Pennsylvania Residents Only
 
 

 
Consider A Short Term Medical Plan From Time Insurance Company
Time's Short Term Medical Prevents Financial Disaster
Even with the best planning, situations occur that result in interruptions in health insurance protection.
They Include:
  • Graduations
  • Career changes
  • New employee health benefit waiting periods
  • Strikes or layoffs
A brief interruption in health insurance can have long-lasting impact should an accidental injury or unexpected illness occur. 

Time's Short Term Medical Plan provides peace of mind when a temporary break in your health insurance could create permanent threat to your financial stability.
Time's STM is...
..EASY.. Don't forego health insurance coverage because you think getting health insurance is difficult.  That's not the case with Time's Short Term Medical.  All you need to do is print out the application, complete it, pay the premium due and coverage is issued.
..AFFORDABLE.. People between jobs think they cannot afford coverage.  This policy was designed to be affordable.  Four deductibles are available, $250, $500, $1000 and $2500.  You choose the deductible that meets your budget.  You select coverage for the exact number of days you need from 31 up to 185 days or choose the Monthy Payment Option, ideal for those or are unsure how long they will need temporary health coverage.  With regular premium payments you may keep the coverage for up to 185 days or lapse your plan if other coverage is secured.  The premium can be charged to your VISA, Mastercard or Discover account.
..CONVENIENT.. Time's Short Term Medical allows you to choose the hospital and doctors you prefer.
..PORTABLE.. Short Term Medical has no restrictions on where services are provided in the United States.
..COMPREHENSIVE.. Extensive benefits ensure that coverage is there when you need it most.  Our plan has a $2 million maximum benefit.  You don't need to worry if your insurance coverage is adequate.
Peace of Mind...Extended Benefits
Sometimes further treatment may be required after the policy period has ended.  If the deductible was met while the policy was in force, we extend up to $1000 for follow-up treatment for that condition, provided services are received within 60 days of the last day of coverage. 

If a policyholder becomes totally disabled as a result of a covered illness or injury during the policy period, coverage will remain in force for that individual until he or she is no longer totally disabled up to a maximum of 12 months or until the $2 million maximum benefit is reached.
Additional Plan Features:
Maximum Family Premium: Regardless of the number of children to be covered, the premium is capped at three dependents.
Maximum Family Deductible: A maximum of three times the deductible amount will satisfy the deductible requirements for all covered persons during a policy period.
Family Capping Maximum: There is a maximum "out of pocket" expense amount per family.  See policy for details.
Eligibility for Short Term Medical:
Healthy individuals between age 15 days and age 64 years and 11 months who have temporary need for health insurance are eligible.  Unmarried dependent children through age 19 ( age 24 if full-time student) may apply for coverage as dependents on their parent's plan.
Persons ineligible for coverage include persons who are: 
  • Unable to meet the requirements specified in the application for coverage.
  • Turning 65 years old or eligible for Medicare during the Benefit Period.
  • Pregnant.  If one family member is pregnant, coverage may not be offered to any family member.
  • Engaged in harzardous activities, sports or occupations.
  • Ineligible for a fully underwritten insurance plan due to health reasons.
  • Foreign visitors or non-U.S. citizens.
  • Seeking coverage while traveling outside of the United States.
Limitations and Exclusions
Time's Short Term Medical plan is non-renewable.  It is meant to bridge a temporary gap in health coverage. 

Short Term Medical is not designed to pay for injuries and illnesses that exist at the time the policy becomes effective.  Preexisting Conditions* are not covered.  Short Term Medical does not cover routine physical exams, normal pregnancy or child birth; mental illness; or changes incurred outside the United States, its possessions or Canada.  Other exclusions as well as other covered services are listed in detail in the policy you will receive upon purchasing Short Term Medical.
*PREEXISTING CONDITION: A sickness, injury, disease or physical condition: 1) for which medical advice or treatment was recommended by a physician or received from a physician within a 5-year period preceeding that Covered Person's Effective Date of Coverage.
AUTHORIZATION PROVISION: To be eligible for full benefits, ceratin medical services must be authorized by Time Insurance Company's trained medical staff.  Follow the instructions in the policy or on the ID card you will receive upon purchase.
REFUNDS: READ YOUR POLICY CAREFULLY. If you are not 100% satisfied with the policy, you can return it within 10 days for a full refund.  No questions asked!  After that time, refunds are not available.
PURCHASING A SECOND PLAN: Time's Short Term Medical Plan is NON_RENEWABLE.  However, if your temporary need continues you may apply for one addtional benefit period if: 
     1) No claims were incurred under a previous plan; 
     2) There has been no significant change in health; and 
     3) The total days of coverage for all plans does not exceed 365 days. 
A new application must be completed.  Should a second application be approved, a new plan will be issued.  THERE IS NO CONTINUOUS COVERAGE between the original and second plan.  Any conditions or syptoms which may have occured under the first plan  will be treated as preexisting under the second plan.
Here's how Short Term Medical works:
You select a deductible amount
$250
$500
$1000
$2500
The Deductible is per policy period
Once the per person deductible is satisfied, Short Term Medical pays 80% of the next $5000 of covered expenses.
Thereafter, Short Term Medical pays 100% of the remaining covererd expenses up to 
$2 million per person.
 
Here's What's Covered:
  • Semi-private hospital room rate and all routine services generally provided while confined in a hospital
  • Physicains visit
  • Drugs prescribed by a physicain
  • Miscellaneous hospital expenses
  • Surgery
  • Anesthesia services
  • Intensive care
  • Emergency Care
  • Outpatient services
  • X-rays and laboratory services
  • Office visits
  • Home health care
  • Ground or air ambulance services
  • Freestanding urgent care centers
  • Medical equipment and supplies, such as crutches
  • Additional benefits that your policy will clearly explain
ABOUT THIS WEB PAGE: This web page provides a brief description of important features of the Short Term Medical plan.  This is not an insurance contract, and only the actual contract will define coverage.  For an outline of coverage, contact your agent for Time Insurance Company.
When Coverage Becomes Effective:
Your coverage will take effect at 12:01 A.M. the day following your approved Requested Policy Date.
Since you are mailing your application, the earliest Policy Date that can be issued is the postmarked date affixed by the U.S. Post Office on the envelope containing your completed application and premium payment.
Application Instructions:
1. Complete all information, sign and date the application. 
2. Calculate the premium for the coverage of your choice.  Refer to Premium    Calculations Instructions listed further down this page. 
3. Mail the application along with your premium payment to your agent.
Make your payment to Time Insurance Company by check or money order. You may charge your premium to VISA, Mastercard, or Discover card.  Enter all digits of your credit card number and expiration date of your card on the lower left corner of the application.
Premium Calculation Instructions:
Choose the payment option that suits your needs; Single Payment or Monthly Payment.  Refer to the appropriate Rate Chart. 
 
Single Payment Calculation:
1. Refer to the column under the deductible of your choice.  Locate the age category and the premium indicated for each person to be insured. Enter premiums on lines A, B or C. 
2.  Add the premiums on lines A, B and C.  Enter the total on line D. 
3. Determine the number of days of coverage you will need.  Enter the number on line E. 
4. Multiply the Total Per Day (line D) by the Number of Days (line E).  Enter the Total Base Premium on line F. 
5. Locate the first three digits of your ZIP code on the ZIP Code Table below.  Enter the factor indicated to the right of that ZIP Code on line G. 
6. Multiply the Total Base Premium (line F) by the ZIP Code Factor (line G).  Enter the result on line H.  This is the Total Premium due with your completed application.		 A______________________ 

B +____________________ 
C +____________________ 

Child
D =____________________ 
Total Per Day
E x____________________ 
Number of Days
F =____________________ 
Total Base Premium
G x____________________ 
Zip Code Factor
H=____________________ 
Total Premium
 
Monthly Payment Calculation:
1. Refer to the column under the deductible of your choice.  Locate the age category and the initial 35-day premium for each person to be insured.  Enter premiums on lines A, B, or C. 
2.  Add the premiums on lines A, B and C.  Enter the total on line D. 
3. Locate the first three digits of your ZIP code on the ZIP Code Table below.  Enter the factor indicated to the right of that ZIP Code on line E. 
4. Multiply the Total Base Premium (line D) by the ZIP Code Factor (line E).  Enter the result on line F.  This is the Total Premium due with your completed application. 
5. To calculate the 30-day installment premiums, repeat steps 1 through 4 using the 30-day installment column on the Monthly Payment Rate Chart. 
 		 A______________________ 

B +____________________ 

 
C +____________________ 
Child
D =____________________ 
Total Base Premium
E x____________________ 
Zip Code Factor
F =____________________ 
Total Initial Premium
 
 
 
Zip Code Factor Table
Factor
*Pennsylvania
0.9
151, 152, 189, 193
1.0
194
1.2
190, 191
1.3
*If your ZIP Code is specifically listed, use the factor for Penna.
Single Payment Rate Chart
Rates are shown daily
Minimum coverage is 31 days, Maximum 185 days.
 
Age
 Gender $250 
Deductible		 $500 
Deductible		 $1000 
Deductible		 $2500 
Deductible
 0-24
 M 2.40 2.00 1.20 1.10
       0-24  F 2.10 1.90 1.20 1.00
25-29 M 2.20 1.80 1.10 1.00
25-29 F 1.90 1.70 1.10 0.90
30-34 M 2.20 1.80 1.10 1.00
30-34 F 2.30 2.00 1.30 1.10
35-39 M 2.70 1.90 1.20 1.10
35-39 F 2.50 2.20 1.40 1.20
40-44 M 3.20 2.10 1.30 1.10
40-44 F 2.70 2.40 1.50 1.20
45-49 M 3.90 2.20 1.40 1.20
45-49 F 3.00 2.60 1.60 1.30
50-54 M 4.40 2.60 1.60 1.30
50-54 F 3.60 3.10 1.90 1.50
55-59 M 4.90 3.10 1.80 1.50
55-59 F 4.40 3.80 2.20 1.80
60-64 M 5.40 3.90 2.20 1.90
60-64 F 5.70 4.90 2.80 2.30
1 Child ... 1.10 1.00 1.00 0.80
2 Children ... 2.10 1.90 1.90 1.50
3+ Children ... 3.00 2.70 2.70 2.20
 
 Monthly Payment Rate Chart
Initial Monthly Premium is Minimum 35 days.
Subsequent premiums are 30 days.
  $250 
Deductible		 $500 
Deductible		 $1000 
Deductible		 $2500 
Deductible
 
Age 
Gender.....
Initial 35
Day Prem.
30 Day
Install. Prem
Initial 35
Day Prem.
30 Day
Install. Prem
Initial 35
Day Prem.
30 Day
Install. Prem
Initial 35
Day Prem.
30 Day
Install. Prem
0-24 M 96.60 82.80 80.50 69.00 48.30 41.40 44.28 37.95
0-24 F 84.53 72.45 76.48 65.55 48.30 41.40 40.25 34.50
25-29 M 88.55 75.90 72.45 62.10 44.28 37.95 40.25 34.50
25-29 F 76.48 65.55 68.43 58.65 44.28 37.95 36.23 31.05
30-34 M 88.55 75.90 72.45 62.10 44.28 37.95 40.25 34.50
30-34 F 92.58 79.35 80.50 69.00 52.33 44.85 44.28 37.95
35-39 M 108.68 93.15 76.48 65.55 48.30 41.40 44.28 37.95
35-39 F 100.63 86.25 88.55 75.90 56.35 48.30 48.30 41.40
40-44 M 128.80 110.40 84.53 72.45 52.33 44.85 44.28 37.95
40-44 F 108.68 93.15 96.60 82.80 60.38 51.75 48.30 41.40
45-49 M 156.98 134.55 88.55 75.90 56.35 48.30 48.30 41.40
45-49 F 120.75 103.50 104.65 89.70 64.40 55.20 52.33 44.85
50-54 M 177.10 151.80 104.65 89.70 64.40 55.20 52.33 44.85
50-54 F 144.90 124.20 124.78 106.95 76.48 65.55 60.38 51.75
55-59 M 197.23 169.05 124.78 106.95 72.45 62.10 60.38 51.75
55-59 F 177.10 151.80 152.95 131.10 88.55 75.90 72.45 62.10
60-64 M 217.35 186.30 156.98 134.55 88.55 75.90 76.48 65.55
60-64 F 229.43 196.65 197.23 169.05 112.70 96.60 92.58 79.35
1 Child 44.28 37.95 40.25 34.50 40.25 34.50 32.20 27.60
2 Children 84.53 72.45 76.48 65.55 76.48 65.55 60.38 51.75
3+ Children 120.75 103.50 108.68 93.15 108.68 93.15 88.55 75.90
 Click here to go to the application page
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