November 1999
Society Catastrophe Insurance Provides $1 Million in Benefits
By Ed Parker
Today the cost of a serious illness or accident often is far beyond the benefits provided by the average hospitalization or major medical insurance policy. The NYSSCPA Catastrophe Major Medical Insurance Plan helps members in these times of need and offers up to $1 million additional coverage to cope with the burden of hospital, surgery, and doctor bills associated with a serious illness or injury.
Large hospital and medical bills can push medical expenses over the limit of basic insurance or even Medicare--especially costs associated with a nursing/convalescent home for custodial care. With medical costs continually rising, this plan provides enough coverage to allow for the care of a sick or injured Society member or their family. It guarantees coverage for residents of New York regardless of age. There are no medical questions to answer or physical exams to endure.
The plan pays up to 100 percent of all reasonable and customary eligible expenses, including daily hospital charges for a semi-private room, miscellaneous hospital service and supplies, and private duty nursing services (while in a hospital or at home); ambulance service; prescription drugs; diagnostic tests; hospice care; psychiatric, mental, nervous, or emotional illness; and casts, splints, braces, trusses, and crutches (both in and out of the hospital). If natural teeth are injured by a non-job related injury caused by an accident, the plan will provide for dental care, treatment or surgery, X-rays, physiotherapy, laboratory tests, and services for diagnosis and treatment.
The plan's nursing and home health care benefits, which are not included in many similar plans, pay up to $300 per week toward a nursing home stay beginning after 14 days of hospital confinement. This benefit provides coverage for up to 100 home health care visits per benefit period.
The deductible amount is the greater of $25,000 or the benefits provided by a basic health insurance plan. Most basic insurance plans usually cover the deductible, eliminating any out-of-pocket expense. Once the policyholder meets the deductible for each injury or illness, the plan pays up to 100 percent of the additional eligible expenses for the three-year benefit period, with a
$1 million lifetime benefit.
All NYSSCPA members and their spouses, parents, and parents-in-law are eligible to apply; parents and parents-in-law can apply even if the member does not. Coverage cannot be cancelled as long as premiums are paid, the policyholder remains an eligible member of the Society, and the group policy remains in force.
The Catastrophe Major Medical Insurance Plan is underwritten by United States Life Insurance Co., which has received an A+ (superior) rating for financial stability from A.M. Best & Co., a leading independent rating service.
For more information, contact NYSSCPA plan administrator Albert H. Wohlers & Co. at
(800) 900-9772, ext. 34309, and ask for account executive Dwayne Thompson. Members also can contact NYSSCPA Manager of Member Benefits Ed Parker at (212) 719-8382, (800) 633-6320, or eparker@nysscpa.org. *
