Hospital Indemnity & Short-Term Recovery Insurance Plan

For members ages 65-99

As you age, the possibility increases that you will require hospitalization and recovery care
for an illness or injury.

The AFA’s Hospital Indemnity & Short-Term Recovery Insurance Plan helps members and their spouse or partner, ages 65 and older, pay for medical bills or out-of-pocket expenses resulting from a hospital stay and subsequent need for home recovery care.

Most health care plans, including Medicare or TRICARE For Life, do not cover all medical costs, especially when it comes to hospital stays. They also have limitations on home recovery care, including nursing home care; occupational, speech or physical therapy; companion care and homemaker services.

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

The AFA Hospital Indemnity Plan pays cash benefits directly to you after a hospitalization and subsequent home recovery care. These benefits are paid in addition to other insurance coverage you may have.

Features of this plan include:

  • Guaranteed acceptance* for members and their spouses ages 65 to 99.
  • A Hospital / Skilled Nursing Facility Benefit that pays up to $1,450 for each unrelated hospitalization per year for covered illnesses and injuries.
  • A Home Recovery Benefit that pays $200 per day, up to a maximum of $8,000** per year, for care prescribed by a physician and governed by a home health care plan of treatment.
  • 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.

** At age 80, the Home Recovery Benefit reduces to $4,000 per year.

The AFA Hospital Indemnity & Short-Term Recovery Plan pays the following benefits:

Benefit(s) Benefit Amount
Daily Hospital of Skilled Nursing Facility
Confinement

For confinements of 1-14 days -- $750 per confinement

For confinements of 15-30 days -- $1,250 per confinement

For confinements of 31 days or more -- $1,450 per confinement

Short-Term Recovery
Benefit Period: 20 days
 
$200 per day

 

The Daily Hospital or Skilled Nursing Facility Confinement Benefit is payable for one or more confinements per year, provided:

  • Confinement begins within 90 days after a covered injury or illness occurs
  • Confinement is not less than 24 hours
  • Readmission to a hospital or skilled nursing facility for the same or related covered illness or injury within 60 days of the initial discharge will be considered part of the original period of confinement.
     

The Short-Term Recovery Benefit is payable for each day a covered person receives recovery services resulting from a covered illness or injury, provided:

  • The covered person must have a home health care plan of treatment for the benefit to be payable, and recovery services must be prescribed by a physician and begin within 90 days following a related confinement in a hospital or skilled nursing facility for which benefits are payment under the policy.
  • For a covered person under age 80, the benefit is payable for up to two benefit periods per year with an aggregate maximum of 40 days. 
  • For a covered person age 80 but under age 100, the benefit is payable for up to one benefit period per year with an aggregate maximum of 20 days.

Monthly Rates

For each member or eligible spouse:


Age
Monthly Rate
Member Only
Monthy Rate
Member & Spouse
65-69 $19.95 $39.90
70-74 $27.95 $55.90
75-79 $39.95 $79.90
80-84* $39.95 $79.90
85-99* $47.95 $95.90

 

*  At age 80, Home Recovery Benefits reduce to $200 a day for up to 20 days per year (one benefit period or up to $4,000 per year). The Hospital or Skilled Nursing Facility Benefits do no change regardless of age.

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.

You are eligible for coverage if you are age 65 or older but under age 100, 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 65 or older but under age 100, a U.S. resident, and not legally separated from you.

A member must be enrolled for coverage under this policy to enroll a spouse for coverage. A member may not elect coverage for his or her spouse if such spouse is covered as a member under the policy. No person can be unsured 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.

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 100.

Spouse or partner coverage terminates when your coverage terminates, premiums are not paid, or your spouse or partner ceases to be eligible according to the terms of the policy.

Spouse or partner continuation: If the member dies while a spouse or partner is covered under the policy, the surviving spouse or partner may continue the benefits in force on the date of the member’s death. We must receive your spouse or partner’s written request and the required premium to continue coverage within 31 days of the premium due date next following the member’s date of death.

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 or being held in a hospital for 24 consecutive hours or more.

Hospital does not include convalescent homes; convalescent, rest or nursing facilities; facilities affording primarily custodial, educational or rehabilitory 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.

Skilled Nursing Facility means an appropriately licensed health care facility or a distinct unit within a hospital or other institution which provides skilled nursing care and related services 24 hours per day, 7 days per week; is under the direct supervision of a physician and has a physician or medical professional available at all times; has a planned program of policies and procedures developed with and reviewed by one of more physicians; and is not mainly a place for rest, custodial care, care of the aged/elderly, care of persons with substance abuse issues/disorders, care of persons with mental or nervous disorders, or a hotel or similar establishment.

Refer to the policy for a complete list of terms and definitions.

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.

In addition, no benefits will be paid under the policy, unless required by law, for:

  • Any mental and nervous disorder, unless specifically allowed by a provision of the certificate of insurance; 
  • Substance abuse, unless specifically allowed by a provision of the certificate; or
  • Custodial care, unless specifically allowed by a benefit provision of the certificate or any rider attached to the policy (if applicable).

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 6 months after a covered person is continuously insured under the policy. A pre-existing condition limitation of 6 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 6-month limitation period, benefits will only be payable for any day of confinement that extends after the end of the limitation period.

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 coverage.

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

 

 

To download an enrollment form, click the Enroll Now button on this screen.

Payment Options

Once your insurance coverage has been approved, there are three methods of payment from which you may choose:

  • Monthly automated bank withdrawal. Payment options for monthly automated withdrawal from a checking or savings account.
  • Credit or debit card. You can choose monthly, quarterly, semiannual, or annual payment when you pay by credit card or debit card.
  • Direct bill. You can choose to receive a monthly, quarterly, semiannual, or annual premium notice in the mail.

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 the website and the policy (Master Policy AGP-40016), 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/STR/0824

 

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

Montana residents, use the link 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
www.ftj.com
 

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