Trustmark Hospital StayPay Insurance
For Trustmark Hospital StayPay® – Group insurance disclosures, click here.
Trustmark Hopsital StayPay® insurance marketing pieces and presentations provide a brief description of benefits under HII 119 and applicable riders CFR 119, CCR 119, FUR 119, IBR 119, ICR 119, RSR 119, SBR 119, TLR 119 and WBW 119. This hospital indemnity insurance policy/group certificate provides limited benefits that are the result of a covered accident or covered sickness. It is not a substitute for medical expense insurance, major medical expense insurance or a health benefit plan alternative. It does not provide comprehensive medical coverage. It is also not a Medicare Supplement policy, nor is it a policy of worker’s compensation. Please refer to your policy/group certificate and outline of coverage, if applicable, for complete information. Limitations on pre-existing conditions may apply. Benefits, definitions, exclusions, form numbers and limitations may vary by state. For costs and coverage detail, including exclusions, limitations and terms, see your agent or write the company. Underwriting conditions may vary, and determine eligibility for the offer of insurance.
No benefits will be paid for losses that are caused by or occur as the result of any of the following:
- A Pre-existing Condition as described and limited in this Certificate;
- Involvement in a war or act of war, declared or undeclared;
- Intentional self-inflicted injury or attempted suicide;
- Commission of or attempt to engage in criminal activity, whether convicted or not, or an illegal occupation;
- Participation in a riot;
- Riding in or driving any vehicle in a race, stunt show, or speed test;
- Engaging in recreational activities involving a high degree of risk, which involve speed, height, a high level of physical exertion, or highly specialized gear;
- Professional or semi-professional sports;
- Recreationally operating, learning to operate, or serving as a crew member of a recreational aircraft, or jumping or falling from any aircraft, including those that are not motor driven;
- Having cosmetic Surgery, cosmetic dental treatment, or other elective procedures that are not Medically Necessary (not including organ donation);
- Tubal ligation, vasectomy or infertility treatment;
- Treatment in a government hospital;
- Any treatment or Surgery considered Investigational or Experimental by the American Medical Association, the Health Care Finance Administration, or the Federal Drug Administration;
- Injury or sickness resulting from using or abusing substances that a reasonable person would understand is in a manner other than intended by the manufacturer, or the prescribing Physician;
- Care or treatment received outside of the covered geographical area, except as provided under Geographical Limitation;
- A newborn child’s routine nursing or well-baby care during the initial Confinement in a Hospital following birth.
- Normal childbirth, if specifically excluded by your policy.
Pre-existing Condition Limitation
No benefit will be paid for any loss incurred during the first 12 months after the Covered Person’s Effective Date which is caused by, related to, or resulting from a Pre-existing Condition.
If a Covered Person requires Appropriate Care due to a Covered Accident or Covered Sickness that begins while outside the covered geographical area, benefit eligibility will be limited to 14 days. After the 14-day period, the Covered Person will not be eligible for additional benefits until the Covered Person returns to the covered geographical areas. Covered geographical areas are the United States and its territories.
Trustmark® and Trustmark Hospital StayPay® are registered trademarks of Trustmark Insurance Company.
Underwritten by Trustmark Insurance Company, Lake Forest, Illinois.
This represents all possible exclusions and limitations that may apply. Actual exclusions and limitations may vary by policy. Your policy will contain exact details.
An A.M. Best rating is an independent opinion of an insurer’s financial strength and ability to meet its ongoing insurance policy and contract obligations. It is not a recommendation of the specific policy provisions, rates or practices of Trustmark. Trustmark is rated A- (4th out of 16 possible ratings ranging from A++ to Suspended).
Last Updated 8/14/2019