This CancerCare Insurance Plan was especially designed to provide
AFAVBA Participants and their families with the extra benefits needed to help pay
for cancer treatments. The AFAVBA CancerCare Insurance Plan helps provide
these benefits at an affordable group rate.
Your CancerCare Insurance Plan benefits are paid in addition to
benefits you receive from any other plan. And you can use the
Plan’s benefits any way you choose — to pay for deductible amounts,
help cover extra household expenses or even to help replace lost
income.
Hospital Room and Board
During a covered hospital stay for cancer treatment, the Plan will
pay you a benefit of up to $75 per day, for up to 90 days per
illness period. This benefit begins from the very first day you are
hospital-confined. If 90 consecutive days or more elapse between treatments,
your in-hospital benefits will begin all over again.
Extended Hospital Benefits
If you are hospitalized for longer than 90 days during an Illness
Period, you qualify for extended hospital benefits. Beginning on
the 91st day of your hospital confinement, the plan will pay your
actual hospital charges, up to $5,000 per month, in lieu of the
other benefits provided by this coverage, up to the lifetime maximum
of $250,000 for all benefits paid.
Blood and Plasma
The Plan provides up to $500 per illness period for charges for pints of
blood or blood plasma. There is no maximum benefit for leukemia.
Diagnostic Benefit
Up to $1,000 per illness period with a lifetime maximum benefit of
$1,500 will be paid for expenses incurred for diagnostic procedures.
These diagnostic procedures must be performed within 45 days prior
to the positive diagnosis of cancer.
Benefits for Skin Cancer
Up to $100 will be paid per session, to remove skin cancer. Skin cancer may
be diagnosed by a physician, not necessarily by a pathologist, which is
required for other forms of cancer.
Surgical Expenses
This benefit pays 20% of a surgeon’s actual charges, up to $1,000 per
operative session (other than for removal of skin cancer as covered
above), subject to a $1,500 maximum lifetime benefit. 20% of actual
charges up to $100 per operation will be paid for the services of an
anesthesiologist ($40 for skin cancer).
Ambulance Transportation
This benefit helps cover the cost of ambulance transportation to or
from a hospital for cancer treatment. The Plan pays up to $75 for each
one-way trip, up to a maximum benefit of $500 for each illness period.
Benefits for Hospice Care
The Plan provides a hospice benefit, paying up to $25 per day for hospice
care following a hospital stay of at least 3 consecutive days for a maximum period of
100 days.
$1,000 First Occurrence Benefit.
Pays a one-time only benefit of $1,000 directly to you at the very first
diagnosis of cancer. This amount will be paid for any cancer, excluding
skin cancer, diagnosed after this coverage has been in force for 30 days.
$50 A Day For Outpatient Treatment.
Today, more and more medical procedures are being performed on an outpatient
basis. This benefit helps with this cost because it pays $50 directly to you
each day that you receive outpatient surgery, blood transfusions, x-ray therapy,
either oral chemotherapy or by injection, or radium or cobalt therapy for the
treatment of cancer.
Provides Benefits For You and Your Family
The Plan provides a lifetime maximum benefit of up to $250,000 for
each insured. Benefits are payable directly to you or, at your option,
they can be assigned to your doctor or hospital.
An Affordable Group Rate That Never Increases As You Get Older
Your premiums will never increase due to age, poor health or the number of
claims you make. Rates will only be changed if they are changed for everyone
insured under this AFAVBA CancerCare Plan.
Premiums
|
| |
Quarterly |
Semi-Annually |
Annually |
|
Individual |
$31.00 |
$62.00 |
$124.00 |
|
Family |
$43.00 |
$86.00 |
$172.00 |
Protection for your Entire Family
Coverage is available for you, your spouse and your eligible dependent
children (children under age 19, age 25, if a full-time college student). To be eligible for coverage you, your spouse and children
must have been cancer and treatment free for the
five-year period prior to the date their coverage begins.
Renewable to Age 85
Your coverage will be continued, through age 85, as long as your premiums are paid on time and the group
master policy remains in effect. Your dependents' coverage will continue as long as they
remain eligible dependents.
Limitations and Exclusions
Benefits are provided only for care resulting from cancer. Treatment of
other injuries or sickness is not covered. Expenses the covered person
is not legally obligated to pay or those charged only because the covered
person has insurance. Treatment or services performed
outside the United States are not covered. Positive pathological proof of
diagnosis of cancer is required, except for skin cancer benefits.
A cancer which is diagnosed in the 5 years prior to the Effective Date
is not covered. For cancer which is diagnosed within the first 30 days of
coverage, claims incurred within the first 12 months of the Effective Date
are not covered. |
