HEALTH

Hospital Indemnity Insurance — Idaho

Hospital Indemnity Insurance is currently available through State Farm Mutual Automobile Insurance Company. Please read a brief description of the State Farm® Hospital Indemnity Insurance Policy available in Idaho.

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General Descriptions of Benefits

  • Daily Benefit: State Farm pays $250 for up to 365 days when you are confined to a hospital for which a charge for room and board is made, for treatment of a covered sickness or injury.
  • Intensive Care Benefit: State Farm pays an additional daily benefit of $250 for up to 14 days for the same or related condition when you are confined in an intensive care unit.
  • Extended Care Benefit: State Farm pays one-half of the daily benefit per day ($125) for up to 100 days per calendar year when you are confined in a qualified extended care facility. The extended care must begin within 30 days of a hospital confinement of at least three days and be for the same or related condition requiring the hospital confinement.
  • Emergency Accident Benefit: You will receive $250.00 for each day you sustain an injury and receive emergency medical treatment within 72 hours of the injury. Only one Emergency Accident Benefit is paid when multiple injuries are sustained as the result of any one accident. This benefit is payable up to a maximum of three times per calendar year per covered person.
  • Outpatient Surgery and Intravascular Catheterization Benefit: State Farm pays $250.00 for each day you undergo an outpatient surgical operation (as identified in the policy) or intravascular catheterization (as defined in the policy).

Benefits for outpatient surgery performed as the result of an injury are paid in addition to the Emergency Accident Benefit.

Only one Outpatient Surgery and Intravascular Catheterization Benefit will be payable when multiple, bilateral, or incidental procedures are performed during the same treatment session.

Exclusions, Exceptions and Limitations

This policy does not cover Confinement or expenses incurred as a result of:

  1. Injury or Sickness as the result of war, declared or undeclared, or any act or hazard of war;
  2. Normal pregnancy and childbirth; however, complications of pregnancy shall be considered as a Sickness;
  3. Elective abortions; however, elective abortions to preserve the life of the female upon whom the abortion is performed, shall be considered as a Sickness.
  4. Any attempt at suicide, whether sane or insane, or any intentionally self-inflicted injury;
  5. Routine well-baby care for newborn children;
  6. Mental or nervous disease or disorder for more than 30 days per calendar year for the same or related illness or illnesses.
  7. Cosmetic surgery, except that cosmetic surgery shall not include reconstructive surgery when the service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because of congenital disease or anomaly of a covered dependent child.

Pre-existing Condition Limitations. No claim for loss incurred by any Covered Person after twelve (12) months from the effective date of coverage of such person will be reduced or denied because a Sickness or physical condition not excluded by name or specific description effective on the date of loss had existed six (6) months prior to the effective date of coverage of such Covered Person. Contact your agent/producer for additional details and cost.

Disclosure

This is a supplement to health insurance and is not a substitute for major medical coverage. Lack of major medical coverage (or other Minimum Essential Coverage) may result in an additional payment with your taxes. If you do not currently have major medical coverage that qualifies as Minimum Essential Coverage under the Affordable Care Act, you are not eligible for this product.

If you currently have a health spending arrangement such as a Health Savings Account (HSA), or if you plan to open one in the future, please consult your tax advisor about the features offered in this supplemental medical policy, and the possible tax implications of combining these plans.

This is a marketing tool intended for use in the sale of insurance. Completion of an application for a State Farm insurance policy will require contact with a State Farm agent/insurance producer.

This information provides only a brief description of coverage. It is not a contract. A complete statement of coverage is found only in the Hospital Indemnity policy. See policy form 97024 ZID1 for exact terms and conditions.

State Farm Mutual Automobile Insurance Company
Bloomington, IL

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