HOSPITAL STAY BENEFIT We will pay per day the Benefit Amount shown in the Schedule of Benefits, subject to the following conditions and limitations, if the Covered Person is confined in a Hospital due to a Covered Injury or Covered Illness. Benefits are payable for up to the Maximum Benefit Period shown in the Schedule of Benefits .
Benefit Conditions The Hospital Stay must meet all of the following: 1. Must be at the direction and under the care of a Physician; and 2. Must be admitted on an Inpatient basis.
The benefit will be paid for each day of a continuous Hospital Stay. If the Hospital Stay begins during the Benefit Waiting Period, the benefit will be paid for each continuous day that extends after the end of the Elimination Period, as shown in the Schedule of Benefits. If benefits are calculated on a monthly basis, pro rata payments will be made for confinements of less than one month.
Benefit Limitations 1.
The benefit is limited to 1 Hospital Stays within a 365 day period. 2. If a benefit is payable under the Hospital Stay Benefit as well as under the Hospital Intensive Care Unit Stay Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is the greater amount. 3. If the Covered Person leaves the Hospital and then returns within 90 days for the same or a related Covered Injury or Covered Illness, we will still count that as one Hospital Stay. However, if the Covered Person is out of the Hospital for at least 90 days and then returns for the same or a related Covered Injury or Covered Illness, we will count that as a different Hospital Stay.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions
HOSPITAL INTENSIVE CARE UNIT (ICU) STAY BENEFIT We will pay per day the Benefit Amount shown in the Schedule of Benefits , subject to the following conditions and limitations, if the Covered Person is confined in an ICU of a Hospital due to a Covered Injury or Covered Illness. Benefits are payable for up to the Maximum Benefit Period shown in the Schedule of Benefits .
Benefit Conditions The Hospital ICU Stay must meet all of the following: 1. Must be at the direction and under the care of a Physician; 2. Must be admitted on an Inpatient basis.
The benefit will be paid for each day of a continuous Hospital ICU Stay. If the Hospital ICU Stay begins during the Benefit Waiting Period, the benefit will be paid for each continuous day that extends after the end of the Elimination Period, as shown in the Schedule of Benefits. If benefits are calculated on a monthly basis, pro rata payments will be made for confinements of less than one month.
Benefit Limitations 1.
The benefit is limited to 1 Hospital ICU Stays within a 365 day period. 2. If a benefit is payable under the Hospital Stay Benefit as well as under the Initial Hospital Intensive Care Unit Benefit, only 1 benefit will be paid for the same Covered Injury or Covered Illness, whichever is the greater amount. 3. If the Covered Person leaves the Hospital ICU and then returns within 90 days for the same or a related Covered Injury or Covered Illness, we will still count that as one Hospital ICU Stay. However, if the Covered Person is out of the Hospital ICU for at least 90 days and then returns for the same or a related Covered Injury or Covered Illness, we will count that as a different Hospital ICU Stay.
The exclusions that apply to this benefit are in the Common Exclusions Section.
Exclusions
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