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Group Hospital Indemnity Insurance

Help reduce the impact on your budget of unexpected and uncovered hospital expenses.

If you or a member of your family became hospitalized, you could be left with deductibles, co-pays and other hospital related expenses not covered by ordinary hospital insurance.

AMA-Sponsored Hospital Income Plan

  • Can pay you up to $500 a day for every day you or any covered family member is hospitalized by any covered injury, pregnancy, or illness.

  • Benefits are paid directly to you, or anyone you may choose, to use any way you wish.

  • Use benefits toward deductibles and co-pays, or everyday expenses at home, or perhaps toward a private room upgrade.

Find out how affordably the Hospital Income Insurance Plan can fit into your overall protection program.

Underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
On Policy Form GMR-FACE/G-29346-1
Under Group Policy No. G-29346-1

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Product Id - 2751
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Group Hospital Indemnity Insurance Coverage Details

Features & Benefits

Help reduce the impact on your budget of unexpected and uncovered hospital expenses.

If you or a member of your family became hospitalized or visit the emergency room, you could be left with deductibles, co-pays and other hospital related expenses not covered by ordinary hospital insurance.

Hospital Income Plan

Can pay you up to $500 a day for every day you or any covered family member is hospitalized by any covered injury, pregnancy, or illness.

Benefits are paid directly to you, or anyone you may choose, to use any way you wish.

Use benefits toward deductibles and co-pays, or everyday expenses at home, or perhaps toward a private room upgrade.

Underwritten by:

New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
On Policy Form GMR-FACE/G-29346-1
Under Group Policy No. G-29346-1

   New York Life

Group Hospital Indemnity Insurance Coverage Details

Choose Up to $500 a Day in Benefits

As an eligible physician, you can choose the Daily Benefit Amount that best suits your needs from $100 per day to $500 per day in $100 increments. The daily benefit is payable directly to you or anyone you choose. And you can use these cash benefits any way you wish: pay hospital telephone bills, make the hospital stay more comfortable with a private room upgrade, or even cover household expenses while you're hospitalized.

No more than 200% of the Daily Benefit Amount is payable for one day of confinement.

 No Waiting Period

There is no waiting period or deductible to meet. Benefits are payable from the first day of hospital Confinement due to an illness or injury for up to 365 days per covered stay, subject to the pre-existing conditions limitation.

Double Benefits for First Day of Hospital Stay (age 60 and Older)

If you are age 60 and older, you may receive the First Day double benefit – up to $1,000 – for your first day of covered hospitalization.

Emergency Outpatient Treatment

The full daily benefit amount is payable for a visit to the Emergency Room, up to 5 times per calendar year for each insured family member, even if you or a family member is not admitted to the hospital.

Observation Care

If you are not admitted into the hospital but kept for observation, you can receive the full benefit amount per visit, up to two times per calendar year. This benefit cannot be combined with other benefits for the same day.

Outpatient Surgery Benefit

The plan can pay the full benefit amount for each visit, up to 5 times per calendar year for each insured family member if you undergo medically necessary outpatient surgery due to a covered surgical procedure. Covered outpatient surgery must be performed by a physician in a hospital or ambulatory surgical center.

Common Accident Confinement

If both you and your insured spouse are hospitalized for the same covered accident, you may receive up to double the daily benefit amount. If you are under age 60, you may receive up to $1,000 a day for 365 days per covered stay while you are both hospitalized. If you are 60 and older, you may receive up to $1,000 a day for 100 days per covered stay while you are both hospitalized.

Skilled Nursing Facility

If you are confined to a Skilled Nursing Facility and are age 60 and over, 50% of your daily benefit amount is payable beginning on the 21st day, for up to 80 days. Confinement must begin within 7 days of a covered hospitalization or observation stay after at least 1 day duration.

Home Convalescence

To help you recuperate at home, 50% of the daily benefit amount is payable to you or your covered spouse age 60 and over (dependent children are not eligible for this benefit) immediately following a covered hospitalization that lasted at least 10 consecutive days. Benefits will be paid for the lesser of: a) the number of days that the covered person was hospital confined, or b) 30 days per calendar year.

Pregnancy

The plan can pay 100% of your daily benefit amount for covered Confinement due to pregnancy, subject to the pre-existing conditions limitation. Complications due to pregnancy are covered immediately.

Alcohol and Drug Abuse

If you are under age 60, the full daily benefit amount is payable for up to 30 days per covered stay if Confined in a hospital due to alcohol or drug abuse.

If you are age 60 and over, the full daily benefit amount is payable for up to 100 days per covered stay if Confined in a hospital due to alcohol or drug abuse. Treatment of alcohol or drug abuse in a Residential Treatment Facility is payable at 50% of your daily benefit amount for up to 30 days per calendar year.

Mental and Nervous Disorders

If you are under age 60, the full daily benefit amount is payable for up to 30 days per covered stay if Confined in a hospital due to mental and nervous disorders. For persons age 60 and over, the full daily benefit amount is payable for up to 100 days per covered stay if Confined in a hospital due to mental and nervous disorders.

Pre-existing Conditions

A pre-existing condition is an injury, pregnancy or illness, whether diagnosed or undiagnosed, for which you have consulted a physician, received medical services or supplies, or taken any medication within the 12 month period (6 months for residents of Alaska, California, Indiana, Montana, New York, North Dakota and Oregon) preceding the effective date of your insurance. Pre-existing conditions will not be covered until 12 consecutive months (6 months for residents of California and Oregon) following the effective date of your coverage. This limitation does not apply to complications of pregnancy.

Eligibility

Acceptance into the Hospital Income Plan is guaranteed as long as you are an active physician residing in the U.S. (see state availability) employed full time, a full-time medical student or a physician retired for reasons other than illness or injury, and under age 80. In addition, you can enroll your spouse or domestic partner under age 80 and all eligible unmarried, dependent children through age 26 (through age 27 in Ohio). Florida residents- dependent children are eligible for coverage through age 26, or if unmarried, through age 29. The eligible member must apply for coverage for themselves in order to apply for dependents coverage.

Effective Date

Coverage will be effective on the date AMA Insurance receives your signed enrollment form, provided premium is paid when due, except for the physician or any covered dependent who is confined to a home, in a hospital, or other medical facility on that date, coverage for that person will be deferred until the day after he/she is no longer so confined provided that the person is still eligible.

Renewability and Termination

As long as the required premiums are paid when due and the group master policy remains in effect, coverage will not terminate unless you request to end such coverage. Dependents coverage ends when the member's coverage ends, premiums for the dependent's coverage are not paid, or they cease to be eligible dependents.

Exclusions

The Policy does not cover: any loss caused or contributed to by war or act of war, whether war is declared or not, confinements which occur while not insured under the Policy; confinements that are not medically necessary; Hospital for which no charge is made that the Covered Person must pay; Confinement in a Residential Treatment Facility for Mental or Nervous Disorders or for any reason other than treatment for alcoholism or drug abuse; and Pre-Existing Conditions as defined.

State Availability

This plan is currently not available in:

MN,NH,NC,TX,VT,WA

Carrier Information

The Hospital Income Plan Plus is Underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010 On Policy Form GMR-FACE/G-29346-1


New York Life

Under Group Policy No. G-29346-1

New York Life is licensed/authorized to  transact business in all of the 50 United States, the District of Columbia, Puerto Rico and Canada. Not all group plans it underwrites are available in all jurisdictions. Please check the applicable insurance brochures for current availability. New York Life’s state of domicile is New York, and NAIC ID# is 66915.

AMA Insurance incurs costs in connection with providing oversight and administrative support for this plan, and are reimbursed for these costs. The American Medical Association also incurs certain expenses in connection with the plan and is reimbursed for such expenses.

IMPORTANT INFORMATION FOR PHYSICIANS ELIGIBLE FOR MEDICARE

This insurance duplicates Medicare benefits when: any expenses or services covered by the policy are also covered by Medicare.
    
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 this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policy underwritten by New York Life Insurance Company. Exclusions, limitations, reduction of benefits and terms under which the policy may be continued in full or discontinued are detailed in the Certificate of Insurance issued to each insured individual and complete details are in the Group policy issued to the policyholder. This program may vary and may not be available to residents of all states.

 
Group Hospital Indemnity Insurance
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