Group Hospital & Home Care Recovery Insurance Plan
The Hospital and Home Care Recovery Plan is designed to provide APWU members under age 75 with extra money to help cover the cost of hospital stays and recovery afterwards. This valuable plan pays a cash benefit in addition to any other health insurance you may have now. That extra money can be used towards medical and home care bills, or other expenses, such as groceries, utility bills, and daily living expenses.
For one affordable rate, you’ll be covered with:
- Up to $1,000 per hospital stay.
- Up to $4,000 each year for home care recovery. Typically less expensive than nursing home stays, in-home care can bring more personalized service and help people recover more quickly.
To keep your rates affordable, at age 80 the annual home recovery benefit maximum reduces to $2,000 year. Rates remain the same.
Acceptance is guaranteed for eligible APWU members. Both you and your spouse may be eligible for this valuable protection. There’s no medical exam or health questions, only one short application to fill out.
CURRENT 2021 BI-WEEKLY PREMIUM RATES
Covered Person's Age
70 - 74
75 - 84*
*For renewal only.
Rates may be changed by New York Life Insurance Company on any premium due date and any date on which benefits are changed. However, your rates may change only if they are changed for an entire class of insureds.
The rates are based on the covered person's age at issue and will increase according to the age groups shown in the above rate charts. For spouse coverage, locate the rate that corresponds to your spouse's age.
There is no termination age. Coverage will remain in effect as long as you continue to pay premiums when due, and remain otherwise eligible.
All rates are current as of 2021.
The Hospital and Home Care Recovery plan is available to APWU members under age 75 and their lawful spouses or domestic partners. Acceptance is guaranteed and there’s no medical exam or health questions to answer. PSEs, Associates and Retirees are also eligible to apply.
The cash payment you receive can be used to help pay medical bills or other costs like groceries, utility bills, and daily living expenses. For each covered hospital stay, you can receive the follow benefit:
|Duration of Hospital Stay||Lump Sum Payment|
|1 to 14 consecutive days, or||$300|
|15 to 30 consecutive days, or||$650|
|31 or more consecutive days||$1,000|
Home Recovery Benefits: In addition to the hospital benefits, if you are discharged from the hospital with a home health care plan of treatment approved by a doctor or Medicare, you are eligible to receive $100 per day for up to 20 days for covered services of an RN, LPN, licensed home health aide, homemaker, companion services, speech, occupational or physical therapy. Services must be received within 90 days of discharge after a covered hospital stay. If you are under age 80, you are eligible for two 20-day benefit periods for a total maximum benefit of up to $4,000 per year. For anyone age 80 or older, you are eligible for one 20-day benefit period for a total maximum benefit of up to $2,000 per year.
- a licensed institution primarily engaged in providing medical services for inpatients, if such institution has:
- permanent facilities for diagnosis and surgery, except that: The surgery requirement does not apply to a hospital which is: (1) primarily engaged in providing treatment of inpatients for mental disorders, chronic diseases, chemical dependency; or (2) rendering treatment or services for rehabilitation after an injury or sickness;
- 24-hour-a-day nursing service by registered professional nurses on duty or call; and
- continuous supervision by a staff of one or more doctors;
- a Christian Science sanatorium currently operated, or currently listed and certified, by the First Church Of Christ, Scientist, of Boston, Massachusetts; or
- a government approved institution or a government approved section of an institution primarily engaged in providing treatment of inpatients for chemical dependency.
References to hospital include: (a) a chemical dependency treatment center only while the treatment of chemical dependency is provided by such facility; and (b) a psychiatric residential treatment center only while the therapeutic care and treatment of mental disorder and nervous disorders are provided by such facility.
Hospital does not include a convalescent home, a nursing home, a rest home, a place for the aged or an
extended care facility.
Successive Periods of Confinement: Successive periods of confinement are treated as if they were one unless they are separated by 90 consecutive days during which you have not been confined to an institution for medical care or treatment or they are due to unrelated causes.
Exclusions & Limitations: At the time your coverage goes into effect, there are certain limitations to the coverage. Any pre-existing conditions you may already be receiving medical treatment for during the 12 months prior to your effective date will not be covered under this policy. Once you have been continuously insured under this policy for twelve months, these limitations do not apply.
Pre-existing Condition: Means an Injury, Sickness or Pregnancy or any related condition for which a person consults a doctor, receives medical services or supplies, or has taken any medication during the twelve month period, immediately before your coverage is effective It does not include any such condition after you have been continuously insured for twelve months.
Effective Date: Coverage will become effective on the first day the premium is deducted from your paycheck following date of approval. If you or your covered spouse is confined at home or a hospital on the date coverage would have been in effect, the insurance will be effective on the day the covered person is no longer confined and is still otherwise eligible.
When Coverage Ends: Coverage ends when your premium is not paid when due, when you request that coverage be terminated, or when the group policy is terminated. Spousal coverage ends when your coverage ends, unless your coverage ends due to death.
Your Evidence of Insurance: Once insured, you will receive a certificate of insurance evidencing coverage is provided under Group Policy G-29315-7.
Limited Benefits Health Insurance: The insurance described provides limited benefit health insurance only. It does not provide basic hospital, basic medical, or major medical insurance.
Not a Medicare Supplement Plan: This plan doesn’t provide Medicare supplement insurance, long term care insurance, nursing home insurance only, home care insurance only, or nursing home and home care insurance. If you are eligible for Medicare, contact your local Social Security office and request a copy of the Medicare Supplement buyer’s guide.
30-Day Free Look: You must be completely satisfied or you get a refund of premium. Once you receive your Certificate of Insurance, you have 30 days to review it. If you are not 100% satisfied, return your Certificate without claim. We will cancel your coverage and return any premium you have paid less claims paid.
The Hospital & Home Care Recovery Plan is not currently available in AZ, CA, CO, MN, MT, ND, NH, NM, VT, WA.
It’s Easy to Apply!
1. Simply complete the provided Group Hospital and Home Care Recovery Insurance application authorizing payroll deductions.
2. Return your application to:
The Voluntary Benefits Plan
P.O. Box 12009
Cheshire, CT 06410
Please call our office if you have any questions at:
Monday through Friday
8:30AM to 5:00 PM EST
You must notify The Voluntary Benefits Plan of any address change for you, your dependents and/or beneficiaries, and any change in employment and union membership status change, life status change (i.e., marriage, divorce, beneficiary or name change), or benefit changes requested. Notice must be in writing.
This is only a brief summary of benefits and is subject to the terms, conditions, exclusions, and limitations of group policy number G-29315-7. Complete terms and conditions are found in the group master policy and are summarized in your certificate.
The Voluntary Benefits Plan
P.O. Box 12009
Cheshire, CT 06410
Licensed Agent: David Generali. Connecticut State License #2322879
Agency Insurance License Numbers: AR: 045147, CA: 0791700
New York Life Insurance Company
51 Madison Avenue
New York, NY 10010
On Policy Form GMR
New York Life has received the highest possible financial strength ratings currently awarded to any U.S. life insurer from all four of the major credit ratings agencies: A.M. Best (A++), Fitch (AAA), Moody's (Aaa), Standard and Poor's (AA+). *
*As of 9/12/19
New York Life Insurance Company is licensed/authorized to transact business in all of the 50 United States, the District of Columbia, Puerto Rico and Canada. However, not all group plans it underwrites are available in all jurisdictions. New York Life Insurance Company’s state of domicile is New York, and NAIC ID# is 66915.
To find out more about your member benefits today, click here.