These plans, providing hospital and surgical expense benefits to those 65 and over, are offered by insurance companies under a mass enrollment technique. Enrollment can be either made during specified time periods on a statewide basis or "all-year-round" by personal application on reaching age 65. Offering hospital room-and-board benefits up to $10 a day, these plans pay benefits for as long as 31-60 days during hospital confinement. Additional benefits are paid to help meet other extra hospital expenses such as drugs. laboratory fees, surgical charges, and even the costs of care in nursing homes. Applicants are eligible irrespective of their past medi cal histories and without medical examinations. Some plans, however, require the newly insured person with a pre-existing health condition to wait six months before benefits are available for that particular condition. Protection of these plans cannot be terminated for any individual policyholder - only for state residents as a group. Similarly, premium charges can only be adjusted for an entire state group - not on an individual policyholder basis. An association group plan, sponsored by the American Association of Retired Persons, is available to persons 65 and over after first joining the Association for a membership fee of $2.00. This plan provides benefits for hospital, surgical, and hospital out-patient treatment. It also has optional benefits covering doctor visits, nursing home care, and extended hospitalization periods. The selected yearly premium range noted above for the plans listed is for all persons 65 and over, at a universal premium charge. EXTENDED BENEFITS: 1. MEDICAL BENEFITS-50 doctor calls each year payable according to schedule: $4.00 for each home call 3.00 for each hospital call 3.00 for each office call 3.00 for each nursing home visit Benefits begin after the member has paid a total of $25 for doctor visits at the rate 2. EXTRA HOSPITAL ROOM AND BOARD BENEFIT — An additional 29 days for each con- 3. POST-OPERATIVE NURSING HOME BENEFIT - Half the daily nursing home charge to a for the next 29 days for post-operative care in nursing home. 12 MONTHS WAITING PERIOD ON CONDITIONS HOSPITALIZED IN 12 MONTHS PRECEDING MEMBERSHIP OF PLAN Optional Benefits-Supplementary accident; Death and dismemberment: In-office-home-hospital medical (Continued on next page) applicant's present health condition and without medical examination. Premiums can be modified only for the entire state group and protection cannot be terminated for an individual policyholder only for the group as a whole. This particular group-type plan is issued as a supplement to a basic "Senior Security" health insurance plan. (See Section 1) Under guaranteed renewable policies which provide benefits for lifetime, the insured person has the sole right of policy termination. The insurance company can adjust premiums only on a policyholder class basis. The selected yearly premium range noted above for the plans listed was calculated for a man 65 years of age at maximum weekly plan benefits. WEEKLY BENEFIT SENIOR CITIZEN HOSPITAL EXPENSE PLANS – $ 70 105 125 "After policy is in force for one year, ten additional weeks will be added for each of the next five years making a total of fifty additional weeks. Insurance Company of North America 1600 Arch Street Philadelphia 1, Pennsylvania |