

Is there a free-look period?

If you are not completely satisfied with this coverage, and you have not filed a claim, you may return the Certificate of Insurance within 10 days and receive a premium refund. Enrollment and administrative fees are non-refundable.

How will I know if I am approved for coverage?

If you and your applicable dependents are able to answer “no” to all underwriting questions on the application, you will automatically qualify for coverage. After completing the online application, you will immediately be provided with a copy of that application, your ID card(s) and your certificate of insurance.

How soon does my coverage begin?

Your STM plan can be effective as early as 12:01 a.m. the next day after the transmission date. However, you can choose a later effective date not to exceed 60 days from transmission date. Coverage ends on termination date listed in your policy. All coverage is subject to approval of your application and payment of the first premium.

If I don’t qualify, will my credit card be charged?

No. Your online quote is free. If you or your applicable dependents do not qualify for coverage, you will be notified as soon as you answer “yes” to any underwriting questions. An error message will appear; the tool will not allow you to continue with the application and you will be directed to contact your agent for additional coverage options.

What if I need coverage for fewer than 30 days?

Like most STM plans, ours have a minimum coverage period of 30 days. You may opt to make a single payment for 30 days of coverage or choose the monthly payment option and cancel when you are ready. Partial months of coverage will not be refunded.

What are my payment options?

You may choose from two convenient options: monthly payments or a single payment. While a single payment may save you money, the best payment method for you depends on your situation.

• You can pay for coverage in monthly payments up to the number of months coverage has been elected. We accept monthly payments by check, money order, credit card or automatic bank withdrawal. If you select this option and your need for insurance ends before your coverage period ends, you can cancel at any time through written notification to our Policy Service Department.
• The single payment option is ideal if you know the exact number of days coverage is needed. This option has a special reduced rate and you only pay for the coverage you need through one, single payment. You can pay in full for any number of days, from a minimum of 30 days to a maximum of 180 days of coverage by check, money order, credit card or ACH. If you make a single payment and choose to cancel your plan before the end of your coverage period, you cannot get a refund.

What if I decide to purchase major medical insurance in the future?

Before you cancel your short-term plan, make sure you have written confirmation from the insurance company that your application for major medical insurance has been approved. Contact us to cancel. Remember, no refunds are available for partial months of coverage.

Do you offer the best prices?

All rates are fixed by law. Our STM plans offer competitive benefits, are subject to a free-look period and are backed by the strength of The IHC Group.

Whom may I contact for assistance?

Please call our customer service department at 800-397-5800, option 3 or send an e-mail to newpolicyservices@ihcgroup.com.

Coverage Specifics

When does my coverage terminate?

STM is specifically designed to fill a temporary insurance need. Depending on the plan and payment option you select, coverage can continue for one to six months, up to 12 months.

Coverage ends on the earliest of the date the premium is not paid when due; or you cease to be a member of the association*; or the group master policy terminates; or you enter full-time active duty in the Armed Forces; or you become eligible for Medicare; or the elected coverage period expires; or Standard Security Life Insurance Company of New York determines fraud or misrepresentation has been made in filing a claim for benefits. A dependent’s coverage ends on the earliest of the date your coverage terminates; or the dependent becomes eligible for Medicare; or the dependent ceases to be eligible.

* Applies only to states where association membership is required.

What happens at the end of my coverage period? May I continue coverage?

Toward the end of your coverage period, you will receive a reapply letter. This letter will advise you on whether or not your state allows you to reapply for another coverage term.

If you may reapply, your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is a new coverage period and not a continuation of the previous period meaning, amongst other things, a new pre-existing condition limitation will apply.

How are benefits covered?

All STM plans offered by IHC Health Solutions pay benefits for each covered person in the following manner (subject to specific benefit limits):

      1. First, you meet the deductible you selected.
      2. Next, the STM plan pays at the coinsurance level you selected, 80 percent or 50 percent of the next $10,000 of covered expenses.*
      3. After this, STM pays 100 percent of covered expenses up to your plans coverage period maximum.

* Coinsurance levels are not applicable to Secure Saver STM

Do I have the option to select my doctors, hospitals, and medical providers?

Yes. You have the freedom to select the doctors and hospitals of your choice. This plan is not an HMO or PPO.

What medical expenses are covered*?

All of the following benefits are subject to your selected plans applicable deductible and coinsurance. Benefits are limited to the usual, customary and reasonable charge for each covered expense, in addition to any specific limits stated in your policy.

• Hospital charges paid at the average semi-private room rate, medical care and treatment
• Outpatient hospital or ambulatory surgical center charges
• Physician services for treatment and diagnosis
• Surgeon services in the hospital or ambulatory surgical center
• Intensive care up to three times the average semi-private room rate
• Ground ambulance services
• Organ, tissue or bone marrow transplants up to $150,000 coverage period maximum
• Acquired Immune Deficiency Syndrome (AIDS) up to $10,000 coverage period maximum**
• Mammography, Pap smear and screens

* Benefits may vary by state.
** The AIDS maximum of $10,000 per coverage period does not apply to policies/certificates issued to residents of AZ, CA, CO, DC, ID, IN, MD, ME, MO, NH, NC or ND. The maximum benefit in KS is $75,000 per coverage period.

What services are not covered?

Following is a partial list of services or charges not covered by STM*:

• Any services that are not medically necessary, as defined in the policy
• Eye exams, eyeglasses, hearing aids
• Dental or orthodontic services
• Treatment of foot conditions
• Conditions resulting from an act of war
• Maternity and newborn treatment prior to discharge, any infertility treatments or sterilization treatments
• Spinal manipulation or adjustment
• Services performed by family members or for which a charge would otherwise not be incurred
• Medical care received outside of the United States, Canada or its possessions
• Services payable by Medicare or workers’ compensation coverage
• Cosmetic surgery, treatment for acne, hair loss or varicose veins
• Transplant services to the transplant donor
• Routine physical exams and tests, preventive care and immunizations
• Experimental or investigational services
• Learning disorders, attention deficit disorder, hyperactivity or autism
• Mental or nervous disorders, depression or suicide attempt
• Alcohol or drug dependency and disorders
• Obesity treatments
• Sleep disorders
• Participation in school or organized competitive sports or any high risk sport

* The limitations and exclusions may vary by state. Please see the Policy/Certificate of Insurance for detailed information about these and other plan limitations and exclusions.

Do I need precertification?

You must notify the precertification service 10 days prior to a non-emergency hospital admission or surgery and 48 hours (or as soon as reasonably possible) following an emergency admission to the hospital for pre-certification of admission. Failure to precertify will result in a benefit reduction of 50 percent. Precertification is not a guarantee of benefits.

What is a family deductible*?

When three covered persons each satisfy their deductible, the deductibles for any remaining covered persons are deemed satisfied for the remainder of the coverage period.

* Family deductibles do not apply to Secure Saver STM

What is the usual, reasonable and customary charge?

Usual, reasonable and customary means with respect to fees or charges, fees for medical services or supplies which are usually charged by the provider for the service or supply given and the average charge for the service or supply in the locality in which the service or supply is received; whichever is less, or with respect to treatment or medical services, treatment which is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as usual, reasonable and customary for services and supplies; we may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies.

How can I save money and make the most of my benefits?

Through the STM plan, you have access to discounted medical services through two national Preferred Provider (PPO) networks: ACS and MultiPlan. The network providers have agreed to provide their services at a negotiated fee and pass these discounts on to you. While you have the flexibility to choose any health care provider, the discounts available through network providers for covered services will help to lower your out-of-pocket cost. The discount will be reflected in your final bill and you will not owe the network providers for the difference between their retail rate and the negotiated fee. You will still be responsible for paying your share of the covered expenses, including any applicable deductible, co-pay and coinsurance for your selected plan.

Using a network provider is voluntary. If you are unable to find a network provider, we will attempt to negotiate a discount for you from your provider. While we can’t guarantee the outcome, if we successfully obtain a discount it will be passed on to you.

To search for a health care provider or facility, please visit the websites listed below. At the time of services, simply present your identification card to the network provider.

ACS* is a comprehensive network of 2,500 ancillary service providers at over 25,000 sites, representing providers of outpatient services, including lab and diagnostic testing, except physicians.

MultiPlan* is one of the nation’s largest networks with more than 500,000 members in 50 states, including physicians, and inpatient and outpatient facilities. www.multiplan.com or 888-342-7427.

* ACS and MultiPlan are not affiliated with Standard Security Life Insurance Company of New York, nor are they part of this insurance plan.

Is there a pre-existing condition limitation?

STM will not provide benefits for any loss caused by or resulting from a pre-existing condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered persons effective date of coverage; or symptoms existed within the five years immediately prior to the covered persons effective date of coverage which would cause a reasonable person to seek diagnosis, care or treatment. The pre-existing condition limitation may vary by state.

What is the Enhancement Series*?

In addition to offering you an association-endorsed short-term medical plan, CA provides additional consumer benefits and services you can use to stay healthy and reduce your medical expenses. These benefits include:

• Coaches and Advocates: For information on providers in your area, the latest consumer health reports and assistance with benefits.
• TelaDoc: TelaDocTM is a national network of board-certified physicians providing cross-coverage consultations 24 hours a day, 365 days a year. This service is free of charge to members. Note that you will need to register online before using this service. Dependents must be 10 years of age or older to use TelaDoc.
• Discount Prescription Drug Card: All members receive a FREE discount prescription drug card.
• Discounted Services:
  • Remote file sharing service: that allows you to easily share large computer files, photos and videos with clients or colleagues.
  • Remote PC access: The ability to remotely access you office PC from home, or your home computer at work.
  • Remote meeting: Live video meeting service that allows you to converse with clients over the Internet.
  • Remote backup: Automatic backup of your personal PC over the Internet for safer file storage at remote location.

* The Communicating for America (CA) Healthy Lifestyle Enhancement Series is not an insurance benefit, nor is it affiliated with Standard Security Life Insurance Company of New York, nor is it a part of the STM insurance plan. The Enhancement Series is not available to residents in the states where the CA membership is not required.

The Companies

Why buy from us?

IHC Health Solutions has provided innovative health care solutions for over 70 years, meeting the needs of our customers with integrity, creativity and value. We strive to provide the best possible insurance coverage in a cost effective manner.

IHC Health Solutions is a customer-driven company differentiating itself through knowledge and experience. We, in conjunction with our trusted insurance carriers and licensed agents, share a mutual desire to provide important benefits to our customers and to meet their needs in an innovative, hassle-free manner.

IHC Health Solutions has a professional team of customer support, marketing, underwriting, claims and compliance specialists. State-of-the-art computer systems and reporting capabilities allow us to provide superior service and flexibility to agent distributors and clients. Licensed and approved nationally, IHC Health Solutions has always met or exceeded all state-mandated requirements including financial security, surety bonds, insurance coverage, and licensing.

This page provides a brief description of the benefits, exclusions and other provisions of the group policy Form SSL-STM-1104 and individual policy SSL-ISTM-1104 (may vary by state). For complete listing, see the Policy/Certificate of Insurance. Benefits may vary by plan and state. STM is not available in all states. Membership in the Communicating for America Association may be required in some jurisdictions. Ask your sales representative.

Who is the association?

Communicating for America, Inc.* (CA) provides many discounts to its members. Your enrollment as a member of CA is completed upon receipt of the association annual dues. Your membership information will be mailed shortly thereafter.

* CA is not affiliated with Standard Security Life Insurance Company of New York, nor is it a part of the insurance coverage. CA is a 501c5 non-profit association headquartered in Fergus Falls, Minn., with an office in D.C., providing members valued benefits and savings since 1972. CA membership does not apply to residents of the following states: ID, IN, KS, LA, ME, MD, MN, MT, ND, NH, NV or SD.

Who is the insurance company?

STM is insured by Standard Security Life Insurance Company of New York (Standard Security), a member of the IHC Group. Standard Security is rated A- (Excellent) by A.M. Best Company, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations to their insureds. Standard Security has chosen IHC Health Solutions, also a member of the IHC Group, to provide service for your STM plan.

The IHC Group is an insurance organization comprised of Independence Holding Company (NYSE: IHC) and its operating subsidiaries. The IHC Group has been providing life, health and stop-loss insurance solutions for over 25 years. For more information on Independence Holding Company and The IHC Group, visit www.ihcgroup.com.

Who is the administrator?

IHC Health Solutions is a fully licensed, full service third-party administrator servicing business worldwide. IHC Health Solutions provides state-of-the-art industry-leading insurance services.