For AFA and AFAVBA Members
Hospital Indemnity Plan

bullet pays you up to $125.00 each day that you are hospitalized starting with day one
bullet pays you up to $375.00 each day that you are in the hospital for cancer treatment
bullet pays you up to $375.00 each day that you are in an intensive care unit
bullet pays you $60 for each treatment received in a hospital emergency room, with a calendar year maximum of 5 treatments.
bullet no medical exam...no health questions
bullet no deductibles

Pays you up to $125 each day (for up to 90 days) that you are hospitalized due to a covered 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. The hospital emergency room has 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 or anyone you choose, 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, except in the case of multiple Monumental Life Insurance Co. Hospital Indemnity Policies. If you hold more than one policy with Monumental, benefits will only be paid once.

Pays you full benefits even if you are hospitalized in a U.S. Government facility.


YOUR AFAVBA Guarantees

Members 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!

TABLES OF BENEFITS AND QUARTERLY PREMIUMS

INDIVIDUAL PLAN
Plan: C-1 D-1 E-1 F-1
Pays Individual: $60/Day $80/Day $100/Day $125/Day
Age  

Quarterly Premiums

 
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
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  

Quarterly Premiums

 
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  

Quarterly Premiums

 
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). Dependent care coverage requirements vary by state. See your policy for details.

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);
  • 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).

How to Apply

  1. Download and print the Application Form for this plan.
  2. Send the completed Application and initial payment to:
    AFA Veteran Benefits Association
    Hospital Indemnity Program
    Monumental Life Insurance Co.
    PO Box 1341
    Valley Forge PA 19482-9946

Insurance Claim Filing Instructions

Click here to have an information packet sent to you.


AFA Veteran Benefits Association
Hospital Indemnity Program
Monumental Life Insurance Co.
520 Park Ave
Baltimore MD 21201

Tel: 1-800-749-6983
E-mail: servicecenter@aegonusa.com
This plan is underwritten and administered by Monumental Life Insurance Company, an AEGON company.

 

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