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Short Term Medical

The Short Term Medical Plan provides health insurance coverage to healthy individuals and/or family members who need coverage for a short period of time. This includes individuals:

How the Program Works

Note: You must submit a new application to re-apply for coverage. Any condition, which occurred 12 months prior to the effective date of each new contract or period of coverage, will be considered a pre-existing condition and will not be covered under the new medical plan. This includes when re-applying for a second period of coverage. After the initial application and one subsequent renewal, a six-month waiting period will apply before you may enroll in Short Term Medical again.

Deductible Options
• Option 1 — $500 individual ($1,500 family)
• Option 2 — $1,000 individual ($3,000 family)
• Option 3 — $2,500 individual ($7,500 family)

Coinsurance
After the deductible is met the plan pays 80% of allowed charges for covered services, you pay the remaining 20% to an out-of-pocket maximum of $5,000 individual ($15,000 family).

Maximum Benefit Limit
The maximum benefit for each covered person is $2 million.

Covered Services
Benefits include, but are not limited to these services:

Exclusions

This description of some important features and exclusions of this benefit program is not a legal document. The contract sets forth in detail the rights and obligations of both you and Blue Cross and Blue Shield of Kansas.

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