Short Term Medical - Frequently Asked Questions

How much does it cost?
Your age, the deductible level, rate of payment and the total number of days you choose for coverage will determine your premium. Refer to page 10 (Instructions for Calculating Your Policy Premium and Total Payment) and page 11 (Daily Rates) in the Plan Description and Enrollment form document on our web site to determine your total premium cost. Don’t forget to include the $20.00 application fee in the total premium payment.

How do I know which column to use to determine the daily rate for me and my spouse?
Any time you are covering two people (including the primary insured) on one application, you would use the two-party rate column. The single rate column is for one person (the insured) only and the Family rate column is for three or more family members to be covered under one policy.

The rate listed for my age is different than my spouse’s, which do I use?
You would determine the correct daily rate by locating the age range of the oldest person. For example if you are 25 and your spouse is 30, you would use the rates listed in the 30-34 age range.

Does this cover prescriptions?
If a prescription was written before the start of the Short Term policy, it will be considered treatment of a pre-existing condition and would not be covered. If it is a new prescription, written during the policy coverage then the total charge of the medication would be considered the same as charges for the office visit and would be applied to the deductible. You will need to submit a copy of the filled prescription record for consideration.

Can I fax the application to you?
We are not able to process the application until we receive the premium check or money order, and you will have to put that in the mail. Mail them in the same envelope so that they stay together. We will use the postmark on the envelope as our date stamp, and can give you the next day as your effective date.

Can you accept a faxed signature?
Yes. As in the case of a dependent who is away at college, they can sign the forms in the necessary areas and then fax them back to you for mailing with the premium check.

Can I pay month-to-month for a 185 day policy?
Yes, but it has to be an automatic payment with a Credit Card or EFT.

What does “Major Medical” mean?
The term Major Medical means that some sort of symptom must be present in order for your visit to be covered. Preventative care is not covered. Depending on the deductible amount you choose, it is likely that unless something major happens, the charges you incur will not be more than your deductible.

When will benefits be paid?
If you have medical services for a condition that occurs during the policy period, you may submit your itemized bills and related prescription receipts for the treatment rendered as a claim and they will be applied towards your deductible. Your deductible must be satisfied before any charges will be considered for benefit payment. Once deductible is satisfied your benefits will be based on the rate of payment that you choose and the usual and customary allowance per service rendered. Pre-existing conditions will not be eligible to apply to deductible or for any benefit payments.

Can I send a business check to pay the premium?
No. We can not accept business funds, including employer paid checks for the Short Term Medical policy unless the person purchasing the policy is the sole proprietor of the business and is purchasing for themselves. We can accept a letter from the agent or the business owner stating this is true.

What happens if I leave my state of residence?
Even though the brochure says available in Oregon or Utah only, that means that you must be a resident of Oregon or Utah in order to apply. The coverage is worldwide, but you must have an Oregon or Utah address to apply for the policy.

What if I am in another country and break my leg?
You will have to pay for the charges there and file the claim when you return. You will also be required to find translation services for the bills before submitting for consideration.

I submitted a claim on my Short Term Medical policy and it was denied due to lack of coverage. Why did this happen?
The most common reason this happens is because the provider sees the word Regence, and sends the claim to Regence BlueCross BlueShield of Oregon or BlueCross BlueShield of Utah instead of to the Short Term Medical claims office. If this happens they must re-send the claim to the Short Term Medical claims department. The Short Term Medical claims phone number and address are on your policy ID card. The Short Term Medical claims office is not set up to take claims electronically. Make sure the provider knows to send a paper claim.

Will this policy count as continuing coverage for HIPPAA?
We cannot guarantee that another carrier will take our policy as continuing coverage.

Can I buy this for my son/daughter who is away at college?
Yes. They will need to sign the application themselves, but if they put their Oregon or Utah address on the application we will accept it. Please be aware that if they are trying to establish out-of-state residency for their college, this policy may work against that.

How many days can I elect to have coverage?
30 to 185 days. The minimum amount of days is 30 and the maximum is 185. You can elect any number of days from the minimum and the maximum as noted.

My Short Term Medical policy is going to terminate next week, can I renew or extend it?
NO. The policy is not renewable and the coverage dates cannot be extended or decreased once it has been issued. Cancellation only can be done in the first 10 days after you receive your policy schedule and identification cards. All cancellations must be in writing and forwarded to our office in the 10 day free look period. The plan allows you to apply for a second policy during a 12-month period. You can do this by submitting another application and premium payment to our office. Any medical conditions that were considered under the first policy will be pre-existing to any additional policy.

When will my coverage become effective?
Your coverage will become effective on either the date after the envelope containing the application and premium payment is postmarked; or the date you elect on the application form, whichever is later. If you drop off your application and premium payment at the Customer Service desk in our office, your coverage will be effective the date after the Customer Service representative receives it or the date you elect on the application form, whichever is later. Coverage cannot become effective prior to or on the date it is mailed or dropped off.

If I am only enrolling my children, can I put them all on one application?
NO. A child cannot list a sibling as a dependent. Each child would be considered the insured and would need to have a separate application. The premium would be based on each child’s age and include the application fee. You can only list dependents when the insured is a parent or legal guardian and the child is under age 23 (under age 26 in Utah) and dependent on the insured for support.

If I split my family up into separate policies, do I have to pay an application fee for each policy?
YES. Each application submitted requires payment of the application fee as part of the premium.

Following is a very brief description of the important features of the policy. This is not the insurance contract and only the actual policy provisions will govern. Please refer to the policy for a detailed description of the rights and obligations of both you and Regence Life and Health Insurance Company.

 

This short-term medical policy is non-renewable.

Individual InterM^SM Medical Insurance