Sterling Estates - 2025 Benefits Guide

Cancer Insurance

Benefit schedule Once your coverage goes into effect, you can file a claim for covered cancer treatments for cancer diagnoses that occur after your insurance’s effective date. Unless otherwise specified, benefits are payable only once. The full list of benefits is listed here. Choose the plan (Level 1 or Level 2) that best meet your needs and your budget.

Covered service

Level 1

Level 2

Second Surgical Opinion

$200

$200

Surgery and General Anesthesia Benefits vary based on the procedure performed. Combined maximum for any one surgery is $2,000 for Level 1 and $7,500 for Level 2. Surgery for skin cancer and reconstruction is not covered under this benefit.

Anesthesia $50 to $1,815

Anesthesia $50 to $1,815

Surgical $150 to $5,500

Surgical $150 to $5,500

Hospital Confinement (limited to 90 days per period of confinement)

$200 Daily

$400 Daily

In-hospital and Outpatient Blood and Plasma

$50 Daily

$50 Daily

Ambulance (limited to 2 one-way trips per period of confinement per person)

$250

$250 Ground $2,000 Air

Cancer Screening Includes colonoscopy, CA 125 test, chest x-ray, flexible sigmoidoscopy, mammogram, pap smear, biopsy, PSA, CT scans or MRI scans, BRCA testing, or Hemocult stool specimen. This benefit is limited to once per benefit year.

$50

$75

In-hospital Doctor Visits Limited to a maximum of 75 visits.

$25 Daily

$25 Daily

Prosthesis Lifetime maximum for surgically implanted prosthesis is $4,000 for Level 1 and $6,000 for Level 2. Lifetime maximum for other devices is $400 for Level 1 and $600 for Level 2.

Surgically implanted $2,000

Surgically implanted $3,000

Other $300

Other $200

Skin Cancer Biopsy Only

$100 $250 $375 $600

$100 $250 $375 $600

Reconstructive surgery following previous excision of skin cancer

Excision of skin cancer without flap or graft Excision of skin cancer with flap or graft

Radiation and Chemotherapy Injected Cytotoxic Medications

$300 Weekly $1,000 Weekly

Pump Dispensed Cytotoxic Medications

$300 First Prescription and Per Refill $150 Per Prescription

$1,000 First Prescription and Per Refill $500 Per Prescription

Oral Cytotoxic Medications

Cytotoxic Medications Administration by Any Other Method

$300 Weekly $1,000 Weekly

External Radiation Therapy

$400 Weekly $450 Weekly $400 Weekly

$600 Weekly $750 Weekly $600 Weekly

Insertion of Interstitial or Intracavity Administration of Radioisotopes or Radium

Oral or IV Radiation This benefit is not payable for the same day the Experimental Treatment benefit is payable. These benefits are not payable for treatment planning, therapeutic devices, immunotherapy, laboratory tests, diagnostic x-rays, dosimetry or simulation associated with these procedures.

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14 | Sterling Estates 2025 Benefits Guide

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