OTHER BENEFITS
Pays $60 per day at home services, 180 days max per calendar year. Pays $150 per day at home private duty nursing, 15 days max per calendar year. Pays $50 per day at home physician visits, 15 days max per calendar year. Pays actual charges, maximum $1,000 per calendar year.
Home Health Care Services Payable when services are provided by a licensed home health care agency. Benefit paid in lieu of all other policy benefits. Must be prescribed by a physician and cannot be provided by a relative. In ID, IL, and WV, pays the greater of $60 or one- fourth the Daily Hospital Confinement benefit. Rental or Purchase of Durable Medical Equipment For the rental or purchase of a respirator or similar mechanical device; brace; crutches; hospital bed; or a wheel chair. Professional Mental Health Consultation For a consultation with a licensed mental health professional when receiving treatment for cancer or a dread disease. The licensed mental health professional may not be a relative. Outpatient Positive Diagnosis Test For a diagnostic test that leads to a positive diagnosis within 90 days of such test. Payable once per diagnosis. Experimental Treatment Treatment must be received in the United States or its territories. This benefit is in lieu of all other benefits payable for the treatment of cancer or dread disease. Blood and Blood Plasma For blood, blood plasma and platelets inserted into a covered person. Not payable for blood which is donated or replaced. Hairpiece Benefit One-time benefit for a hairpiece when hair loss is the result of cancer treatment. Physical, Occupational or Speech Therapy $50 for each 60-minute session for Physical, Occupational or Speech Therapy. Tutor Tutor session for an insured child under age 19, when the child is receiving treatment for cancer or a dread disease. Mammography Benefit In CA, ID and MT only, pays actual charges for a mammography screening administered to a Covered Person according to the schedule listed in the policy. Pap Smear Benefit In CA only, pays the actual charges for one Pap Smear each year administered to each female Covered Person age 18 or older.
$50 per session. Lifetime maximum of $250.
$250 for a diagnostic test.
Pays actual charges, to a lifetime maximum of $10,000.
Pays actual charges, to a maximum of $5,000 per calendar year.
Pays $100
$50 each session. Lifetime maximum of $1,500.
$25 per 60-minute. Lifetime maximum of 50 sessions. Pays actual charges to a maximum of $70.
Pays actual charges to a maximum of $75.
OPTIONAL RIDERS (available at additional cost)
Intensive Care Unit Rider (Form Numbers ICUR 4000, ICUR 4000 ID, ML-ICUR 4000, FL ICUR4000) (including state variations) Benefits Reduce to ½ at age 70. Benefit for Intensive Care Unit . If a Covered Person is confined in an Intensive Care Unit of a Hospital, we will pay the ICU Daily Benefit Amount for each day of such confinement, not to exceed 30 days during any one period of confinement. Benefit for Step-Down Unit. If a Covered Person is confined in a Step-Down Unit of a Hospital, we will pay for each day of such confinement, not to exceed 30 days during any one period of confinement. Critical Care Benefit Rider (Form Number CCBR 4000, CCPR 4000 ID, ML-CCBR 4000, FL CCBR 4000) (including state variations) Benefit for Heart Disease - A Heart Disease benefit will be paid for the actual charges incurred by a Covered Person for the following due to Heart Disease: 1. pacemaker insertion; 2. angioplasty; and 3. heart catheterization. This benefit is limited to a lifetime maximum. Benefit for Heart Attack/Stroke - A Heart Attack/Stroke benefit will be paid for the actual charges incurred by a Covered Person.
Pays $600 per day
Pays $300 per day step down unit
Pays Actual charges to lifetime max $2,500
Pays Actual charges to lifetime max $5,000
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