HOSPITAL BENEFITS:
Ambulance We will pay for transfer of a covered person to or from a hospital for confinement as an inpatient. In CA, we will provide direct reimbursement to the medical transportation provider. Physician’s Attendance We will pay a Physician’s Attendance benefit if the regular physician visits during a confinement in the hospital. Prescribed Drugs and Medicines Actual charges for drugs and medicines prescribed while confined in a hospital. Limited to the first 70 days for each period of confinement. Government or Charity Hospital Pays a total benefit of $200 per day of treatment for outpatient Teleradiotherapy, Radio-Active Isotopes Therapy, Chemotherapy, Chemotherapy Enhancer Drug, Anti-Nausea, and Immunotherapy, as indicated in the policy, received in a government or charity hospital. Paid in lieu of all other benefits except for transportation and lodging benefits. Extended Benefits Beginning on the 71st day of one continuous period of hospital confinement for cancer or a dread disease. Payable in lieu of all other benefits payable for the same time period.
$250 per trip 3 trips per year
$50 per day
Actual charges to a maximum of 20% of the Daily Hospital Confinement Benefit.
$200 per day
$1,000 per day
OTHER CARE FACILITY BENEFITS:
Hospice Care For confinement in a hospice care center for care provided if a covered person has been diagnosed as terminally ill due to cancer or dread disease. Limited to a lifetime maximum of 180 days for confinement in a hospice care center, or 30 days if hospice services are provided in the covered person’s home. Extended Care Facility Confinement must be recommended by the attending physician and begin within 14 days of a covered hospital confinement. All days for which a Hospital Confinement benefit is paid will be included in determining the maximum of 70 days for the Extended Care Facility benefit. ID, IL and WV, pays actual charges incurred to the greater of $100 or one-fourth of the Daily Hospital Confinement Benefit. Private Duty Nursing Service We will pay when confined in a hospital and a private duty nursing service is retained.
$100 per day
$100 for each day of confinement to a maximum of 70 days
$150 per day
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