Hospital Indemnity Insurance Plan

For members ages 18-64

Many types of diseases and illnesses, as well as accidents and injuries, can lead to lengthy,
unexpected hospital stays — and unexpected medical bills.

Most health care plans, including TRICARE plans, do not cover all medical costs, especially when it comes to hospital stays. These plans generally feature co-pays and deductibles that could leave you with thousands of dollars in out-of-pocket expenses when you or a family member is hospitalized.

Additionally, hospitalizations often mean extra bills for travel, meals and lodging, unexpected childcare, elder care, or pet care expenses, or extra costs for household help.

The AFA Hospital Indemnity Insurance Plan pays cash benefits directly to you after a hospitalization, and you can spend this money as you see fit. These benefits are paid in addition to other insurance coverage you may have.

Other features of this plan include:

  • Guaranteed acceptance* for members and their spouses under age 65.
  • Two benefit levels from which to choose – the Low Option, which pays $100 per day of hospitalization, and the High Option, which pays $150 per day. New York residents only: There is a single plan available with a $240 per day hospitalization benefit.
  • Exclusive rates based on the group buying power of AFA membership!

* This policy is guaranteed acceptance but does contain a Pre-Existing Condition Limitation. Please refer to the information below on exclusions and limitations, such as Pre-Existing Conditions.

The AFA Hospital Indemnity Plan pays the following benefits:

Benefits Low Option High Option
First day of hospital confinement; must begin within 90 days of covered injury or illness
$500 per day

$1,000 per day
Daily hospital confinement up to 90 days per year; must begin within 90 days of covered injury or illness
$100 per day


$150 per day
Daily Intensive Care Unit (ICU) confinement up to 30 days per year; must begin within 90 days of covered injury of illness
$200 per day


$300 per day

Low Option Monthly Rates

$500 first day confinement / $100 per day hospitalization / $200 per day ICU

 


Age
Member
Only
Member
& Spouse
Member
& Family
Member
& Child(ren)
18-24 $3.72 $14.94 $23.57 $10.89
25-29 $5.82 $15.81 $24.24 $13.19
30-34 $6.31 $14.52 $22.81 $13.72
35-39 $5.22 $10.46 $18.63 $12.47
40-44 $4.43 $8.88 $17.04 $11.52
45-49 $5.35 $10.67 $18.82 $12.39
50-54 $6.99 $13.98 $22.14 $13.98
55-59 $9.20 $18.45 $26.61 $16.13
60-64 $10.79 $21.64 $29.79 $17.72
65-69* $11.27 $22.64 $30.79 $18.20
70-74* $11.75 $23.63 $31.79 $18.67
75-79* $15.13 $30.32 $38.48 $22.03
80-84* † $10.58 $21.23 $25.31 $14.00

 

High Option Monthly Rates

$1,000 first day confinement / $150 per day hospitalization / $300 per day ICU

 


Age
Member
Only
Member
& Spouse
Member
& Family
Member
& Child(ren)
18-24 $6.76 $27.32 $42.53 $19.40
25-29 $10.53 $28.81 $43.67 $23.53
30-34 $11.42 $26.32 $40.92 $24.47
35-39 $9.39 $18.88 $33.25 $22.17
40-44 $7.96 $15.96 $30.31 $20.44
45-49 $9.56 $19.05 $33.40 $21.95
50-54 $12.41 $24.82 $39.17 $24.71
55-59 $16.26 $32.60 $46.95 $28.45
60-64 $18.84 $37.76 $52.11 $31.02
65-69* $19.71 $39.60 $53.95 $31.90
70-74* $20.58 $41.42 $55.77 $32.77
75-79* $26.32 $52.76 $67.11 $38.47
80-84* † $18.39 $36.88 $44.06 $24.40


Rates are based on the attained age of the insured member and increase as the member enters each new rate category.  Rates and/or benefits may change on a class basis.

* Premiums for ages 65 and above are for renewal only

† The benefit amount payable for each covered person will decrease by 50% on the premium due date on or next following date the member attains age 80.

The AFA Hospital Indemnity Plan pays the following benefits for residents of New York:

Benefit
Amount

Daily hospital confinement up to 90 days per year; must begin within 90 days of covered injury or illness

$240 per day

Monthly Rates for New York

$500 first day confinement / $240 per day hospitalization

Age

Member Only

Member & Spouse

Member & Family

Member & Child(ren)

18-24

$2.44

$9.31

$16.68

$8.60

25-29

$4.04

$10.18

$17.41

$10.35

30-34

$4.37

$9.81

$16.98

$10.72

35-39

$3.76

$7.41

$14.51

$10.01

40-44

$3.27

$6.56

$13.65

$9.39

45-49

$4.13

$8.27

$15.36

$10.23

50-54

$5.68

$11.37

$18.46

$11.74

55-59

$7.76

$15.56

$22.65

$13.78

60-64

$9.94

$19.92

$27.01

$15.95

65-69*

$10.23

$20.52

$27.61

$16.25

70-74*

$10.53

$21.11

$28.20

$16.54

75-79*

$14.22

$28.51

$35.60

$20.20

80-84* †

$10.05

$20.18

$23.72

$13.00


Rates are based on the attained age of the insured member and increase as the member enters each new rate category.  Rates and/or benefits may change on a class basis.

* Premiums for ages 65 and above are for renewal only

† The benefit amount payable for each covered person will decrease by 50% on the premium due date on or next following date the member attains age 80.

You are eligible for coverage if you are age 64 or younger, a U.S. resident, and a current member of the Air & Space Forces Association (AFA).

Your lawful spouse or partner also is eligible, provided he or she is age 64 or younger, a U.S. resident, and not legally separated from you.

Your unmarried dependent children ages 26 or younger also are eligible. Dependent children older than age 26 are eligible if they are incapable of self-sustaining employment because of an intellectual or physical handicap.

A member must be enrolled for coverage under this policy to enroll a spouse, partner or dependent(s) for coverage. A member may not elect coverage for their dependent if such dependent is covered as a member under the policy. No person can be insured as a dependent of more than one member under the policy.

When coverage begins: Coverage is effective as of the first day of the month after the administrator receives your enrollment form and first premium payment.

Deferred Coverage Effective Date: All coverage effective dates, changes in coverage effective dates, new dependent coverage effective dates and reinstatement of coverage effective dates for a member or a dependent will be deferred if on the date the member or a dependent is to become covered, he or she is hospitalized or confined elsewhere.

Such coverage will not start until the first day of the month on or next following the day after:

  1. The member or the dependent is no longer hospitalized or confined elsewhere, and
  2. The member or the dependent has engaged in all of the normal and customary activities of a person of like age, gender and good health for at least 15 consecutive days.

In no event will dependent insurance become effective before a member becomes insured.

When coverage ends: Your coverage remains in effect if premiums are paid, the Master Policy is in force, and you remain a member, until you reach age 85.

Spouse, partner or dependent coverage terminates when your coverage terminates, premiums are not paid, or they cease to be eligible dependents.

Satisfaction guarantee: Once you receive your Certificate of Insurance you have a full 30 days to review it. If you’re not satisfied, return it within 30 days of receipt; premiums paid will be refunded, minus any claims paid.

Definitions

Confined or Confinement means the assignment to a bed in a medical facility for a period of at least 20 consecutive hours or being held in a hospital for 24 consecutive hours or more. This definition does not include a newborn child’s initial confinement in a hospital following birth for routine medical and nursing care.

Confined Elsewhere means a member or a dependent is unable to perform, unaided, the normal functions of daily living or leave his / her home or other place of residence without assistance.

Hospital does not include convalescent homes; convalescent, rest or nursing facilities; facilities affording primarily custodial, educational or rehabilitation care; facilities primarily for care of the aged/elderly, care of persons with substance abuse issues/disorders, or care of persons with mental and nervous disorders; or a distinct unit within a hospital that primarily treats or is dedicated to the care of persons with substance abuse issues/disorders or mental and nervous disorders.

Exclusions

No benefits are payable under the policy for any illness or injury that results from or is caused by a covered person’s:

  • Suicide or attempted suicide, whether sane or insane, or intentional self-infliction
  • Voluntary intoxication (as defined by the law of the jurisdiction in which the illness or injury occurred) or while under the influence of any narcotic, drug or controlled substance, unless administered by or taken according to the instruction of a physician or medical professional
  • Voluntary intoxication through use of poison, gas or fumes, whether by ingestion, injection, inhalation or absorption
  • Voluntary commission of or attempt to commit a felony, voluntary participation in illegal activities (except for misdemeanor violations), voluntary Participation in a Riot, or voluntary engagement in an illegal occupation
  • Incarceration or imprisonment following conviction for a crime 
  • Travel in or descent from any vehicle or device for aviation or aerial navigation, except as a fare-paying passenger in a commercial aircraft (other than a charter airline) on a regularly scheduled passenger flight
  • Ride in or on any motor vehicle or aircraft engaged in acrobatic tricks/stunts (for motor vehicles), acrobatic/stunt flying (for aircraft), endurance tests, off-road activities (for motor vehicles), or racing
  • Participation in any organized sport in a professional or semi-professional capacity
  • Travel or activity outside the United States or Canada
  • Involvement in any declared or undeclared war or act of war (not including acts of terrorism), while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntarily or as required by an employer.

If you or your spouse or partner notify us of active-duty service or training outside the continental United States, Hawaii, Puerto Rico or Alaska, we will refund any premiums paid for any period for which no coverage is provided as a result of the exclusion.

In addition, we will not pay for any benefits under the policy, unless required by law for:

  • Elective abortion or complications thereof
  • Artificial insemination, in vitro fertilization, test tube fertilization
  • Sterilization, tubal ligation or vasectomy, and reversal thereof
  • Aroma therapeutic, herbal therapeutic, or homeopathic services
  • Any mental and nervous disorder, unless specifically allowed by a provision of this Certificate
  • Substance abuse, unless specifically allowed by a provision of the policy
  • Medical mishap or negligence on the part of any physician, medical professional, or therapist, including malpractice
  • Custodial care, unless specifically allowed by a benefit provision in the policy or any rider attached to the policy (if applicable)
  • Elective or cosmetic surgery or procedures, except for reconstructive surgery: 
    1. incidental to or following surgery for disease, infection, or trauma of the involved body part, or
    2. due to congenital anomaly or disease of a dependent child which has resulted in a functional defect
  • Dental care or treatment, except for: 
    1. treatment due to an Injury to sound natural teeth within 12 months of the Accident, and 
    2. treatment necessary due to congenital disease or anomaly.

Congenital anomalies of newborn and newly adopted children are not excluded if otherwise covered under the terms of the policy.

Over-Insurance Limitation

If a covered person is insured under any other hospital indemnity policy underwritten by Hartford Life and Accident Insurance Company, any claim for benefit is only payable under one policy.

The covered person (or their beneficiary or estate, in the event of death) may elect under which policy benefits are payable. We will return the amount of premium paid for any other hospital indemnity policy that is declined by the covered person retroactive to the later of:

  • the last date any benefit was paid for any covered person under the other hospital indemnity policy, or 
  • the effective date of insurance for the covered person under the other hospital indemnity policy.

Pre-Existing Condition Limitation

The plan does not pay benefits for any covered illness or covered injury that results from, or is caused or contributed to by, a pre-existing condition until 12 months after a covered person is continuously insured under the policy. A pre-existing condition limitation of 12 months will also apply to any benefit amount increase or the addition of any benefit under the policy.

If a covered person becomes confined as the result of a pre-existing condition prior to completing this 12-month limitation period, benefits will only be payable for any day of confinement that extends after the end of the limitation period.

Pre-existing condition means any illness or injury for which a covered person received treatment in the 12 months prior to: the date the covered person became insured under the policy; or the date of any increase in benefit amounts or the addition of any benefit under the Policy.

The AFA Hospital Indemnity Insurance Plan is a supplement to health insurance and is not a substitute for major medical coverage. It does not provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.

THIS IS A HOSPITAL CONFINEMENT INDEMNITY POLICY. THE POLICY PROVIDES LIMITED BENEFITS. This limited health benefit plan (1) does not constitute major medical coverage, and (2) does not satisfy the individual mandate of the Affordable Care Act (ACA) because the coverage does not meet the requirements of minimum essential care.

Important Notice to Persons on Medicare

THIS INSURANCE DUCPLICATES 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 of 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 Hartford Life and Accident Insurance Company.

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

Form PA-9055

 

 

This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy (Master Policy AGP-5955, NY: AGP-5956), the terms of the policy apply.

All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, and terms under which the policies may be continued in full or discontinued.

Complete details are in the certificate of insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.


#8824/HLA/HIP/0824


Not available in AK, CA, CT, HI, ME, MA, NJ, NM, UT, WA and WV
 

New York and Montana residents, use the links below:

 

 

Underwritten by:

Hartford Life and Accident Insurance Company
One Hartford Plaza
Hartford, CT 06155
www.thehartford.com

Form Series GBD-2800, GBD-2900, or state equivalent.

 

 

 

Administrated by:

Forrest T. Jones & Company*
P.O. Box 418131
Kansas City, MO 64141-8131
 

* For Arizona residents, the administrator is Forrest T. Jones Consulting Company