Short Term Health Insurance Coverage Information

• Important Information

• Covered Short Term Health Insurance Expense Highlights

• Eligibility Requirements

• Plan Limitation & Exclusion Highlights

• Plan Highlights - Short Term Health Insurance

• About Standard Security Life & Co-ordinated Benefits

• FAQ (Frequently Asked Questions)

Important Information

Short term health insurance plans do not provide benefits for pre-existing conditions, work related conditions, and preventive care.  If you or a dependent have an existing health condition, you may want to consult with your independent insurance agent prior to changing or purchasing health/medical insurance coverage

This website provides general information about the American Health Shield – Short Term Health Insurance Plan.  It is not a contract.  The complete terms, provisions and conditions or coverage are described in the Policy or Certificate issued by The Standard Security Life Insurance Company to approved applicants.  Plan benefits, limitations and exclusions vary by state.

This plan of insurance is not currently available to residents of:

ID, MA, ME, ND, NH, NJ, NY, OR, RI, SD, VT.

This plan of insurance, under Policy Form STP-01, is underwritten by The Standard Security Life Insurance Company.  The Policy and Certificates issued under it, will be deemed amended to conform to the minimum requirements of the laws of the state in which coverage is issued.

Covered Medical Expense Highlights

The American Health Shield – Short Term Health Insurance Plan provides benefits for Covered Medical Expenses related to covered Injury or Sickness, which are:  1) not in excess of Usual and Customary Charges; 2) not in excess of a maximum benefit amount; 3) made for services and supplies which are a Medical Necessity and listed as Covered Medical Expenses in the Policy or Certificate issued by The Standard Security Life Insurance Company. 

• Services of licensed Physicians, Registered Nurses, Surgeons, and Anesthetist 
• Hospital services including outpatient department or ambulatory surgical facility services
• Hospital room and board and general nursing care, while confined in a semi-private room
• Hospital Emergency Room & Intensive Care
• Pre-admission Testing
• Physiotherapy
• Diagnostic X-ray Services and Laboratory Tests
• Chemotherapy and Radiation Therapy
• Prescription Drugs and Injections
• Ground Ambulance Services
• Braces and Appliances

Covered Medical Expenses and Benefits vary be state. Detailed information about these and additional Covered Medical Expenses is listed in the Policy or Certificate issued by The Standard Security Life Insurance Company to approved applicants.

Note - Usual and Customary Charges means the lesser of: 1) the actual charge; 2) what the provider would accept for the same service or supply in the absence of insurance; or 3) the reasonable charge as determined by The Standard Security Life Insurance Company, based on factors such as: a) the most common charge for the same or comparable service or supply in a community similar to where the service or supply is furnished; b) the amount of resources expended to deliver the treatment rendered; c) charging protocols and billing practices generally accepted by the medical community or specialty groups; or d) inflation trends by geographic region.  

Eligibility Requirements

You and your spouse (to 64 and 11 months) and your unmarried dependent children (between age 15 days and age 19 or 23 if a full-time student) that live with you may apply for coverage.  To be considered for coverage, proposed insured's must not:

a) have other hospital, major medical, health, governmental, or medical insurance coverage in force that will not terminate prior to the Effective Date of the plan;

b) be pregnant or the expectant father of an unborn child on the Effective Date;

c) have been declined for insurance due to health reasons;

d) have received consultation of treatment, within the past five years, for any conditions identified on the application;

e) purchase this insurance as coverage for sport related injury's

Note: Child(ren) only coverage is available by applying via mail or fax. The application must be physically signed by the parent or guardian.  

Limitation & Exclusion Highlights

Unless specifically listed as a Covered Expense in the Policy or Certificate (or as may be provided by an Endorsement attached to the Policy or Certificate), no benefit will be paid for loss or expense caused by, contribution to, or resulting from:

A Pre-existing Condition, defined as: 1) the existing of symptoms within the 12 months immediately prior to the Insured’s Effective Date or, 2) any condition which originates, is diagnosed, treated, or recommended for treatment or for which medication was prescribed or recommended within the 12 months immediately prior to the Insured’s Effective Date; 2. Charges in excess of Usual and Customary Charges; 3 Addiction, alcoholism and codependency; 4. Congenital conditions; 5. Circumcision; 6. Cosmetic procedures, except cosmetic surgery required to correct an Injury for which benefits are otherwise payable under this plan; 7. Custodial care or rehabilitation care service and supplies; 8. Dental treatment, except for accidental Injury to sound, natural teeth; 9. Elective abortion; 10. Expenses incurred outside of the United States, its possessions, territories or Canada; 11. Hearing examinations, hearing aids, eye exams, glasses or contacts; 12. Injury caused by, contributed to, or resulting from the use of alcohol, intoxicants, hallucinogenic, illegal drugs, or any drugs or medications that are not taken in the dosage or for the purpose prescribed by the Insured Person’s Physician; 13. Injury or Sickness for which benefits are paid or payable under any Worker’s Compensation or Occupational Disease Law or Act, or similar legislation; 14. Injury or Sickness to the extent that benefits are paid by Medicare or any other government law or program (except Medicaid); or medical coverage under any automobile insurance; 15. Mental Illness and behavioral problems; 16. Normal pregnancy, maternity services or supplies; 17. Organ transplants; 18. Participation in a riot or civil disorder; commission of or attempt to commit a felony or fighting; 19. Reproductive/infertility services; 20. Routine and/or screening physical examinations, testing, or treatment; 21. Services rendered or supplies purchased from your immediately family; 22. Skydiving, parachuting, hang gliding, glider flying, parasailing, sail planning, bungee jumping, or flight in any kind of aircraft (except while riding as a passenger on a regularly scheduled flight of a commercial airline) Injury or sickness due to collegiate or professional sports; 23. Sleep disorders, supplies, treatment, or testing related to sleep disorders; 24. Suicide or attempted suicide while sane or insane; 25. Intentionally self-inflicted Injury; 26. Treatment in a Government hospital, unless there is legal obligation for the Insured Person to pay for such treatment; 27. Treatment or removal or repair of tonsils or adenoids, except for a Medical Emergency; 28. Sclerotherapy for veins or the extremities; 29. Service supplies or treatment of acne, acupuncture, allergy (including testing); 30. Nasal, sinus surgery, deviated nasal septum, skeletal irregularities of jaws; 31. Breast reduction or augmentation; 32. Weight management services; 33. War or any act of war, declared or undeclared; or while in the armed forces of any country.

Plan limitations and exclusions vary by state. Detailed information about plan limitations and exclusions are listed in the Policy or Certificate issued by The Standard Security Life Insurance Company to approved applicants.