Hospital Accident Plan from Franklin Madison provides cash benefits to the insured in the event of hospitalization due to a covered accident.
Account Types
Share/Share Draft/Credit Card
Eligibility
- 18 or Older and a member of the Plan Sponsor
- No termination age, however, Daily Hospital Confinement (Injury), ICU and ER benefits reduce to 50% of Original Benefit at age 65 or older, and to 25% of Original Benefit at age 75 or older.
- Acceptance is guaranteed – no medical exams or physician statements required.
Cash Benefits
- Plan pays $900 per day for each day of hospitalization – up to 365 days for covered injury.
- Plan pays $1800 per day for each day in Intensive Care Unit – up to 365 days for covered injury
- Play pays $450 for emergency room treatment of a covered injury, once per accident, up to 365 days per year
Family Coverage
Spouse
- Emergency room benefit – $450 per day
- Daily Hospital Confinement – $450 per day
- Daily ICU Confinement – $900 per day
Dependent Child(ren)
- Emergency room benefit – $450 per day
- Daily Hospital Confinement – $225 per day
- Daily ICU Confinement – $450 per day
Additional Features
Inflation Benefit Rider – 10% for each year the Covered Person remains continuously covered under the Policy for a maximum of 5 years
Exclusions
As with all insurance programs, some exclusions apply, which are detailed in the Certificate/Policy of Insurance.
FAQs
Q: I have health insurance through my employer. Why do I need Hospital Accident Plan?
A: This insurance supplements your other coverage plans. In the event you are hospitalized because of an accidental injury, HAP pays you cash for each day you are hospitalized.
Q: Is the amount paid directly to the hospital or to my physician?
A: No. The cash is paid directly to you, unless you say otherwise, to spend any way you choose. It’s designed to help defray the cost of hospitalization or the incidentals that result from an unplanned hospital stay.
Q: Can I specify that the payment be paid directly to the hospital or to my physician?
A: Yes. You may designate a doctor, hospital, or anyone you choose.
Q: If I go to the hospital for elective surgery, can I file a claim?
A: No. This insurance pays for covered accidents only. Hospitalization due to sickness or disease is not covered.
Q: How much coverage can I get? Can I insure my family, too?
A: You can be covered up to $900 per each day of hospitalization; ICU benefits can cover you up to $1800 each day you are hospitalized. The emergency room benefit is $450. You may also choose single or family coverage, which protects your spouse and dependent children at a reduced benefit amount. See your Certificate/Policy of Insurance for specific amounts.
Q: Do I have to take a medical exam or answer a lot of health questions?
A: No. There are no medical questions or physical exams required to qualify.
Q: Can I be turned down for this insurance?
A: No. Your coverage is guaranteed provided you are 18 years of age or older.
Q: Is there an age cut off?
A: There is no termination age; however,
benefits reduce to 50% at age 65 or older, and reduce to 25% at age 75 or older.
Q: When does my coverage begin?
A: The effective date is shown on your
Certificate/Policy of Insurance.
Q: How long does it take before I receive my Certificate/Policy of Insurance?
A: It takes about 30 days from the time the enrollment form is received to process and issue the Certificate/Policy of Insurance.
Q: What if I decide to cancel?
A: If you choose not to keep your insurance, simply call toll-free 1-877-517-0555, and your insurance will be cancelled.
Q: How will I be billed?
A: If you are a share/share draft/credit card account holder, the premiums will automatically be debited from your account monthly. This transaction will be reflected on your statement.
Q: How do I file a claim?
A: Call toll-free 1-877-517-0555 weekdays, 7:00 a.m. to 8:00 p.m. CST. Or visit https://fmservices.com.
Q: How long will it take to process my claim?
A: The claims are processed within five days of the Plan Administrator receiving the appropriate information and documentation in their offices. Once processed, the claim is then forwarded to the underwriter for determination of benefits.
Q: How will my members identify the insurance coverage charge on their statements?
A: Franklin Madison Group is the third-party administrator for the insurance carrier providing premium billing and other services on behalf of the carrier. Franklin Madison facilitates the premium debit or charge and may be indicated on the bill. Please refer all insurance questions to Franklin Madison at 877-517-0555. For faster service, please provide the coverage ID located within the billing descriptor (9-digit number starting with 6 or 7). Or visithttps://fmservices.com.
Q: May my credit union representative call customer service on my behalf?
A: To maintain the privacy of the insured, information can only be provided if the primary insured is present to give consent.