NEA® CarePlus Hospital Insurance Plan (Hospital Indemnity and Short Term Recovery Insurance Plan)

How the Plan Works

Pays you up to $1,450 cash benefits for Hospital and/or Skilled Nursing Facility stays for a covered injury or sickness.

NEA CarePlus pays you or someone you choose a lump sum cash benefit depending on how long your stay is to help pay for your covered Hospital stay and other Home Recovery Expenses.


Number of Days for a Covered Hospital/Skilled Nursing Stay Your Cash Benefits
1-14 days $750
15-30 days $1,250
More than 31 days $1,450

 

Pays you up to $8,000* ($200 a day) additional cash benefits for covered Home Recovery Expenses

The NEA CarePlus Hospital Insurance Plan doesn’t stop paying once you’re out of the Hospital. Since many patients are being released from the Hospital sooner, this plan pays you or someone you choose cash benefits to help with your recovery at home.

With this plan, you’ll collect $200 for each day you incur a covered Home Recovery Expense. Benefits are paid for up to 40 days per year (maximum 20 days per occurrence).* Services must be received within 90 days of discharge from the Hospital and must have a home health care plan of treatment approved by Medicare or TRICARE.

That’s up to a total of $8,000* a year you won’t have to pay out of pocket for the Home Recovery care you need.

Plus, your Home Recovery Benefits will be paid in addition to your Hospital Benefits.

These Home Recovery Benefits are designed to help cover lost income, pay for medical or adaptive home equipment, or home health aide or convenience items like a heating pad, over the counter medications, etc.

 

Affordable Monthly Premium

Thanks to the group buying power of 3 million NEA members, you pay an affordable group rate:

    Age     Member
(per month)
Spouse / Domestic Partner
(per month)
65-69 $19.95 $19.95
70-74 $27.95 $27.95
75-79 $39.95 $39.95
80-84* $39.95 $39.95
85+ $47.95 $47.95

 

*At age 80, Home Recovery benefits reduce to a maximum of 20 days per accrual year or a maximum of $4,000 (one benefit period).

All premiums are based on the age of each Insured person at enrollment and increase as you reach each new age bracket.

The company reserves the right to change rates and/or benefits on a class basis. You will be billed quarterly.


You cannot be turned down due to heath or age

Your acceptance in the NEA CarePlus Hospital Insurance Plan is guaranteed for all Members who are: in good standing with the NEA; age 65 or older; under age 100, and; citizens or legal residents of the United States, its territories and protectorates.

Insurance benefits payable are subject to your policy’s Pre-Existing Conditions Limitations.

There are additional eligibility restrictions as well: The Member must be enrolled for Coverage under this Policy in order to enroll Dependent(s) for Coverage.

A Member may not elect coverage for their Dependent if such Dependent is covered as a Member under the Policy. No person can be insured as a Dependent of more than one Member under the Policy.

Your spouse or domestic partner is also guaranteed acceptance as long as he or she is over age 65. Spouse means any individual legally married to the Member under the laws of the state or jurisdiction in which the marriage took place who is: not legally separated from the Member; a citizen or legal residents of the United States, its territories and protectorates; over age 64, and; under age 100.


Keeps on paying if Hospitalized again

Unlike some plans, this plan picks up from where you left off if you’re Hospitalized again within 60 days for the same or related Sickness or Injury. And there is no limit on the number of Hospital stays per year as long as your periods of confinement for the same or related Sickness or Injury are separated by at least 60 Days or for a new Sickness or Injury unrelated to the causes of the prior confinement.


Coverage will not be terminated due to health or age

The NEA CarePlus Hospital Insurance Plan is yours for as long as you want it—no matter what your age.

You can keep this coverage as long as you want provided you continue to pay your premiums when due, NEA continues the plan, you continue NEA membership and the group Master Policy stays in force.

Your spouse or domestic partner can continue this coverage as long as he or she meets eligibility requirements. If you were to die, your spouse or domestic partner can continue this coverage (see your Certificate of Insurance for more details).


Effective Date

Your coverage will become effective on the first day of the month your Confirmation Form and first premium payment are received, provided you are not Confined in the Hospital. If you are Hospital-Confined, your effective date will be when you resume your normal activity.


Pre-Existing Conditions

During the first 6 months of a coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-Existing Condition means any Injury or Sickness, including pregnancy; diagnosed or undiagnosed, for which you have received medical care within the 6-month period prior to your coverage effective date or the date of an increase in coverage. During that time, benefits for all other accidents or illnesses will be paid under the policy provisions. You are urged to consider this limitation before dropping any coverage you may have until the waiting period is over.


Medicare Notice

If you are on Medicare, please see this important Medicare Notice.


Exclusions

This plan does not cover intentionally self-inflicted Injuries, suicide or attempted suicide, whether sane or insane.

Confined, 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.

Hospital does not include:
1) convalescent homes, or convalescent, rest or nursing facilities;
2) facilities affording primarily custodial, educational or rehabilitory care;
3) 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
4) 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.

Skilled Nursing Facility means an appropriately licensed healthcare facility, or a distinct unit within a Hospital or other institution, which: provides skilled nursing care and related services 24 hours per day, 7 days per week; is under the direct supervision of a Physician and has a Physician or Medical Professional available at all times; has a planned program of policies and procedures developed with and periodically reviewed by one or more Physicians; and is not mainly a place for rest, Custodial Care, care of the aged/elderly, care of persons with Substance Abuse issues/disorders, care of persons with Mental and Nervous Disorders, or a hotel or similar establishment.

Confinement in a skilled nursing facility must be at the direction of a Physician. This definition does not include a Hospice Facility, nursing home, Rehabilitation Facility or swing bed hospitals that are authorized to provide and be paid for extended care services.

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 the benefits are subject to the terms and conditions of the policy. Policies underwritten by the 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 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.


Hospital Indemnity Form Series includes SRP-1151, or state equivalent.
Policy AGP-40012.




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 requirements of minimum essential coverage.

This policy provides limited benefits health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services.

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

 

In this transaction, Mercer Consumer, a service of Mercer Health & Benefits Administration LLC, is acting as the exclusive insurance agent and program manager for Hartford Life and Accident Insurance Company (Insurer) for this type of coverage, and not as your insurance broker. As the agent for Insurer, Mercer Consumer may provide these services: enrollments, ongoing servicing, billing, marketing, customer administrative and claim servicing and communications. In accordance with industry custom, we are compensated through commissions that are calculated as a percentage of the insurance premiums charged by insurers. We may also receive additional monetary and nonmonetary compensation from insurers or from other insurance intermediaries, which may be contingent upon such facts as volume, growth or retention of business. This compensation may include payment from insurers for marketing-related expenses or investments in technology. Our compensation may vary depending on the type of insurance purchased and the insurer selected. We will provide you additional information about our compensation upon your request. You may obtain this information by referring to https://www.personal-plans.com/disclosure and entering the security code E525346341009 or call us at 1-888-206-5088 for specific details.

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