ACONSUMERGUIDETOSHORT‐TERMLIMITED‐BENEFITHEALTHINSURANCEPLANS 3/15/2019
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QuestionstoAsk
IfyouarethinkingaboutpurchasingSTLDhealthinsurancecoverage,itisimportanttoask
questionsandtoconfirmthatthelanguageinthepolicyaddressesthoseissues.
WillthispolicycoverconditionsIalreadyhaveatthetimeIpurchasethepolicy?IfI
renewthepolicyorbuynewpolicies,willtheplanrenewal/extensioncoverconditionsI
developduringtheinitialpolicytermorwilltheconditionsbeconsideredpre‐existing
conditions?
Willthepolicycovermedicalcarethatisimportanttome,suchasprescriptiondrugs,
doctorvisits,emergencyroomvisits,hospitalization,laboratoryservices,imaging,
maternityandnewborncareormentalhealthdisorders?
Isthereawaitingperiodbeforetheplanwillcoverhealthcareservices?
Aretherelimitationsonthenumberofcoveredvisitsorthemaximumamountpayable
foraspecifictypeofservice?
Istherealimit(out‐of‐pocketmaximum)onwhatImayberequiredtopayduringthe
policyperiodformydeductible,coinsuranceandco‐payment?
Doesthepolicyincludeanannualorlifetimelimitontheamounttheinsurerwillpay?
DoIhavetojoinanassociationtopurchasetheSTLDplan?Ifyes,whatisthemonthly
costfortheassociation?
OtherThingsYouShouldKnow
10‐dayRighttoReturn.Whenyoureceiveyourpolicy,youshouldimmediatelyandcarefully
reviewthetermsandconditionstodetermineifthepolicymeetsyourhealthcareneeds.Ifthe
policyisnotrenewableandyoudecidethatyoudonotwantthepolicy,youhavea10‐dayright
toreturnthepolicyforafullrefund.
HealthCareAppeals.Ifyourinsurerdeniesyourrequestforahealthcareserviceordeniesa
claimforservicesthatyouhavealreadyreceived,youmayhavetherighttoappealthedenial.
Alongwiththepolicy,theinsurermustalsoprovideyouwithaHealthCareAppealsPacketthat
explainsyourappealrights.
InquiriesandComplaints.Ifyouhavequestionsorconcernsaboutshort‐termhealthinsurance,
youmaycontacttheArizonaDepartmentofInsuranceConsumerAssistanceSectionbye‐mail
state).IfyoubelievethataninsurancecompanyorinsuranceprofessionalviolatedArizonalaw,
pleasevisitourwebsitetohelpyoudeterminewhetheryoushouldfileacomplaintortakea
differentapproachtowardresolvingyourproblem.