HCC STM Benefits

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How HCC Life STM Coverage Works

Plan benefits are subject to the deductible and coinsurance with the exception of visits to an urgent care center. The deductible is waived when you receive care at an urgent care center, and instead you pay a $50 copay, after which coinsurance applies. An urgent care center means a facility separate from a hospital emergency department where patients can be immediately treated for injury or sickness on a walk-in basis without an appointment.

Graphic chart of how coverage works.

Choice of Plan Options

Length of Coverage Up to 6 or 12 months
Purchase in full or make monthly payments
Deductible
Amount you pay toward covered expenses
before the plan pays benefits
$250, $500, $1,000, $2,500, $5,000, or $7,500
A maximum of 3 deductibles is required per family
Coinsurance
Percentage of eligible expenses the plan
pays after the deductible
80% or 50% of the next $5,000 of eligible expenses
Coverage Period Maximum
The maximum amount the plan pays
$1 million or $2 million

HCC Life STM covers the following expenses:

After you satisfy your deductible, HCC Life STM will begin paying eligible expenses according to the coinsurance you select and up to the coverage period maximum that you choose. Benefits are based on usual and customary charges of the geographical area in which charges are incurred.

  • Inpatient and outpatient charges made by a hospital, including inpatient prescription drugs
  • Charges incurred at an urgent care center after a $50 copay
  • Charges made by a physician, surgeon, radiologist, anesthesiologist, and any other medical specialist to whom the physician has referred the case
  • Charges made for dressings, sutures, casts or other supplies prescribed by the attending physician or specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices for repeat use at home
  • Charges for diagnostic testing using radiology, ultrasonographic or laboratory services
  • Charges for oxygen and other gases and anesthetics and their administration
  • Charges made by a licensed extended care facility upon direct transfer from an acute care hospital
  • Emergency local ambulance transport in connection with injury or sickness resulting in inpatient hospitalization
  • Expenses related to complications of pregnancy
  • Charges for physical therapy that is prescribed in advance by a physician in relation to a covered injury or sickness

HCC Life STM does not cover:

HCC Life STM does not cover: pre-existing conditions* (including those not inquired about on the enrollment form); preventive or wellness doctor visits; dental or optical treatments; routine physical exams; normal pregnancy or childbirth; well child care; interscholastic and intercollegiate sports injuries; over-the-counter medications and outpatient prescription drugs; expenses incurred outside the United States, its possessions or territories, or Canada.

The following conditions are also excluded: varicose veins, substance abuse and alcoholism, chronic fatigue or pain disorders, and allergies, except for emergency treatment of allergic reactions. Expenses during the first 6 months after the effective date are excluded for (subject to all other coverage provisions, including the pre-existing condition limitation): a. Total or partial hysterectomy, unless it is medically necessary due to a diagnosis of carcinoma; b. Tonsillectomy; c. Adenoidectomy; d. Repair of deviated nasal septum or any type of surgery involving the sinus; e. Myringotomy; f. Tympanotomy; g. Herniorraphy; or h. Cholecystectomy.

*Pre-existing conditions refers to conditions for which you received medical treatment, diagnosis, care, or advice within a specific number of months immediately preceding your effective date. The “pre-ex” period will vary depending on the state in which HCC Life STM is purchased. This exclusion does not apply to a newborn or newly adopted child who is added to coverage.

Waiting Period

When coverage is purchased within 3 days of the effective date, you will only be entitled to receive benefits for sicknesses that begin, by occurrence of symptoms and/or receipt of treatment, at least 72 hours following the effective date. This waiting period does not affect benefits for injuries.

This is a partial list of exclusions and limitations. Please see the certificate for detailed information about these and other plan exclusions and limitations. Benefits, provisions, limitations and exclusions may vary by state.

HCC Life STM Eligibility

You are eligible to enroll in HCC Life STM if you are aged 2 through 64 and you meet the following requirements:

you are not pregnant or, if requesting dependent coverage, not an expectant father or planning on adopting;
you will not be covered under other medical insurance at time of requested effective date;
you are not a member of the armed forces of any country, state or international organization, other than on reserve duty for 30 days or less; and
you are able to answer “no” to the medical questions on the application.
Your spouse under age 65 and dependents under age 19 are also eligible for coverage, provided they meet the same requirements. Unmarried children under age 25 may also be included as a covered dependent if enrolled full-time in an accredited school or college. Eligibility for children ages 19 through 25 may vary by state.In order to receive coverage, applicant may be required to enroll in the Consumer Benefits of America

The description of coverage in these pages is for informational purposes only. Actual
coverage will vary based the terms and conditions of the policy issued. The information described herein does not amend or otherwise affect the terms and conditions
of any insurance policy issued by HCC Life Insurance Company or its affiliates. In
the event that a policy is inconsistent with the information described herein, the
language of the policy will take precedence. Please see the policy for detailed information about these and other policy exclusions and limitations. Benefits, provisions,
limitations and exclusions may vary by state.