Hospital Income Insurance

Coverage Details

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Choose up to $600 a Day in Benefits

Choose a daily benefit from $100 to $600 a day, in $100 increments. This cash benefit can be paid directly to you or to anyone you choose for each day you or a covered dependent is confined to a hospital. And it can be used in any way you see fit… to help with out-of-pocket medical expenses, transportation to and from the hospital, private room upgrades, even to cover household expenses.

No Waiting Period or Deductible

Benefits are payable from the first day of hospital confinement due to a covered illness or injury, and they can continue for up to 365 days for each covered stay, subject to the pre-existing conditions limitation and terms of the Certificate of Insurance.

Double Benefits for First Day of Hospitalization

If you’re over 60, you can receive double your daily benefit for your first day of covered hospitalization. That’s as much as $1,200.

Emergency Outpatient Treatment

Your full daily benefit is payable for each covered visit to the emergency room — for up to five visits a calendar year, even if you’re not admitted to the hospital.

Observation Care

Receive your full daily benefit per visit, if you’re kept for observation without being admitted to the hospital. This benefit can be paid twice per calendar year, but it can’t be combined with other benefits if you are confined in-hospital, except if you and your insured spouse are involved in the same accident, or on the first day of hospital confinement if you are age 60 or older.

Outpatient Surgery Benefit

Receive your full daily benefit amount, up to five times per calendar year, for a covered medically necessary surgical procedure performed by a physician in a hospital or ambulatory surgical center.

Common Accident Confinement

Receive double your daily benefit amount, if both you and your insured spouse are hospitalized for the same covered accident. That’s up to $1,200 a day while you’re both hospitalized. For up to 365 days, if you’re under age 60, or up to 100 days, if you’re 60 or over.

Skilled Nursing Facility

If you’re age 60 or over and confined to a Skilled Nursing Facility, you’ll receive 50% of your daily benefit for up to 80 days, starting on day 21. Confinement must begin within seven days of a covered hospitalization or observation stay of at least one day.

Home Convalescence

If you and your covered spouse are age 60 or over and totally disabled (as defined in the certificate,) you can get help recuperating at home after a covered hospital stay of at least 10 consecutive days. You can receive 50% of your full benefit amount for either the number of days you were hospital confined or 30 days per calendar year, whichever is less.

Pregnancy

This plan pays 100% of your daily benefit amount for covered hospital confinement due to pregnancy. Benefits are subject to pre-existing condition limitations, but complications due to pregnancy are not subject to the pre-existing limitation.

Alcohol and Drug Abuse

Receive your full daily benefit amount for up to 30 days per covered stay, if you are under age 60 and confined to a hospital due to alcohol or drug abuse. Receive full daily benefit amount for up to 100 days if you are age 60 or older. Treatment in a residential facility is payable at 50% of your daily benefit amount for up to 30 calendar days a year.

Mental and Nervous Disorders

Receive your full daily benefit amount for up to 30 days per covered stay, if you are under age 60 and confined to a hospital due to mental and nervous disorders. Full daily benefit payable for up to 100 days if you are age 60 or older.

Underwritten By:

Underwritten by:

New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
Under Group Policy No. G-29346-1
On Policy Form GMR-FACE/G-29346-1

NEW YORK LIFE and the NEW YORK LIFE
Box Logo are trademarks of New York Life Insurance
Company. Other trademarks are the property of their
respective owners.

Your acceptance is guaranteed if you are a physician residing in the U.S. (see state availability) and Actively Engaged Full-Time (as defined in the Certificate of Insurance), or a physician under age 80 who retired for reasons other than illness or injury. You can also enroll your spouse or domestic partner under age 80 and your eligible, unmarried children under age 27. Florida residents: dependent children are eligible for coverage through age 26 or, if unmarried, through age 29. Dependent coverage is only available if you apply for coverage for yourself.

A pre-existing condition is an injury, pregnancy or illness, whether diagnosed or undiagnosed, for which you have consulted a physician, received medical services or supplies, or taken any medication within the 12-month period preceding the effective date of your insurance. (The 6-month period preceding the effective date for residents of AK, CA, IN, MT, NY, ND, OR.) Pre-existing conditions will not be covered until 12 consecutive months following the effective date of coverage. (6 months in CA and OR.) This limitation does not apply to complications of pregnancy.

Coverage will be effective on the date AMA Insurance receives your signed enrollment form, provided premiums are paid when due, except for physicians or covered dependents who are confined to a home, in a hospital, or other medical facility on that date. In that case, coverage will be deferred until the day after that confinement ends, provided the person is still eligible.

Coverage is provided as long as you remain an eligible member or eligible dependent, premiums are paid when due, and the group master policy remains in effect and is not amended to end coverage for your class of insureds, coverage will not terminate unless you request to end it. Dependent coverage ends when your coverage ends, premiums for dependent coverage are not paid, or the dependent ceases to be eligible.

The Policy does not cover: any loss caused or contributed to by war or act of war, whether war is declared or not, confinements which occur while not insured under the Policy; confinements that are not medically necessary; Hospital for which no charge is made that the Covered Person must pay; Confinement in a Residential Treatment Facility for Mental or Nervous Disorders or for any reason other than treatment for alcoholism or drug abuse; and Pre-Existing Conditions as defined.

This coverage is currently not available in MN, NH, TX, VT, and WA.

Carrier Information

Underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
On Policy Form GMR-FACE/G-29346-1
NEW YORK LIFE and the NEW YORK LIFE
Box Logo are trademarks of New York Life Insurance
Company. Other trademarks are the property of their
respective owners.

New York Life is licensed/authorized to transact business in all of the 50 United States, the District of Columbia, Puerto Rico and Canada.  Not all policies it underwrites are available in all jurisdictions.  Please check the applicable insurance brochures for current availability.  New York Life’s state of domicile is New York, and NAIC ID# is 6691 5.

AMA Insurance incurs costs in connection with providing oversight and administrative support from this coverage and is reimbursed for these costs.  The American Medical Association also incurs certain expenses in connection with the coverage and is reimbursed for such expenses.

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 benefits are subject to the terms and conditions of the policy.  Policy underwritten by New York Life Insurance Company.  Exclusions, limitations, reduction of benefits and terms under which the policy may be continued in full or discontinued are detailed in the Certificate of Insurance issued to each individual and complete details are in the Group policy issued to the policyholder.  This program may vary and may not be available to residents of all states.

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SMRU #1766472