Educational overview

Short-Term Medical & Hospital Indemnity

How these plans work — separately or together

Presented by 30A Health Insurance | Licensed insurance agency | 30ahealthins.com

IMPORTANT: This is a short-term, limited-duration policy, NOT comprehensive health coverage. This is temporary, limited coverage. It has fewer benefits than comprehensive health insurance, and coverage lasts only for a limited time. This coverage is not required to comply with federal requirements for individual health insurance, principally those in the Affordable Care Act. It is generally not Minimum Essential Coverage. Check the policy for exclusions and limitations, including preexisting conditions, hospitalization, emergency services, maternity, preventive care, prescription drugs, and mental health and substance use disorder services. If this coverage ends, you may have to wait until Open Enrollment to get other coverage. You may be able to get more comprehensive coverage, including Marketplace, Medicaid, or CHIP. Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325).

IMPORTANT: Hospital indemnity / fixed-benefit coverage is a limited-benefit policy, NOT health insurance. These policies may pay a limited dollar amount if you have a covered event (such as a hospital stay or a doctor visit, depending on the plan). You are still responsible for costs the policy does not pay. This is not a substitute for comprehensive health insurance, is generally not Minimum Essential Coverage, and does not have to include most federal consumer protections that apply to comprehensive coverage. Benefits, waiting periods, preexisting-condition limits, and exclusions apply. Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325).

Slide 2

What you will learn

What short-term medical (STM) is — and what it is not
What hospital indemnity / fixed-benefit coverage is — and what it is not
How the two can work on the same medical event without replacing each other
Two Allstate Health Solutions options on this site: Short-Term Medical, and Medical Expense Shield (Aetna network)
UnitedHealthcare UHOne (Golden Rule): short-term health insurance and fixed-benefit insurance — used separately or together
A simple “which may fit” guide — not a recommendation

This is general education. It is not a policy, quote, diagnosis, or advice. Only the issued policy controls benefits. A licensed agent must confirm what is for sale in your state.

Slide 3

Two different kinds of coverage

Short-Term Medical (STM)

Temporary medical expense coverage for a limited term
After you meet a deductible, the plan may pay a share of covered bills (for example 50%, 80%, or 100% — plan-specific)
Usually uses a provider network for discounted rates
Typically does NOT cover preexisting conditions
Not ACA coverage. Not Medicaid. Not Medicare.

Hospital indemnity / fixed-benefit

Limited-benefit insurance that pays a SET cash amount for a covered event or service
Payment is generally the scheduled amount — not “whatever the bill is”
Often paid to YOU; you can use it toward deductibles, coinsurance, or other expenses
May have little or no deductible on the cash benefit itself
Not a replacement for major medical insurance

Think of STM as help with a covered medical bill. Think of indemnity as a scheduled cash benefit if a covered event happens. They solve different problems.

Slide 4

How STM and indemnity can work on the same event

1

You have a covered hospital stay or medical service

2

STM (if the service is covered and in force) applies its deductible, coinsurance, network rules, and exclusions to the medical bill

3

The indemnity / fixed-benefit plan (if the event is covered and in force) pays its scheduled cash benefit — generally regardless of what STM paid

4

You remain responsible for any remaining medical bills and for any costs neither plan covers

Illustration only — not a quote or guarantee

Example of the idea, not real benefits:

Hospital bill: $40,000
STM may pay part of covered charges after its deductible and coinsurance
Indemnity may pay a set amount (for example, a per-admission and/or per-day cash benefit — amounts vary by plan)
That cash can help with the STM deductible, coinsurance, travel, or other bills
It will not automatically equal your out-of-pocket cost

These are usually SEPARATE policies. Buying both does not turn them into ACA coverage, does not add preexisting-condition coverage if the policies exclude it, and does not remove exclusions.

Slide 5

Please read this before comparing carriers

Important product limits to understand

They are not required to cover ACA essential health benefits
They generally exclude preexisting conditions (definitions and look-back periods vary)
They may exclude or limit maternity, mental health, substance use, prescription drugs, and preventive care
They can deny applications based on health history (medical underwriting is common)
They are not Minimum Essential Coverage
They are not guaranteed renewable like many ACA plans
Short-term plans expire; you may not be able to buy another term, and a new illness can become a preexisting condition on a later application
Using an out-of-network provider can increase what you owe
State law controls maximum term, renewals, and whether a product may be sold to you

Slide 6

Allstate Health Solutions — Short-Term Medical

Temporary medical-expense coverage for a coverage gap

Intended to help with unexpected covered illness or injury while you are between comprehensive plans, waiting for a job-based plan, or waiting for Open Enrollment
Typically offers a choice of term length, deductible, and coinsurance (options vary by state)
After the deductible, the plan may pay a percentage of covered expenses — doctor visits, diagnostic testing, hospitalization, and surgery, when covered
Access to a national PPO network; Allstate STM commonly uses Aetna Open Choice® PPO in many markets (confirm in your quote)
Some plans include features such as telemedicine or an urgent-care copay — only if listed in the policy
Underwritten. Preexisting-condition limitations apply.

Consider learning more if you need short, temporary coverage, can budget for a deductible, and mainly want help with a new, unexpected medical bill — not ongoing treatment of a known condition.

Slide 7

Medical Expense Shield (MES)

Two policies working together — STM + a fixed-benefit plan — Aetna network

MES is not a third type of insurance. It is a package: a Short-Term Medical policy plus a separate fixed-benefit (indemnity-style) policy
Usually one application, one premium, and one ID card — still two contracts
The fixed-benefit side is designed to pay scheduled, first-dollar cash benefits for covered services from day one (no deductible on that cash schedule)
Money you spend out of pocket on care may also count toward the STM deductible (see the policy)
After the STM deductible is met, the STM side may pay a high percentage of most remaining covered services for the rest of the term; the fixed-benefit side can keep paying its schedule
STM portion commonly uses the Aetna Open Choice® PPO network
Two fixed-benefit levels are typically offered (names such as Covered Core and Covered Plus). Benefits, maximums, and deductibles are plan- and state-specific.

Consider learning more if you want temporary STM and a cash-benefit layer in one package, and you want Aetna PPO access — especially if a stand-alone STM deductible would be hard to fund without a cash benefit.

Slide 8

How the two Allstate options differ

	Allstate STM only	Medical Expense Shield
What it is	One short-term medical policy	STM policy + separate fixed-benefit policy, sold together
How bills are helped	Share of covered medical expenses after deductible/coinsurance	STM share of covered bills PLUS scheduled cash benefits
Cash to you?	Generally pays toward covered provider bills per the STM contract	Fixed-benefit side pays scheduled amounts; STM side works like STM
Deductible experience	You typically meet the STM deductible before coinsurance help	Cash benefits may start before the STM deductible is met; out-of-pocket may still apply to the STM deductible
Network	Commonly Aetna Open Choice® PPO (confirm)	STM portion commonly Aetna Open Choice® PPO (confirm)
Complexity	Simpler: one policy	Two policies, one package — read both contracts
Who often compares it	Shorter gap; can fund a deductible	Wants first-dollar cash help and STM together

MES is not "STM with no deductible." The STM policy still has a deductible. The extra policy is a limited cash benefit.

Slide 9

UnitedHealthcare UHOne — a different carrier family

Short-term health insurance and fixed-benefit health insurance

UHOne individual products are typically underwritten by Golden Rule Insurance Company, a UnitedHealthcare company
Two different products (not one combined name): 1) Short-term health insurance — temporary medical-expense coverage; 2) Fixed-benefit health insurance (including products such as Health ProtectorGuard®) — scheduled cash benefits for listed services
You can apply for one, the other, or both — they are separate policies
Fixed-benefit UHOne coverage is generally not limited to a 30–90 day STM term; many plans may be renewed through age 65 where allowed
Networks and discounts (often a UnitedHealthcare or MultiPlan network, depending on product) should be verified in your quote
Medically underwritten. Preexisting-condition limitations apply to STM and may apply to fixed-benefit waiting periods or listed conditions.

UHOne is not Allstate. Do not assume benefits, networks, or rules match.

Slide 10

UHOne Short-Term Health Insurance

Temporary coverage for a defined term (term length is set by state law and the product you are offered)
Designed for gaps: job change, aging off a parent’s plan, waiting for Open Enrollment, or similar short needs
After deductible and coinsurance, may help pay covered doctor, urgent care, hospital, and surgery charges when those benefits are in the plan
In-network care usually costs less because of contracted rates; you can often see specialists without a referral if the plan says so
Some plans include limited preventive or prescription benefits — only if the policy lists them
Not ACA coverage. Generally does not cover preexisting conditions. A new application later can treat a condition that started during the first term as preexisting.

Consider learning more if you want a UnitedHealthcare-branded STM option, care about that network in your area, and need temporary — not long-term — medical-expense coverage.

Slide 11

UHOne Fixed-Benefit (indemnity) coverage

Pays a listed dollar amount for a listed service (office visit, hospital day, surgery tier, etc.) — not a percentage of the billed charge
Typically no medical deductible to “meet” before a covered cash benefit is payable (visit limits, waiting periods, and maximums still apply)
Often used to help with deductibles, copays, coinsurance, or everyday expenses
May include wellness, office visit, and Rx cash benefits on some plan levels, plus hospital benefits
Can be applied for outside Open Enrollment in many states
THIS IS LIMITED BENEFIT INSURANCE. It is not major medical and is not a substitute for comprehensive coverage.

Consider learning more if you already have (or will have) a high-deductible plan or STM and want a cash layer — or if you understand you are buying scheduled cash benefits only, not a plan that pays the hospital bill in full.

Slide 12

UHOne STM and fixed-benefit — one, the other, or both

STM only

Temporary help with covered medical bills after deductible. Ends when the term ends. Use when the main risk is a new accident or illness during a short gap.

Fixed-benefit only

Ongoing scheduled cash benefits (where renewable). Does not become major medical. Use only if you understand the plan will not pay the actual hospital invoice — it pays its schedule.

Both together

STM applies to the medical bill. Fixed-benefit pays its cash schedule on covered services. Together they can reduce the cash you must produce when STM deductible/coinsurance come due. Together they still are not ACA coverage and still generally exclude preexisting conditions.

Pairing two limited plans does not create comprehensive coverage.

Slide 13 · Not advice

A starting guide — your situation decides

If you…	Start by asking about…
Have a short, defined gap and can fund a deductible	Allstate STM or UHOne STM
Want STM plus a first-dollar cash layer in one Allstate package, and Aetna PPO access matters	Medical Expense Shield
Want UnitedHealthcare/Golden Rule STM and may also add a renewable cash-benefit plan	UHOne STM + UHOne fixed-benefit
Need coverage for a known condition, pregnancy, ongoing prescriptions, or mental health care	These products are often a poor fit. Look at ACA Marketplace, Medicaid/CHIP, or job-based coverage at HealthCare.gov

Slide 14

Questions that prevent surprises

Is this product actually available in my state, for my age, and for my dependents?

What is the exact term, and can I renew or only re-apply?

What is the preexisting-condition look-back, and what counts as preexisting?

Are my doctors and hospital in-network for THIS plan (Aetna Open Choice vs UnitedHealthcare network — they are not the same)?

What is the deductible, coinsurance, and coverage-period maximum?

If I add indemnity/fixed-benefit: what is the exact cash amount for a hospital admission, ICU day, ER visit, and office visit?

Are prescriptions, maternity, mental health, and preventive care covered, limited, or excluded?

Will a condition that starts during this term block a later policy?

Is there a waiting period on the cash-benefit side?

Can I see the outline of coverage and exclusions before I pay?

Slide 15

Get answers for YOUR state and YOUR health history

A licensed agent with Christian Regalado can:

Confirm which of these products, if any, may be offered to you
Run in-network doctor/hospital checks for Allstate/Aetna and for UHOne
Compare STM-only vs STM + indemnity using real outlines of coverage
Review ACA Marketplace, Medicaid, and other options that may protect you better

Requesting information is not an application and does not enroll you. You will be contacted by a licensed agent. You can also shop comprehensive options anytime at HealthCare.gov or 1-800-318-2596.

Your request for information can be reviewed by a licensed agent through 30A Health Insurance. This is not an application or enrollment.

Slide 16

Disclaimers and licensed-producer notice

Christian Regalado is a licensed insurance agent operating through 30A Health Insurance. NPN: 20141067. Licensed in Florida and Colorado. This material is for general education. It is not a contract, quote, or offer of coverage. It is not legal, tax, or medical advice. Products discussed may include short-term, limited-duration insurance and excepted-benefit / fixed-indemnity (hospital indemnity or fixed-benefit) insurance. They are NOT Affordable Care Act (ACA) Marketplace plans, NOT Minimum Essential Coverage, NOT Medicare, NOT Medicare Advantage, NOT Part D, NOT Medigap, and NOT Medicaid. They are not connected with or endorsed by the U.S. government, CMS, or HealthCare.gov. Short-term medical and fixed-benefit/hospital indemnity plans have limitations, exclusions, waiting periods, benefit maximums, and (commonly) preexisting-condition exclusions. Benefits vary by plan, county, and state law. Networks (including Aetna Open Choice® PPO and UnitedHealthcare networks) are not identical and are not available in all areas. Provider participation can change. Allstate® and Allstate Health Solutions products are underwritten by the issuing company named in the policy (Allstate Health Solutions is a marketing name). Aetna® and Open Choice® are registered trademarks of Aetna Inc. and are used for network access only; Aetna does not underwrite Allstate STM/MES unless the policy says so. Medical Expense Shield is a packaged offering of a short-term medical policy and a separate fixed-benefit policy — two contracts. UnitedHealthcare® UHOne products referenced are typically underwritten by Golden Rule Insurance Company, a UnitedHealthcare company. Health ProtectorGuard® is a limited-benefit fixed-indemnity product, not major medical. UHOne is not affiliated with Allstate. You may be able to obtain more comprehensive coverage through the Health Insurance Marketplace, Medicaid, CHIP, or an employer plan. Visit HealthCare.gov or call 1-800-318-2596 (TTY 1-855-889-4325). If you have Medicare, call 1-800-MEDICARE or visit Medicare.gov. This agency does not offer every plan in your area. Plan documents control. Ask for the outline of coverage, exclusions, and provider directory before you apply.