Benefits
Issue Ages 18 to 64½: Base Plan Choices 1 Day Issue Ages 64½ to 89: Base Plan Choices
Daily Benefit Amount $50 to $10,000
Hospital Confinement Benefit Your base hospital confinement benefit will pay a daily benefit directly to you if you are hospitalized for observation or confinement. After 60 days of being discharged, your benefits will fully restore.
Daily Benefit Amount $50 to $750 $50 to $750 $50 to $750
3 Days 6 Days 10 Days
If confined to a hospital for a mental or nervous disorder, your policy will pay you $175 per day, up to 7 days per calendar year. This benefit is paid in lieu of your hospital confinement indemnity benefit. If you are admitted to a hospital and discharged within 12 and 24 hours for observation or confinement, your policy will pay as follows: For the 1 Day benefit period option, 25% of your daily benefit amount is payable. For all other benefit period options, 100% of your daily benefit amount is payable. Your policy will pay $150 if you are treated for an Injury in an Emergency Room or an Urgent Care Facility. This benefit is payable up to 6 days per calendar year. Your policy will pay $200 per ground or air ambulance ride to or from a medical facility. This benefit is payable up to 4 times per calendar year, with a lifetime maximum of 15 trips. Option 1: Your rider will pay $100, $150 or $200 per day for days 1 through 50 if you are confined to a skilled nursing facility. Option 2: Your rider will pay $100, $150 or $200 per day for days 21 through 100 if you are confined to a skilled nursing facility. Your confinement to a skilled nursing facility must be within 30 days of a period of hospital confinement of at least three consecutive days. In addition to your base hospital confinement indemnity benefit, your First Day Hospital Admission Benefit Rider will pay either $250, $500 or $750 upon admission to the hospital. This benefit is payable up to 6 times per calendar year. Your Outpatient Surgical Procedure Benefit Rider will pay $250, $500, $750 or $1,000 per day when a surgical procedure is performed in an ambulatory surgical center or outpatient hospital facility. This benefit is payable up to 2 times per calendar year.
Mental Health
Short Duration Hospital Stay
Emergency Room or Urgent Care
Ambulance Benefits
Optional Riders
Skilled Nursing Facility Benefit Rider
First Day Hospital Admission Benefit Rider (Not available under 64½)
Outpatient Surgical Procedure Benefit Rider (Not available in CT)
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