Hospital Indemnity and Short Term Recovery Insurance

Hospital Indemnity and Short Term Recovery Insurance  

Overview

Hospital Indemnity and Short Term Recovery Insurance Plan (RecoveryCare)

When you're recovering at home after an inpatient hospital stay, you want to keep your self-reliance; stay in better control of your health care choices and get well quickly. But without a backup plan, you may find out too late that you can't afford the home recovery care you want. You could end up settling for home health care that's just not up to your standards.

 

You could use your savings or retirement income to help pay for home recovery care or you can use the NARFE Hospital Indemnity and Short Term Recovery Insurance Plan (RecoveryCare). This member benefit was designed and negotiated to help with expenses that may not be covered by other plans. Medicare and your FEHB plan respond to only those Medicare-covered services as defined in your Home Health Care plan of treatment. Unfortunately you may need additional help outside this plan of treatment. That is what the Short Term Recovery Plan is designed to do help meet those extra needs..

 

You or anyone you choose can collect cash benefits for each inpatient Hospital and/or Skilled Nursing Facility Stay for a covered Injury or Sickness - even if you don't need home health care afterwards.

  • After your first day of a covered hospital stay, you'll collect $750.
  • After 14 days in the Hospital (days 15-30), you'll get an additional $500.
  • After 30 days in the Hospital (days 31 or more), you'll collect another $200.
  • That's up to $1,450 per covered Hospital and/or Skilled Nursing Facility stay.

 

Following your Hospitalization, you can also collect Home Recovery Benefits.

 

The 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 payable under the Policy.

 

With the Home Recovery Benefit, you'll collect $200 a day for each day you incur a covered home health care expense. Benefits are paid for two benefit periods, up to 40 days per Accrual Year. That's up to $8,000 per year! Starting at age 80, this benefit reduces to $4,000 — one 20-day benefit period — each year. (There is a maximum of 20 days per benefit period and each benefit period must follow a separate Hospitalization.)

 

 

Forms

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.


Enrollment Form


Claim Form

Tell Me More

Valuable Protection

The RecoveryCare Plan is designed for NARFE members and spouses (spouse may not be legally separated or divorced from the Member) age 65 and older but under age 100, and a citizen or legal resident of the United States. It pays cash benefits if you're admitted to the Hospital as an inpatient for a covered Injury or Sickness. Then, it provides a benefit that helps pay for home health care expenses when you're recovering at home after the Hospital stay. You'll receive benefits for physical, speech, and occupational therapy. Benefits would be payable for nursing services by a Registered Nurse (RN) and Licensed Practical Nurse (LPN).

In some cases, you may need personal care after your Hospital stay as well. The NARFE RecoveryCare Plan provides a benefit that can help pay for a home health aide to assist you with items such as bathing and getting dressed. It can even help pay for homemaker services if you need someone to help with the laundry, shopping, cleaning, and cooking.

 

Coverage may vary and is not available in all states.
  • How the plan works

    Pays In Addition To FEHB And Medicare

    Although The Federal Employees Health Benefits Program (FEHB) and Medicare are generous in what they pay for, they don't cover everything.

    For example, Medicare only covers intermittent and part-time care. In addition, it does not cover 24-hour care or homemaker services. If you need more home health care than what Medicare covers, you may have to choose between paying for it yourself or go without it. Plus, you may end up having to pay someone to do things you normally do yourself such as lawn care or home maintenance. The Hospital Indemnity and Short Term Recovery Benefits can help.

    But with the NARFE RecoveryCare Plan, it can help pay for homemaker services as long as your physician prescribes just one home health care expense after a covered confinement in a Hospital and/or Skilled Nursing Facility.

    Benefits You Can Count On

    The NARFE RecoveryCare Plan pays benefits for your Hospitalization and your recovery afterward:

    1. Hospital and/or Skilled Nursing Facility Benefit: You'll collect $750 when you're admitted as an inpatient to a Hospital for at least one day. If your Hospital stay exceeds 14 days (15 - 30 days), you'll get an additional $500. If you're in the Hospital for 31 days or more, you'll collect another $200. Time spent as an inpatient in a Skilled Nursing Facility is also included for the purpose of calculating the Hospital benefit. Plus, you can collect the Hospital and/or Skilled Nursing Facility Benefits multiple times as long as your Periods of Confinement are unrelated and separated by more than 60 days. For example, if you're Hospitalized three times in one year for unrelated illness or injury, you're eligible to collect at least $750 each time. Confinement in the Hospital must begin within 90 days after a Covered Injury occurs.
    2. Home Recovery Benefits: After a covered Hospitalization, if your Physician prescribes Home Recovery Services, you can collect $200 a day (for up to 40 days). This $200-a-day benefit is payable up to two benefit periods per accrual year with an aggregate maximum of 40 days ($8,000). If you are age 80 or older, this benefit is payable up to one benefit period per accrual year with an aggregate maximum of 20 days ($4,000).


    *At age 80, Home Recovery benefits reduce to $200 a day for up to 20 days per Accrual Year (one benefit period or up to $4,000 per year). The Hospital and/or Skilled Nursing Facility Benefits do not change regardless of age.

     

    Guaranteed Acceptance

    Currently, all NARFE members and spouses age 65 and older, but under age 100, are guaranteed acceptance in the Hospital Indemnity and Short Term Recovery Insurance Plan. This means your acceptance into this plan is guaranteed. However, the insurance benefits payable are subject to the policy's Pre-Existing Conditions Limitation.
    You'll have protection for new health conditions right away. Any pre-existing health conditions are not covered for 6 months. (See Other Important Information for details found below.)
    When Spouses are both Eligible Members, coverage may not be duplicated by applying as dependents of each other.

     

    Your Protection Starts Right Away

    Your RecoveryCare Plan will start the first day of the month after we receive your enrollment form and first premium payment.

     

    Coverage For The Long Haul

    You can keep your coverage as long as you want. It won't end due to age, unlike many other insurance plans on the market. At age 80, Home Recovery Benefits reduce from $8,000 per year maximum to 4,000 per year maximum and are limited to one benefit period per year. As long as the Group Master Policy remains in force, you only need to pay your premiums when due to keep your protection. Your spouse’s coverage will remain in effect as long as your coverage is active, premiums are paid, and they meet the eligibility requirements.

  • Rates

    Affordable Group Rates

     

                                                                                           Monthly Group Rates
    Age Member or Spouse
    65-69      $ 19.95
    70-74         $ 27.95
    75-79      $ 39.95
    80-84 *      $ 39.95
    85+*      $ 47.95

     

    *At age 80, Home Recovery benefits reduce to $200 a day for up to 20 days per Accrual Year (one benefit period or up to $4,000 per year). The Hospital and/or Skilled Nursing Facility Benefits do not change regardless of age.

     

    For your convenience, you'll be billed quarterly. You cannot be singled out for a rate increase. Rates and/or benefits may be changed on a class basis. Rates are based on the attained age of the Insured person and increase as you enter each new age category.

     

    If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

  • Additional Plan Details

    THIS IS A LISTING OF HIGHLIGHTS FOR THIS INSURANCE PLAN. BE SURE TO REVIEW THE ENTIRE WEBSITE FOR A DETAILED PLAN DESCRIPTION.
     

    Type of Insurance: Hospital Indemnity and Short Term Recovery Insurance
    Designed For: NARFE members and spouses (not legally separated or divorced) age 65 and older but under age 100, and a citizen or legal resident of the United States
    Underwritten by: Hartford Life and Accident Insurance Company, Hartford, CT 06155
    The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company, Hartford, CT 06155
    Policy Form Number: Hospital Indemnity Form Series includes GBD-2800, GBD-2900, or state equivalent.
    Policy Number: AGP-40010

     

    Other Important Information

    Pre-Existing Conditions Limitation

    A Pre-Existing Condition means any Illness or Injury for which a Covered Person received Treatment in the 6 months prior to: 1) the date the Covered Person became insured under the Policy or any Prior Policy (if applicable); or 2) the date of any increase in benefit amounts or the addition of any benefit under the Policy. This definition does not include an annual or routine medical examination, test, observation, screening or procedure, unless such procedure results in the diagnosis of an Illness or Injury. We will 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 and/or any Prior Policy (if applicable). 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, including any changes from the Prior Policy (if applicable). 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.

     

    Successive Periods Of Coverage

    Periods of Confinement in a Hospital separated by less than 60 days and due to the same or related causes are considered part of the same period of confinement.

     

    Hospital

    A Hospital means an institution licensed to operate as a hospital pursuant to law; primarily and continuously engaged in providing or operating either on its premises or in facilities available to the hospital on a prearranged basis and under the supervision of a staff of licensed physicians, medical, diagnostic and major surgical facilities for the medical care and Treatment of sick or injured persons on an in-patient basis for which a charge is made; and providing 24-hour nursing service by or under the supervision of registered nurses (RNs).

     

    Skilled Nursing Facility and/or Hospital do not mean convalescent homes, or 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.


    Confined or Confinement means the assignment to a bed in a medical facility or being held in a Hospital for a period of 24 consecutive hours or more.

     

    We will pay the Daily Hospital or Skilled Nursing Facility Confinement Benefit Amount shown in the Benefit Schedule for each day a Covered Person is Confined to a Hospital or Skilled Nursing Facility as an Inpatient as the result of a Covered Illness or Covered Injury. The Confinement must begin within 90 days after a Covered Injury occurs. This benefit is only payable once per day, even if the Confinement is the result of more than one Covered Illness or Covered Injury. If a Covered Person is discharged from the Hospital or Skilled Nursing Facility and again becomes Confined as an Inpatient for the same or related Covered Illness or Covered Injury within 60 days of discharge, it will be considered the same period of Confinement.

     

    Inpatient means a Covered Person who is Confined and charged by a medical facility for room and board or is being held in a Hospital for a period of 24 consecutive hours or more. The requirement that a Covered Person be charged by the medical facility does not apply to confinement in a Veteran's Administration Hospital or other Federal Government Hospital.

     

    Exclusions And Limitations

    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, we will not pay for any benefits under the Policy, unless required by law for:
    1) any Mental and Nervous Disorder, unless specifically allowed by a provision of this Certificate;
    2) Substance Abuse, unless specifically allowed by a provision of this Certificate; or Custodial Care, unless specifically allowed by a benefit provision in this Certificate or any rider attached to the Policy (if applicable).

    This Web site 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 Web site and the policy, 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, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to the insured individual. This program may vary and may not be available in all states.
     

    THIS IS A HOSPITAL CONFINEMENT INDEMNITY POLICY. THE POLICY PROVIDES LIMITED BENEFITS.

     

    This limited 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.

     

     

    CLICK HERE TO READ AN IMPORTANT NOTICE TO PERSONS ON MEDICARE: THIS INSURANCE DUPLICATES SOME MEDICARE BENEFITS

Contact Us

We're here to help! Please contact us in whatever manner is most convenient for you.
 

 Address
Mercer Consumer
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-800-233-5764
 Hours
 M-F 7a -5p CT
 Email
narfe.service@mercer.com
 Insurance Company Address
Hartford Life and Accident Insurance Company
One Hartford Plaza
Hartford, CT 06155

FAQs

Answers about the plan, including eligibility, options, enrollment, customer service and more.
  • How soon can my protection start?

    Your protection starts as soon as the first day of the month after we receive your Confirmation Form and first premium payment.
  • Do I have to meet with an insurance agent?

    Issuance of this policy is handled over the Internet and the mail. You can review the materials in the privacy of your home and purchase your policy directly through the mail without meeting with an agent. You can, of course, talk to a licensed representative if you'd like. Please click the Contacts section for the toll-free number.
  • What benefits would I collect?

    The plan would pay cash benefits for your hospitalization for a covered sickness or injury and your recovery afterward:

    1. Hospital Benefit: You'd collect $750 when you're admitted to a Hospital as an Inpatient for at least one day, regardless of whether you need home recovery care later. If your hospital stay exceeds 14 days, you'd get an additional $500. After 30 days in the Hospital, you'd collect another $200.
    2. Home Recovery Care Benefits: You'd collect $200 a day for each day you incur a covered home health care expense. Benefits are paid to you or anyone you choose for benefit periods, up to 40 days* per Accrual Year. (Maximum of 20 days per occurrence.)

    That's up to a total of $8,000* per year, for the home recovery care you need. Plus, your Hospital Benefit is unlimited in the number of times you can collect it as long as your Periods of Confinement are unrelated and separated by more than 90 days. 

    Conditions for which you've received medical care or treatment in the 6 months before your effective date will be covered after you've been in the plan for 6 months; or when you've gone 6 months without treatment for the condition, whichever is sooner.

    * At age 80, Home Recovery Care Benefits reduce to 20 days per Accrual Year and an annual maximum of $4,000 (one benefit period).

  • How does this plan work?

     

    The Short Term Recovery Plan pays you or any one you choose cash benefits once you're admitted to the Hospital as an Inpatient.

    This plan also helps pay benefits that can be applied toward home health care expenses when you're recovering at home after the hospital stay. You'd receive benefits for physical, speech and occupational therapy. Nursing services by a Registered Nurse (RN) and Licensed Practical Nurse (LPN) are also covered. 

    In some cases, you may need personal care after your hospital stay as well. The Short Term Recovery Plan can help to pay when a Home Health Aide comes to assist you with items such as bathing and getting dressed. It can even help cover homemaker services if you need someone to help with your laundry, shopping, cleaning and cooking.

     

     

  • Will acceptance into this plan always be guaranteed?

    We're hopeful it will be. However, it's unclear at this point whether underwriting will be necessary in the future for you to qualify. 

    This means now is the perfect time to get in on the plan, when you can’t be turned down for any reason (subject to the Pre-existing Conditions Limitation).
  • Who can sign up?

    All members, over age 65 and their spouse, are guaranteed acceptance into this plan. Insurance benefits payable are subject to your policy's Pre-Existing Conditions limitation. All active members who are age 65 or over who are enrolled in Medicare.
  • What if I have second thoughts after I enroll?

    You will have 30 days from the date of receipt to review the insurance Certificate. If you are not satisfied with the terms of the Certificate, simply return it to the Insurance Administrator and any premiums paid will be refunded in full, minus any claims paid.
  • When does my protection end?

    You can keep the Short Term Recovery Plan as long as you want. Your coverage won't end due to age. At age 80, home health benefits reduce from a $8,000.00 per year maximum to a $4,000 per year maximum. As long as the Master Policy remains in force, you only need to pay your premiums when due and remain an association member to keep your protection. A member's spouse’s coverage ends when the member's does, the Master Policy terminates, and when premiums are not paid. Your spouse can not be legally separated or divorced from you.

    SRP-1151 A (HLA) (5476)
Hospital Indemnity Form Series includes GBD-2800, GBD-2900, or state equivalent.
98548

Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.