Traditional NEA Hospital Care Insurance Plan
Plan Details

Choice of daily benefit

With this plan, you can choose daily benefits from $10 to $250 (in $10 units) to be paid directly to you. Or, you may assign benefits to be paid directly to the hospital or any other health care facilities in which you receive care. This Plan will pay the daily benefit amount for each day of confinement in a hospital as long as the confinement is due to sickness or injury and begins while the insured is covered under the policy. There is no waiting period for benefits to begin (subject to Pre-Existing Conditions Limitations).

Pays in addition to health coverage

Benefits will be paid regardless of any medical insurance you may already have and in addition to any Medicare benefits.

Family coverage

You (if you’re under age 70), your spouse or domestic partner (in order for spouse to be eligible they cannot be legally separated or divorced from the member), and your children (to age 27) are guaranteed acceptance in the Traditional NEA Hospital Care Insurance Plan Plan (subject to Pre-Existing Conditions Limitation). If you elect member and spouse coverage, your spouse or domestic partner’s benefit amount must be the same as yours. If you elect child(ren)’s coverage, you may choose a child(ren)’s daily benefit of 50% or 100% of your own benefit.

Pregnancy benefits

The traditional NEA Hospital Care Plan pays a daily benefit amount for each day of confinement in a hospital due to pregnancy up to 365 days beginning with the first day of your hospital stay. This includes confinements for complications and childbirth/delivery.

Home convalescent benefits

Pays one-half the Daily Benefit Amount for each day of total disability immediately following a period of hospital confinement for which benefits were paid under the Hospital Income Benefit for at least 10 consecutive days.

The maximum payment period for this benefit is equal to the lesser of the number of days of prior hospital confinement or 30 days.

This benefit terminates upon attainment of age 70, coverage will continue until the total disability ceases or the last day of the home convalescent maximum payment period.

Dependent children coverage is not provided.

Affordable monthly premium

Use this calculator to compute your cost.

Coverage you can keep for life

You may keep your coverage for as long as you wish as long as the Master Policy between NEA and the insurance company is in force, you pay premiums when due, you maintain membership in NEA, and you do not enter the Armed Forces for more than 30 consecutive days of active service.

Coverage for your family members ends when yours does, when they are no longer eligible, or when their premiums are not paid. Your dependent’s coverage will remain in effect as long as your coverage is active, premiums are paid, and they meet the eligibility requirements. Coverage for your family members will not end if you are in active service in the Armed Forces or if you should die.

In the event of your death or entry into active service in the Armed Forces, your dependents who were insured at the time may continue their coverage while they remain otherwise eligible, provided that your spouse* was insured and continues his or her personal coverage. At this point, your spouse’s* age will be used to determine the rates.

Exclusions

To keep your rates affordable, this plan does not cover intentionally self-inflicted injuries, suicide or attempted suicide, whether sane or insane (in Missouri or Colorado, while sane), or any loss caused or contributed to by war or act of war whether war is declared or not.

Hospital and Skilled Nursing Facility do not mean any institution of part thereof which is used primarily as: convalescent home, or skilled nursing facility; a plce for rest, custodial care, or for the aged; a clinic; or a place for the treatment of mental illness, alcoholism, or drug addiction. However, a place for the treatment of Mental, Nervous, or Emotional Disrders will be rearded as a Hopsital if: it is part of an institution that meets the above requirements; and it is listed in the American Hospital Association Guide as a general hospital.

Confined or confinement means being an Inpatient in a Hospital due to Sickness or Injury.

Maximum benefit paid

Under this plan, the maximum benefit period for each separate physical condition requiring hospitalization is 365 days. After a subsequent six-month period of non-hospitalization, you are again eligible for benefits for the same condition.

Additional hospital income benefits payable under this or other policies for confinement in an intensive care unit or for confinements resulting from a diagnosis of cancer are not considered in determining the aggregate total benefits subject to the $250 day maximum.

We will not pay more than the maximum Daily Benefit Amount for any one day of Hospital Confinement.

When coverage begins

Your coverage will become effective on the first of the month after approval of your Confirmation form and first premium payment are received, provided you are not confined in the hospital. If you are hospital-confined, your effective day will be the day following final medical discharge from confinement.

Pre-existing conditions limitations

During the first 6 months of a covered person’s insurance, losses incurred for pre-existing conditions are not covered. This will not apply to a loss that the covered person incurs after being free of medical care for the condition for a 6 month period (ending any time on or after his or her effective date). (A pre-existing condition, as used in this limitation, means any injury or sickness, diagnosed or undiagnosed, for which medical care is received by a covered person within 6 month period prior to the covered person’s effective date of insurance).

Age reduction

Any daily benefit amount, in excess of $40 per day, will be reduced by 50% or to $40, whichever is less, on the premium due date on or next following the member’s attainment of age 70. The dependent child’s daily benefit amount reduces.

*Or domestic partner.

This website explains the general purpose of the insurance described, but in no way changes of 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. Policies underwritten by the Hartford Life Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in fill of discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

The Hartford^® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life Insurance Company.

SRP-1151 A (HL) (5185)