AICPA Insurance Programs

Catastrophe Major Medical is not accepting new applicants at this time.

Group Catastrophe Major Medical Insurance
Benefit Summary

Benefit	Amount Paid
Hospital Room & Board hospital's average charge for a semi-private room and all reasonable & customary hospital supplies & services, per day	100%*
Intensive Care hospital's average charge for an IC unit, including room & board, registered nursing care and special equipment & supplies on a standby basis, per day	100%*
Other Expenses anesthetics and their administration, x-ray services, lab tests & services, blood & blood plasma not replaced by donors, oxygen, use of radium & radioactive isotopes, chemotheraphy, preventive mammography & cytologic screening and prescription drugs	100%*
Psychiatric, mental, nervous or emotional disorders, alcoholism, or drug addiction while not hospitalized	up to $100 per visit ($5,000 lifetime maximum)
Physicians' Fees diagnosis, treatment, surgery	100%*
Pregnancy & Complications Of Pregnancy regular benefits apply	100%*
Private Duty Nursing (Medically necessary and given by a registered or licensed practical nurse)	up to $120 per 8-hour shift, not to exceed $360 per day ($35,000 lifetime maximum while insured)
Physiotherapy (by a licensed Physiotherapist)	100%*
Care in a Convalescent Home (must begin within 14 days after a hospitalization ends and be due to the injury or sickness which required the hospitalization)	up to $500 per week ($78,000 lifetime maximum while insured)
Home Health Care part-time or intermittent home nursing care, home health aide services, occupational, speech & respiratory therapy, medical social work, and special meals & nutritional services (must be in lieu of confinement in a hospital or skilled nursing facility and set up and approved by your physician and a home health care agency)	up to 100 visits per calendar year; 4 hours of home health aide services will be considered one home health care visit
Hospice Care	up to 210 consecutive days of confinement per benefit period & 5 visits per benefit period for bereavement counseling to the family
Dental Care Limitation charges incurred for dental care, treatment or surgery if such charges result from a non-job related injury to natural teeth, the injury is caused by an accident that occurs while the person is insured and such charges are rendered within 12 months of the accident or they are made by a hospital while the person is hospitalized TMJ (temporomandibular joint dysfunction): charges except for crowns or bridgework	100% 100%
Eye Care Limitation charges incurred for eye exams to prescribe or fit corrective lenses for eyeglasses if such charges result from a non-job related injury and the injury is caused by an accident that occurs while the person is insured	100%*
Cosmetic Treatment or Surgery Limitation charges that result from a non-job related injury or sickness or charges that result from a congenital disease or anomaly of a dependent child that results in a functional defect	100%*
Medical Equipment charges to buy, rent, repair or maintain artificial limbs, crutches, wheel chairs and other medical equipment, appliances & supplies	100%*
Ambulance Service Ambulance service to or from hospital	Up to $2,000 per benefit period

*100% of covered reasonable and customary charges

Other Features & Options:

Common Accidents If 2 or more insured members of your family are injured in the same accident, the following will apply: The covered charges incurred by each person due to the accident will be combined. If the total exceeds one deductible amount, no further deductible will be required for each person for any injury caused by the accident.

Medicare Parts A & B If you are a Medicare beneficiary, the plan pays as if Medicare is your basic plan.

Conversion of Coverage If your insurance ends for any reason other than failure to pay the premiums, you, your spouse and dependent children may buy an individual policy of medical care insurance from United States Life within 31 days after insurance ends. Evidence of insurability will not be required.

Continuation of Coverage If you die, your insured dependents may continue their medical care insurance provided the group policy remains in effect; your dependents remain eligible; and they pay their premiums when due. Insurance for a dependent child may be continued past the age limit if he/she cannot support himself/herself because he/she is mentally or physically handicapped. Premium payment will be required. Proof of the handicap must be provided.

Coverage not available in AZ, KY, MA, ME, OR, VT, WA, Puerto Rico and the US Virgin Islands.

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