Advances in medicine and technology mean that medical treatments are more successful than ever before, and many injuries and illnesses are no longer fatal. But the costs of treatment, survival, rehabilitation, and recovery can be staggering — and even if you have excellent health insurance, the out-of-pocket expenses associated with just one major medical trauma could deplete your savings.
That's why MedCASH makes so much sense. It's supplemental insurance that can give you cash under two types of circumstances: (1) when you're hospitalized or visit the emergency room, or (2) when you're first diagnosed with any one of 17 eligible Critical Conditions.
MedCASH is not a reimbursement (or indemnity) plan; instead, cash benefits are paid directly to you based on your coverage amount. Cash benefits can also be used any way you choose, including to help cover any medical or personal expenses you may incur.
No one is immune to unexpected or critical illnesses. When they strike, it can be sudden and stressful. Having the security of extra discretionary cash can help ease the resulting financial burden as you consider your options for care and impending lifestyle changes.
With MedCASH, your whole family can get coverage — you, your spouse or Domestic Partner, and your dependent children under age 21 (or under age 27 if they're full-time students). You can then collect benefits any time that any of your covered family members has a qualifying hospital stay or first diagnosis. Like other ADA-sponsored insurance plans, the coverage you elect for yourself determines the coverage that your dependents may have.
First, you choose any Daily Benefit amount1 for your Hospital Coverage, ranging from $100 to $500. Then MedCASH can pay you cash in the amount of your Daily Benefit for each day you are hospitalized, up to 500 consecutive days in most cases.
| Two types of MedCASH coverage | |
|---|---|
| Hospital Coverage | Critical Condition Coverage |
|
Daily Benefit: Any amount you choose, from $100 to $500, paid per day of hospitalization Benefits payable for up to 500 days in most cases Cash benefits payable from your first day in the hospital Benefits for emergency room visits, outpatient surgery, cancer treatment, and other special circumstances |
Lump-sum benefit: Up to $50,000, paid upon first diagnosis of an eligible Critical Condition Basic coverage (10 times your Daily Benefit) automatically included in MedCASH coverage Optional coverage* at 50 times or 100 times your Daily Benefit Benefits for 17 qualifying Critical Conditions, including heart attack, stroke, life-threatening cancer, and HIV |
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*Optional coverage is subject to underwriting approval based on your responses to a brief medical questionnaire. |
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Because there is no waiting period for this coverage, you can get benefits quickly. In fact, your Daily Benefit is payable from the very first day2 of hospitalization. And no matter what Daily Benefit amount you select, it is automatically doubled3 when:
You can even receive benefits if you are hospitalized due to a mental or nervous disorder4 — for up to 100 days. And the following special circumstances can qualify you for 50% of your Daily Benefit:
Best of all, you decide how much Hospital Coverage you want — it is totally up to you. And if you elect coverage for your dependents, each covered family member will be eligible for the same Daily Benefit amount you choose. Note: Hospital Coverage is automatically provided for newborns at birth, even if you don't have dependent coverage. It lasts for 31 days and will cover any non-routine infant care.
Critical Condition Coverage is a new type of insurance that's designed to help protect you from the financial strain that can accompany surviving a critical illness. It's cutting edge coverage that isn't readily available yet in the United States. The ADA is among the first to make this breakthrough insurance available in a group policy.
| What qualifies as a Critical Condition? | ||
|---|---|---|
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Thanks to modern medicine, you are more likely than ever to survive life-threatening and catastrophic illness. But will your finances survive? The "CASH" in MedCASH can make out-of-pocket expenses and resulting lifestyle changes less burdensome on your family. Critical Condition categories* covered by the MedCASH Plan are:
*Critical Condition categories are fully defined in the Certificate of Insurance issued to Plan participants. Benefits are determined by meeting requirements of waiting period, first diagnosis, and survival period. Specific limitations and exclusions may apply. |
Most health insurance policies have a maximum dollar amount of benefits that can be paid on your behalf, and you could reach that ceiling surprisingly quick if you're critically ill. Of course, when your bills exceed that maximum, the remaining costs are your obligation. The cash benefits from your MedCASH Critical Condition Coverage can not only help you cope with the financial aftermath of such things as lengthy hospital stays and costly rehabilitation, but they can also give you more choices to pursue treatment and/or medical services you might not otherwise afford.
How it works: When you or a covered dependent is first diagnosed with one of 17 eligible Critical Conditions, MedCASH can provide you with a lump-sum cash benefit — to be used however you choose. Eligibility for benefits is subject to a brief waiting period (either 30 or 90 days depending on the Critical Condition), and the covered patient must survive the diagnosis by at least 30 days in most cases. Each of your covered family members under age 65 is eligible for the Critical Condition Coverage benefit.
Basic Critical Condition Coverage — 10 times the Daily Benefit amount you choose for your Hospital Coverage — is automatically built into the core MedCASH Plan, giving you up to $5,000 in Critical Condition Coverage. You can choose, however, to apply for Optional Critical Condition Coverage that is either 50 times or 100 times your Daily Benefit...and then you could receive a one-time, lump-sum cash benefit of up to $50,000. Note: Optional Critical Condition Coverage is subject to underwriting approval based on your responses to a brief medical questionnaire.
The amount of Daily Benefit you choose for Hospital Coverage determines the total amount of your Critical Condition Coverage. For example, if your Daily Benefit is $500, then your Basic Critical Condition Coverage would be 10 times $500 (or $5,000). If you choose Optional Critical Condition Coverage, you could have coverage of either 50 or 100 times $500, as illustrated in the table below. Your covered spouse or Domestic Partner can have either Basic Critical Condition Coverage or the same Optional Critical Condition Coverage you choose. All your covered dependent children will automatically have Basic Critical Condition Coverage.
| Relationship between Hospital Coverage and Critical Condition Coverage | |||
|---|---|---|---|
| Core MedCASH Plan | Optional Critical Condition Coverage | ||
|
Hospital Coverage
Daily Benefit |
Basic Critical
Condition Coverage |
Option 50
(50 x your Daily Benefit) |
Option 100
(100 x your Daily Benefit) |
| $100 | $1,000 | $5,000 | $10,000 |
| $200 | $2,000 | $10,000 | $20,000 |
| $300 | $3,000 | $15,000 | $30,000 |
| $400 | $4,000 | $20,000 | $40,000 |
| $500 | $5,000 | $25,000 | $50,000 |
The higher coverage is a very good value, and it makes sense when you consider the hefty out-of-pocket payments, extensive treatment, rehabilitation, or renovations that a critical condition may require.
One of the best features of the MedCASH Plan is that your Hospital Coverage can be renewed all the way to age 90 — which can really come in handy if your health deteriorates as you age. And your eligibility for benefits is not affected by any other insurance you may have, including Medicare. Critical Condition Coverage is renewable to age 65.
To renew your MedCASH coverage, you must simply remain an ADA member and pay premiums when due.
It's easy to get this supplemental medical insurance — especially because acceptance for Hospital Coverage and Basic Critical Condition Coverage is guaranteed without any medical exams. As long as you are an ADA member, actively working full-time, and are under age 60, you and your eligible dependents can enroll in the core MedCASH Plan and you cannot be turned down. All you need to do is complete an application.
Notes: 1. Optional Critical Condition Coverage is not guaranteed; coverage is subject to underwriting approval based on your responses to a brief medical questionnaire. 2. When you request coverage for your Domestic Partner, both of you must also submit a signed affidavit of Domestic Partnership.
1 Daily Benefit amounts are available in $50 increments from $100 to $500. After age 65, the Daily Benefit is $100.
2 A pre-existing limitation applies to Hospital Coverage.
3 Beginning at age 65, these Hospital Coverage benefits are payable at 100% and are not doubled.
4 Hospital benefits for mental/nervous disorders are payable up to a maximum of $300 per day.
5 Cancer treatment may include IV chemotherapy or radiation, provided on either an inpatient or outpatient basis.
6 Benefits are payable as long as care is ordered by your physician and occurs within 7 days of being hospitalized at least 3 days for the same condition. Post-hospital confinement or treatment does not include hospice care.
Please check Legal Notices for additional information pertaining to this Plan.