TRICARE, Medicare, and health insurance through your job or anywhere else are important to help pay sky-high Hospital costs. But did you ever consider the extra and hidden costs of going to the Hospital?

The AFSA Hospital Cash Insurance Plan helps pay for all of those extras such as: copayments, deductibles, gas for driving to and from the Hospital, motel expenses, meals in restaurants, long-distance phone calls, and so on. In addition, it can help pay for items that make your Hospital stay more comfortable, like a private room or a TV.

Plan Highlights

• Guaranteed acceptance¹ for AFSA members and families under age 65
• Pays up to $120.00 a day
• Economical group rates—thanks to the group buying power of 130,000 AFSA members
• Pays cash benefits directly to you, or any one you choose
• No limit to the number of claims

¹This policy is guaranteed acceptance, but it does contain a Pre-Existing Conditions Limitation. Please refer to the website for more information on exclusions and limitations, such as pre-existing conditions.

Up to $120.00 a Day
The Plan pays $45.00 — $60.00 — up to $120.00 daily benefits for each day you’re Hospitalized for any covered injury or sickness.

Guaranteed Acceptance
As a member under age 65, you and your family are GUARANTEED ACCEPTANCE in the Hospital Cash Insurance Plan. This means that although you will not be asked to take a medical exam or answer medical questions at the time of enrollment, insurance benefits payable are subject to your policy’s pre-existing conditions limitation. You, your spouse, and unmarried children can enroll in the Plan, as well as your dependent parents and parents-in-law.

Protection Starts Right Away
Your protection will start the first day of the month after we receive your Enrollment Form and first premium payment. Benefits are paid from the first day you’re Hospitalized. There are no deductibles. You’re covered right away for Hospital stays due to new health conditions. And, after 12 months, you’re covered for any existing conditions, too.

Benefits Paid Directly to You
All benefits are paid directly to you unless you tell us to send them right to your doctor or Hospital.

Economical Rates
The group buying power of more than 130,000 AFSA members secured the following affordable monthly rates*:

One rate covers all your children—no matter how many you have. Children’s coverage can’t be more than half your coverage. For example, with the $120.00 daily benefit, each of your children may be covered for $60.00 a day.

*You will be billed quarterly unless you say otherwise. All billing modes except annual will include a $2.00 billing fee. Multiply the above rate by 3 to calculate your quarterly premium.

Premiums are based on each person’s age when coverage becomes effective and increase on January 1 after the next highest age bracket is reached. Rates and/or benefits may be changed on a class basis.

Keep Your Coverage for the Long Haul
You can keep your Hospital Cash Plan as long as you’d like — no matter what your age — no matter what your health. As long as you pay your premiums when due, continue your AFSA membership, and the Master Policy remains in force, you may continue this valuable protection. Your children may continue their coverage as long as they are under age 21, or 23 if full-time students, premiums paid, and our coverage remains in effect. Your spouse can continue his or her coverage as long as you are not legally divorced. Your dependent’s coverage will remain in effect as long as your coverage is active and premiums are paid.

Five Years Payment
You’ll get Hospital income benefits for up to five years for any one period of Hospitalization. When you go to the Hospital several times because of the same or related injury or sickness—if those times aren’t separated by 90 or more days—they are considered the same period of Hospitalization.

Pays You Benefits
You’ll get benefits regardless of what you may collect from other insurance plans. And, unlike many other Hospital income insurance, your benefit amount will not decrease as you get older.

Special Benefit
Your daily benefit doubles up to a maximum of $240.00 if you’re Hospitalized in the intensive care unit.

Other Important Information About This Coverage

Qualified Hospital:
A Hospital must be engaged primarily in medical care and treatment of sick and injured persons on an inpatient basis, have full surgical facilities, be under the supervision of legally qualified physicians, and provide 24-hour R.N. nursing services to qualify. A sanitarium operated by or certified by the First Church of Christ, Scientist, Boston, Massachusetts, also qualifies. A convalescent home; skilled nursing facility, a place for rest, custodial care, or for the aged; or a place primarily for mental illness, drug addiction, or alcoholism does not qualify. Confined or Confinement means being an Inpatient in a Hospital due to Sickness or Injury.

However, a place for the treatment of mental, nervous, and emotional disorders will be regarded as a Hospital if it is part of an institution that meets the above requirements and is listed in the American Hospital Association Guide as a general Hospital.

Pre-Existing Condition Limitation:
During the first two years of coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-Existing Condition means any injury or sickness including pregnancy; diagnosed or undiagnosed, for which you have received medical care within the 12-month period prior to your coverage effective date or the date of an increase in coverage. During that time, benefits for all other accidents or illnesses will be paid under the policy provisions. You are urged to consider this limitation before dropping any coverage you may have until the waiting period is over.

Exclusions:
Like all Hospital insurance plans, there are some things that are not covered in order to keep costs down. They include: intentionally self-inflicted injuries, suicide or attempted suicide, whether sane or insane, (in Missouri or Colorado while sane); any loss caused or contributed to by war or act of war, whether war is declared or not; pregnancy or childbirth, except Complications of Pregnancy; pre-existing conditions as defined in the Pre-Existing Condition Limitation provision. Upon request, we will refund the pro-rata portion of any premium paid for the period a Covered Person is in the armed forces.

IMPORTANT NOTICE TO PERSONS ON MEDICARE
THIS INSURANCE DUPLICATES SOME MEDICARE BENEFITS

This is not Medicare Supplement Insurance

This insurance pays a fixed dollar amount, regardless of your expenses, for each day you meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.

This insurance duplicates Medicare benefits when:

• any expenses or services covered by the policy are also covered by Medicare.

Medicare generally pays for most or all of these expenses.

Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

• Hospitalization
• physician services
• hospice
• other approved items and services

Before You Buy This Insurance

√ Check the coverage in all health insurance policies you already have.

√ For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.

√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Form PA 9055