Short Term Recovery
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When you're recovering at home after a hospital stay, you want to keep your self-reliance — stay in control of your healthcare choices — and get well quickly. But without a backup plan, you may find out too late that you can't afford the home recovery care you want. You could end up settling for home health care that's just not up to your standards.

You could use your savings or retirement income to help pay for home recovery care — or you can enroll in ROA's Short Term Recovery Insurance Plan (RecoveryCare). This member benefit was designed and negotiated to help with expenses Medicare may not cover. (Medicare covers a lot, but it was never meant to cover everything.)

RecoveryCare provides cash benefits. You or anyone you choose can collect right away... $200.00 a day cash benefits (up to $8,000.00 a year* to a maximum of 40 days per accrual year) starting with your first home health care treatment. Plus, you'll lock in up to $1,450.00 cash benefits for every Inpatient Hospital and/or Skilled Nursing Facility stay for a covered Injury or Sickness - even if you don't need home health care afterwards. After your first day of an Inpatient Hospital stay you'll collect $750.00. After a 14 day Inpatient Hospital stay, you'll get an additional $500.00. After 30 days in the Hospital as an Inpatient, you'll collect another $200.00. The Recovery benefit is provided for the following services including physical therapy, occupational therapy, speech therapy,nursing care, companion services, home health and homemaker services.

* At age 80, the Home Recovery Benefit would reduce to an annual maximum of $4,000 for covered services.

How to Enroll

To enroll for coverage, contact Mercer Consumer. Or, to speak to a customer service representative call
1-800-247-7988

Coverage may vary and is not available in AZ, ID, LA, MN, MT, NV, NM, OR, SD, VT, WA and WV.

 

Valuable Protection

RecoveryCare pays cash benefits if you're admitted to the Hospital as an inpatient for a covered Injury or Sickness. Then, it provides a benefit that helps pay for home healthcare expenses when you're recovering at home after the Hospital stay. You'll receive benefits for physical, speech, and occupational therapy. Benefits would be payable for nursing services by a Registered Nurse (RN) and Licensed Practical Nurse (LPN).
In some cases, you may need personal care after your Hospital stay as well. RecoveryCare provides a benefit that can help pay for a home health aide to assist you with items such as bathing and getting dressed. It can even help pay for homemaker services if you need someone to help with the laundry, shopping, cleaning, and cooking.

Pays in Addition to Medicare and TRICARE For Life

Although TRICARE For Life (TFL) and Medicare are generous in what they pay for, they don't cover everything.
For example, Medicare only covers intermittent and part-time care. In addition, it does not cover 24-hour care or homemaker services. If you need more home health care than what Medicare covers, you may have to choose between paying for it yourself or going without it.
RecoveryCare was specifically designed to provide benefits to help pay for costs caused by a Hospital stay and recovery period. These costs include homemaker services not considered "necessary" by your doctor, gas and other travel expenses to see doctors, as well as over-the-counter medications and supplies not covered by a health insurance plan.

If you're Medicare eligible, as long as Medicare approves just one home healthcare expense for you, ROA's RecoveryCare Plan pays.

Coverage You Can Count On

The RecoveryCare Plan pays benefits for your hospitalization and your recovery afterward:

  • ROA Hospital and/or Skilled Nursing Facility Benefit: You'll collect $750.00 when you're admitted to a Hospital for at least one day, regardless of whether you need home recovery care later. If your Hospital stay exceeds 14 days, you'll get an additional $500.00. After 30 days in the Hospital, you'll collect another $200.00. That's up to a maximum of $1,450.00 per year. Time spent as an inpatient in a Skilled Nursing Facility is also included for the purpose of calculating the Hospital benefit. Plus, your ROA Hospital Benefit is unlimited in the number of times you can collect it. For example, if you're hospitalized three times in one year, you'll collect at least $750.00 each time.
  • Home Recovery Care Benefits: You'll collect $200.00 a day for each day you incur a covered home healthcare expense. Benefits are paid for two benefit periods, up to 40 days per Accrual Year.* (There is a maximum of 20 days per occurrence.) That's a maximum of up to $8,000.00 a year for members under age 80 (up to $4,000.00 a year for members age 80 and over) you won’t have to pay out of pocket for the home recovery care you need. 

Your Acceptance is Guaranteed

All ROA Members and their spouse who are age 65 or older and enrolled in Medicare or TRICARE are guaranteed acceptance into the RecoveryCare Plan. This means that insurance benefits payable are subject to your policy's Pre-Existing Conditions Limitation.
You'll have protection for new health conditions right away. Any pre-existing health conditions are not covered for 6 months, or until you've gone 6 months without treatment, whichever is sooner.
Please note: We're hopeful acceptance into the RecoveryCare Plan will always be guaranteed. However, it's unclear whether health questions or other underwriting will be necessary in the future for you to qualify.

You Pay Economical Group Rates

Thanks to the group purchasing power of more than 66,000 ROA Members, you can take advantage of the RecoveryCare Plan at the economical rates listed below.

Monthly* Group Rates

 

Age

Member or spouse

65-69

$19.95

70-74

$27.95

75-79

$39.95

 80-84*

$39.95

85+**

$47.95

*You'll be billed quarterly. If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option. You cannot be singled out for a rate increase. Your rates will not be increased or decreased unless they are increased or decreased for everyone in your classification or age group. Rates are based on your attained age and increase as you enter a new age category.
** At age 80, Home Recovery Care Benefits reduce to $200.00 a day for up to 20 days per year. The ROA Hospital Benefit remains the same and remains unlimited, regardless of how many times you're admitted to a Hospital.

Your Protection Can Start Right Away

Your ROA Short Term Recovery Plan will start the first day of the month after we receive your Enrollment Form and first premium payment (subject to the Pre-Existing Condition Limitation.)

Your Protection Won't End Because of Your Health or Age

You can keep your RecoveryCare Plan as long as you want. It won't end due to age, unlike many other insurance plans on the market. At age 80, home health benefits reduce from a $8,000.00 per year maximum to a $4,000.00 per year maximum. As long as the Master Policy remains in force, you only need to pay your premiums when due and remain an ROA Member to keep your protection in place. Your spouse’s coverage ceases when your coverage terminates; premiums are not paid; the Master Policy is no longer in force; or they become legally separated or divorced from you.

You Get Top-Notch Service

Whenever you have questions about your RecoveryCare Plan, simply call our toll-free helpline at
1-800-247-7988. If you have a question like how to submit a claim or about your premium status, our phone system will handle it quickly and efficiently.
If you have a more difficult question, you'll talk to a helpful RecoveryCare Plan expert. Our experts know the Plan inside and out and will make sure you get the answers you need.
 

Other Important Information About This Coverage


Pre-Existing Condition Limitation

A Pre-existing Condition means any Injury or Sickness, diagnosed or undiagnosed, for which medical care is received by a covered person within the 6-month period prior to the covered person's effective date of insurance.

For the purposes of this limitation, we will consider:
       a)  Medical care received when:
            1) a physician is consulted or medical service is given; or
            2) treatment is recommended or prescribed by, or received from a physician
       b)  Treatment to include but not be limited to, any:
            1) medical examination, test, attendance, or observation;
            2) medical services, supplies or equipment, including their prescription or use; or
            3) prescribed drugs or medicines, including their prescription or use.

All manifestations, symptoms, or findings which result:
       a) from the same or related accident or sickness; or
       b) from any aggravations of accident or sickness;
are considered to be the same accident or sickness for the purpose of determining a
Pre-Existing Condition.

Conditions Prior to Effective Date: During the first 6 months of a covered person's insurance, losses incurred for Pre-Existing conditions are not covered. This will not apply to a loss that the covered person incurs after being free of medical care for the condition for a 6-month period (ending any time on or after his or her effective date).

Exclusions and Limitations

This Plan does not cover intentionally self-inflicted injuries, suicide or attempted suicide, whether sane or insane (while sane in Missouri or Colorado).

Definitions

A Hospital or a Skilled Nursing Facility does not mean any institution or part thereof used principally as a rest home, a home for the aged, or a place for custodial care; or a place for the care of drug addicts, alcoholics, or the mentally ill.
Confined or Confinement means being an Inpatient in a Hospital due to Sickness or Injury.
Periods of Confinement in a Hospital separated by less than 90 days and due to the same or related causes are considered part of the same period of confinement.

This limited health benefit plan (1) does not constitute major medical coverage, and (2) does not satisfy the individual mandate of the Affordable Care Act (ACA) because the coverage does not meet the requirements of minimum essential coverage.

Eligibility
Where available This plan is not available in AZ, ID, LA, MN, MT, NM, NV, OR, SD, VT, WA and WV
Notes Association members and spouses age 65 and over are eligible.
Details
  Summary*
Type of Insurance Hospital Income and Short Term Recovery
Designed For Association members and spouses age 65 and over
Form Number SRP-1151 A (HLA) (5338)
Group Policy Number AGP-5338
Issue Ages 65 and above
Underwritten By Hartford Life and Accident Insurance Company
*This is a listing of highlights for the above Insurance plan. Be sure to review the entire web site for a detailed plan description.

 

IMPORTANT NOTICE TO PERSONS ON MEDICARE
THIS INSURANCE DUPLICATES SOME MEDICARE BENEFITS

This is not Medicare Supplement Insurance

This insurance pays a fixed dollar amount, regardless of your expenses, for each day you meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.

This insurance duplicates Medicare benefits when:

  • any expenses or services covered by the policy are also covered by Medicare.

Medicare generally pays for most or all of these expenses.

Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

  • hospitalization
  • physician services
  • hospice
  • other approved items and services

Before You Buy This Insurance

Check the coverage in all health insurance policies you already have.

For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.

For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

 PA-9055

 

Answers about the plan, including eligibility, options, enrollment, customer service and more.

Issuance of this policy is handled over the Internet and the mail. You can review the materials in the privacy of your home and purchase your policy directly through the mail without meeting with an agent. You can, of course, talk to a licensed representative if you'd like. Please click the Contacts section for the toll-free number.
To learn more about the Short Term Recovery Plan, contact the Plan Administrator, Mercer Consumer toll-free at 1-800-247-7988, or download an application and brochure by clicking on the link at the top of this page.
To enroll for coverage, download an enrollment form by clicking on the link at the top of this page, or to speak to a customer service representative, call our toll-free number: 1-800-247-7988

The Short Term Recovery Plan pays you or anyone you choose cash benefits once you're admitted to the Hospital as an inpatient.

This plan also pays a cash benefit for each day a covered home health care expense is incurred when you're recovering at home after the hospital stay. You'll receive benefits for physical, speech and occupational therapy. Benefits would be payable for nursing services by a Registered Nurse (RN) and Licensed Practical Nurse (LPN) .

In some cases, you may need personal care after your hospital stay as well. The Short Term Recovery Plan can be used for a Home Health Aide to assist you with items such as bathing and getting dressed. It could even help with homemaker services if you need someone to help with your laundry, shopping, cleaning and cooking.

Your protection starts as soon as the first day of the month after we receive your Confirmation Form and first premium payment.

The plan would pay cash benefits for your hospitalization for a covered sickness or injury and your recovery afterward:
Hospital Benefit: You'll collect $750 when you're admitted to the Hospital as an inpatient for at least one day, regardless of whether you need home recovery care later. If your hospital stay exceeds 14 days, you'll get an additional $500. After 30 days in the hospital, you'll collect another $200.

Home Recovery Care Benefits: You'll collect $200 a day for each day you incur a covered home health care expense. Benefits are paid to you or anyone you choose for benefit periods up to 40 days per Accrual Year. * (Maximum of 20 days per occurrence.)

That's up to a total of $8,000 per year. You won't have to pay out of pocket for the home recovery care you need. Plus, your Hospital Benefit is unlimited in the number of times you can collect it. For example, if you're hospitalized three times in one year, you'll collect at least $750 each time.

Conditions for which you've received medical care or treatment in the 6 months before your effective date will be covered after you've been in the plan for 6 months; or when you've gone 6 months without treatment for the condition, whichever is sooner.

* At age 80, Home Recovery Care Benefits reduce to $200 a day for you up to 20 days per Accrual Year (one benefit period and an annual maximum of $4,000).

You will have 30 days from the date of receipt to review the insurance certificate. If you are not satisfied with the terms of the certificate, simply return it to the Insurance Administrator and any premiums paid will be refunded in full, minus any claims paid.
You can keep the Short Term Recovery Plan as long as you want. Your coverage won't end due to age. At age 80, home health benefits reduce from a $8,000.00 per year maximum to a $4,000 per year maximum. As long as the Group Master Policy remains in force, you only need to pay your premiums when due and remain an association member to keep your protection. A member's spouse's coverage ends when the member's does and when premiums are not paid. Your spouse can not be legally separated or divorced from you.
All members, over age 65 and their spouse, are guaranteed acceptance into this plan. This plan is yours for the asking. You have to satisfy the Waiting Period for Pre-Existing Conditions.
We're hopeful it will be. However, because this is a new plan, it's unclear at this point whether underwriting will be necessary in the future for you to qualify. This means now is the perfect time to get in on the plan, when you can't be turned down (subject to Pre–existing Conditions Limitations).

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

ROA Short Term Recovery Claim Form

Insurance Enrollment Form and Brochure (Plan not available in AZ, ID, LA, MN, MT, NV, NM, OR, SD, VT, WA and WV.)

 



Download Adobe Acrobat Reader

We're here to help! Please contact us in whatever manner is most convenient for you.

Program Administrator

Mercer Consumer
12421 Meredith Drive
Urbandale, IA 50398
Phone: 1-800-247-7988
E-mail: roa.service@mercer.com
Hours: 7 am to 5 pm M-F (Central)
Web site: http://www.mercer.com

Insurance Company

Hartford Life and Accident Insurance Company
200 Hopmeadow Street
Simsbury, CT 06089
Web site: http://www.mercer-web.com/products/thehartford.html

Important Notes:

This web site explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this web site and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

SRP-1151 A (HLA) (5338)

Insurance Application and Brochure Download

Our Role & Compensation

Details of Mercer disclosure of the compensation.

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