Rates and Information
Short-Term Major Medical

Short Term Medical Insurance (STM) coverage can protect you and your family in the event of an unexpected serious illness or injury. STMM is designed to provide coverage for major hospital, medical and surgical expenses incurred as a result of medically necessary care for a covered illness or injury.

"I'll only be without coverage for a few months, what could happen?"
"I'm strong and healthy. I don't need insurance."
"It'll never happen to me."

These phrases are heard much too often and people are, unfortunately, going without health insurance. But, the reality is the unexpected happens everyday. Someone falls down the stairs, gets injured in a car accident or develops a sudden illness. In a single moment, your world can change. These unexpected illnesses or injuries can be startling, so can the doctor bills. That's why it's so important to have reliable, temporary health insurance that will cover the medical expenses when the unexpected occurs... that's why you need Short Term Medical Insurance.

Special Features:

  • Coverage for up to 90 days

  • Choose any doctor or hospital

  • Affordable Rates

  • Convenient Payment Options

    • Visa/MasterCard/Discover, or Automatic Bank Withdrawal

What type of medical expenses are covered?

  • Hospital Charges: average semi-private room rate, medical care and treatment

  • Physician Services for in-patient or out-patient diagnosis, treatment and surgery

  • Ambulatory Surgical Center charges

  • Intensive Care: up to three times the average semi-private room rate

  • X-Ray Exams, Laboratory tests and analyses

  • X-Ray and Radioactive isotope therapy, anesthesia, oxygen, casts, splints, crutches, braces, surgical dressings, artificial limbs or eyes, rental of medical supplies

  • Blood or blood derivatives and their administration

  • Ambulance Services: $250 per emergency

  • Acquired Immune Deficiency Syndrome (AIDS): $10,000 lifetime maximum

  • Home Health Care: up to 40 visits

Detailed information about these and additional covered expenses is listed in the Policy. Not all covered expenses apply in every state, and additional expenses might be covered in your state. Consult the Policy for provisions in your state.

What are the benefits and how do they work?

You pay the Plan Deductible - $1000 for each insured (to a maximum of $3000 per family) (Deductible applies per coverage period, not per cause)
The Plan pays 80% of the first $10,000 of covered* expenses You pay 20% of the first $10,000 of covered* expenses

The Plan pays 100% of the next $1,000,000 of covered* expenses

  * reasonable and customary charges apply to covered expenses

What is a reasonable and customary charge?

A “reasonable and customary charge” is the charge typically made by physicians or suppliers of medical services, medicines and supplies within a specific geographic area.

Do I need precertification?

Pre-admission certification prior to eligible inpatient hospitalization or surgery by the covered individual within 48 hours is required. This is not a guarantee of benefits. Failure to precertify will result in benefit reductions.

Who can be covered in the Short-Term Medical Plan?

STMM is offered to you and your spouse (through age 64 and not eligible for Medicare) and your dependent children up to age 26 who have a social security number and can answer “No” to five health questions on the application. Child-only coverage is available for ages 2 through 18.

Is there a pre-existing condition limitation?

Yes. Pre-existing conditions are not covered. This includes any condition or complication that was treated or produced symptoms within five years prior to your STM effective date.

How do I enroll in the STM Plan?

Unlike the other benefit options included in The Benefit Alliance Plan, your rate for STM coverage depends on your age, sex, residence State and zip code. For this reason, it is necessary that you call Leslie & Associates on their TOLL FREE CUSTOMER SERVICE NUMBER: (800) 644-6854. L&A Customer Service Representatives will answer your questions regarding the Plan, provide rate information, and assist you in enrolling in the Plan if it meets your needs.

When does my STM coverage start?

All coverage is subject to approval of your application and payment of the first monthly premium. However, if you can answer “No” to the health questions on the application and elect to pay by VISA or MASTERCARD, your coverage can become effective within 24 hours! If you elect a different payment method, your coverage will begin as early as the day following the U.S. postmark stamp on your return envelope to Leslie & Associates.

How long will my STM coverage last?

The STM plan offers coverage for up to 90 days. If your need for health insurance coverage continues after your initial coverage period ends, you may apply (in most states) for another STM Plan and coverage period. The next coverage period is not continuous and any condition that occurred during the
prior coverage period will be excluded as a pre-existing condition.

What services are not covered*?

  • Routine physical exams and tests, preventative care and immunization

  • Any services that are not medically necessary

  • Experimental or investigational services

  • Eye exams, eyeglasses, hearing aids and surgery

  • Dental or orthodontic services

  • Cosmetic surgery

  • Treatment of feet conditions

  • Medical care received outside of the United States

  • Maternity and newborn treatment prior to discharge, any fertility treatments or sterilization treatments

  • Over-the-counter medications and prescription drugs (See Benefit Alliance Plan for prescription drug coverage)

  • Conditions resulting from an act of war, suicide attempt or high-risk sports

  • Services payable by Medicare or Worker’s Compensation coverage

  • Transplant services to the transplant donor

  • Learning disorders, attention deficit disorder, hyperactivity or autism

  • Obesity treatments

  • Sleep disorders

  • Certain surgeries during the first six months

*Please see the certificate of insurance for a complete listing of the limitations and exclusions

PLEASE NOTE - This is only a brief description of the Short Term Medical Plan benefits, exclusions and other policy provisions. It is not a contract. All coverage is subject to the terms, conditions and limitations of the insurance company issuing the policy. Individual state limitations and/or variations may apply.

Temporary health insurance is a short-term plan designed for individuals who don’t currently have health insurance. Temporary policies do not cover pre-existing conditions. Temporary health insurance is also not considered minimum essential coverage under the Affordable Care Act (also called Obamacare), and even if you enroll in and maintain temporary coverage you may NOT be exempt from the Shared Responsibility Payment (tax) that may otherwise apply for not having qualifying health insurance.

To learn more about the availability of these plans, ask questions, and get rate quotes:

Call Leslie & Associates, Inc. at 1-800-644-6854

These plans are not available in all states

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Copyright ©2003-2007 Leslie & Associates, Inc. All rights reserved.
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