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Hospital Indemnity Plan
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pays you up to $125.00 each day that you are hospitalized starting with day one
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pays you up to $375.00 each day that you are in the hospital for cancer treatment
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pays you up to $375.00 each day that you are in an intensive care unit
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pays you $60 for each treatment received in a hospital emergency room, with a calendar
year maximum of 5 treatments.
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no medical exam...no health questions
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no deductibles
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Pays you up to $125 each day (for up to 90 days) that you are hospitalized due to illness
or accident.
Pays you triple benefits up to $375 each day (for up to 90 days) that you are hospitalized for the treatment of cancer.
Pays you triple benefits up to $375 each day that you are confined to an intensive care unit.
Pays you up to $60 for each outpatient treatment in a hospital emergency room and
for outpatient surgery in a hospital, with a calendar year maximum of 5 treatments. Not more than one
treatment will be payable in any period of 24 consecutive hours.
Pays you starting on day one of your hospitalization...and there are
no deductible amounts.
Pays you directly so that you can put the money toward expenses not covered
by your basic health insurance or use the money any way you see fit, or you can assign it to a provider.
Pays you for each and every day that you
are hospitalized for up to a full 365 days per confinement for injury or sickness...
or up to 60 days for hospitalizations due to mental or nervous disorders.
Pays you regardless of any other benefits or coverage you may have.
Pays you full benefits even if you are hospitalized in a U.S.
Government facility.
YOUR AFAVBA Guarantees
You and your family are eligible for AFAVBA Group Coverage.
You and your family are eligible for this AFAVBA Hospital Indemnity Program at the economical
group rates for which you qualify. If you wish to cover yourself only, choose the Individual
Plan. If you wish your spouse covered as well, choose the Limited Family Plan. If you would like to cover
yourself, your spouse and all of your eligible dependent children, choose the Full Family Plan.
Renewable Coverage.
You cannot be cancelled regardless of the number of claims you make. Only you can cancel as long as
the Master Policy with AFAVBA remains in force and your premiums are paid on time.
Pre-existing Conditions Limitations:
Injuries sustained or a sickness for which an insured person has received medical treatment or advice
from a physician within 12 months (in CA: 6 months immediately prior to the Effective Date of Coverage;
in PA 90 days) prior to the effective date of insurance, are considered to be Pre-existing conditions.
A confinement resulting from a Pre-existing condition will not be covered until after 12 consecutive
months (in CA: 6 consecutive months), during which time the insured person is covered under the policy
and receives no medical treatment or advice (except in CA and PA). The plan is subject to the terms,
conditions, exclusions and limitations of the group policy.
You choose the payment option that’s convenient.
Two payment methods are offered for your convenience. You may choose to be billed quarterly or have these
quarterly premiums automatically deducted from your bank account through our direct deposit program. Many
people choose this latter way so as to eliminate additional bills and the necessity of writing and mailing
checks.
You must be satisfied or your money back!
If you are not completely satisfied with your coverage when you receive your Certificate of Insurance, simply
return it to us within 30 days of receipt. Any premium paid will be refunded to you in full.
3 Plans with 4 Levels of Benefits
available to suit your needs!
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TABLES OF BENEFITS AND
QUARTERLY PREMIUMS |
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INDIVIDUAL PLAN |
| Plan: |
C-1 |
D-1 |
E-1 |
F-1 |
| Pays Individual: |
$60/Day |
$80/Day |
$100/Day |
$125/Day |
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Age |
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Quarterly Premiums |
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| Under 40 |
$21.00 |
$27.50 |
$34.00 |
$42.50 |
| 40-49 |
26.25 |
34.50 |
42.75 |
53.44 |
| 50-59 |
31.20 |
41.20 |
51.20 |
64.00 |
| 60-64 |
46.20 |
61.20 |
76.20 |
95.25 |
| 65-69 |
59.80 |
79.40 |
98.80 |
123.50 |
| 70-74 |
69.40 |
92.20 |
114.80 |
143.50 |
| 75-79 |
80.20 |
106.60 |
132.60 |
165.75 |
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80 and over |
Rates available on request |
LIMITED FAMILY PLAN: PRIMARY INSURED & SPOUSE |
| Plan: |
C-2 |
D-2 |
E-2 |
F-2 |
| Pays Primary
Insured: |
$60/Day |
$80/Day |
$100/Day |
$125/Day |
| Pays Spouse: |
$45/Day |
$60/Day |
$75/Day |
$93.75/Day |
| Age |
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Quarterly Premiums |
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| Under 40 |
$41.00 |
$53.75 |
$66.50 |
$83.12 |
| 40-49 |
51.00 |
67.00 |
83.00 |
103.75 |
| 50-59 |
60.80 |
80.40 |
100.00 |
125.00 |
| 60-64 |
89.20 |
118.20 |
147.20 |
184.00 |
| 65-69 |
117.20 |
155.40 |
193.40 |
241.75 |
| 70-74 |
136.00 |
180.40 |
224.60 |
280.75 |
| 75-79 |
157.20 |
208.40 |
259.60 |
324.50 |
| 80 and over |
Rates available on request |
FULL FAMILY PLAN: PRIMARY INSURED, SPOUSE & CHILDREN |
| Plan: |
C-3 |
D-3 |
E-3 |
F-3 |
| Pays Primary
Insured: |
$60/Day |
$80/Day |
$100/Day |
$125/Day |
| Pays Spouse: |
$45/Day |
$60/Day |
$75/Day |
$93.75/Day |
| Pays Children: |
$30/Day |
$40/Day |
$50/Day |
$62.50/Day |
| Age |
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Quarterly Premiums |
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| Under 40 |
$51.50 |
$67.50 |
$86.00 |
$107.50 |
| 40-49 |
61.50 |
80.75 |
100.00 |
125.00 |
| 50-59 |
69.20 |
91.40 |
113.60 |
142.00 |
| 60-64 |
98.00 |
129.20 |
160.40 |
200.50 |
| 65-69 |
126.00 |
166.00 |
206.00 |
257.50 |
| 70-74 |
145.40 |
191.60 |
237.60 |
297.00 |
| 75-79 |
166.40 |
219.40 |
272.00 |
340.00 |
| 80 and over |
Rates available on request |
*Covered dependents include children
between the ages of 14 days and 19 years of age (26 if unmarried in Utah) or if
a full-time student, to age 23 (age 25 in Georgia).
Policy exceptions
Benefits will not be paid under this Policy for Hospital Confinements caused by, resulting from or
contributed to by:
- Routine physical exams or Hospital Confinement for other than Injury
or Sickness, or which is not Medically Necessary;
- Intentionally self-inflicted injury, while sane or insane (Missouri
while sane);
- Treatment of a nervous or mental condition, alcoholism or drug
addiction;
- Injuries resulting from active military service (MN Only);
- Dental care, except as a result of injury to sound natural teeth (MN Only);
- Well-baby care of a newborn dependent child;
- Treatment or service rendered in any Hospital or Convalescent
Facility owned or Operated by the Federal Government where, in the absence of insurance, there is
no legal obligation to pay (Except SC);
- Declared or undeclared war or any act of war;
- Pregnancy (except Complications of Pregnancy, as defined in this
policy);
- Expenses incurred or care received outside of the United States (MN Only);
- Participating in a riot; or committing an assault or felony (MN Only).
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Download and print the Application Form for this plan.
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Send the completed Application and initial payment to:
AFA Veteran Benefits Association
Hospital Indemnity Program
Monumental Life Insurance Co.
PO Box 17480
Baltimore, MD 21298-8948

Click
here to have an information packet sent to you.
AFA Veteran Benefits Association
Hospital Indemnity Program
Monumental Life Insurance Co.
PO Box 17480
Baltimore, MD 21298-8948
Tel: 1-800-749-6983
E-mail: servicecenter@aegonusa.com |
This plan is underwritten and administered by Monumental Life Insurance Company, an
AEGON Company. Monumental Life is
(as of 5/30/07) rated “A+” (Superior 2 out of 16) by the A.M. Best Company, independent analysts of the insurance industry.
This rating attests to the company’s financial strength and operating performance. Monumental Life is rated “”AA” (Very Strong)
(as of 6/22/07) by Standard & Poor’s Insurance Rating Services. This rating refers to claims paying ability.
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