Accident Medical Expense Plans

Metal Gap 2: Accident Medical Insurance

Guaranteed issue medical gap plan that provides lump-sum payment for covered critical illnesses as well as accident medical expense, and accident hospital confinement.

 

Your major medical plan could leave you responsible for deductible and coinsurance expenses in the case of a serious accident or illness. Metal Gap 2 offers options to complement your health plan in the event of a covered illness or accident.

 

Metal Gap 2 insurance includes accident and critical illness benefits to allow you to focus on your number one priority: getting better. Metal Gap 2 insurance provides benefits for covered accidents up to the selected maximum amount, or the actual expense you incur, whichever is less. Critical illness benefits provide a lump-sum payment that is sent directly to you and can be used for anything you choose, including:

 

• Out-of-pocket expenses

• Living expenses

• Lost wages

 

Critical illnesses and serious accidents are never expected. Metal Gap 2 provides you with additional coverage you need while recovering, and your acceptance is guaranteed!

 

. > View the Metal Gap Brochure

 

• Accident Medical Expense: Benefits are payable for covered charges incurred by a covered person due to injury up to the select maximum benefit amount, or the actual expense you incur, whichever is less. Charges are payable only for an injury for which the first treatment or service is incurred within the initial treatment period and for which expense for all treatment or service is incurred within the benefit period. No benefits are available beyond the benefit period.
• Accidental Death and Dismemberment: The benefit is paid when an accident results in death or a covered loss or dismemberment. The amount paid will vary based on the nature of the loss. This benefit is available once during the coverage period.
• Critical Illness: Covered critical illnesses include life-threatening cancer; heart attack; kidney (renal) failure which is independent of disease or bodily infirmity or any other cause; stroke; coma; coronary artery bypass graft; loss of sight, speech or hearing; major organ transplant; paralysis and severe burn. (Covered illnesses may vary by state.) The percentage of the benefit paid varies based on the illness diagnosed. In addition to the standard plan benefit, a critical illness benefit of $2,500 is available for each covered dependent child. Refer to the Critical Illness Indemnity Benefit Rider for complete details on each covered critical illness. In the event that a Covered Person is first Diagnosed with one of the conditions listed below during the first 30 days after the Covered Person’s Effective Date of Coverage, the benefit will be limited to the lesser of $500 or 10 percent of the total amount that would have been paid had the condition been diagnosed after 30 days of the effective date of coverage. Only those conditions listed in the Benefit Rider will be covered.
• Inpatient and Outpatient Surgical: The benefit is paid for a covered inpatient or outpatient surgical procedure to repair damage, control a disease or certify a diagnosis. One inpatient and one outpatient benefit are available per calendar year.
• Hospital Admission Benefit and Hospital Confinement Benefit: The first-day hospital admission benefit is available when admitted as an inpatient due to a covered accident or sickness. The daily hospital confinement benefit is paid for up to 10 days of a covered inpatient hospital stay. The first-day confinement benefit is available once per calendar year, and the daily confinement benefit is available for up to 10 days per calendar year.
• Availability – Metal Gap 2 is available in the following states: AK, AL, AR, AZ, FL, GA, HI, IA, ID, IL, IN, KS, LA, MD, ME, MI, MN, MS, MT, NC, NE, NM, NV, OH, OK, OR, SC, SD, TX, UT, WA, WI, WV, WY. Availability is subject to change.