These special features . No medical examination. The husband or wife (regardless of age) of an enrollee may enroll in New York 65 at the same time. • Sons and daughters may enroll their eligible parents without requiring them to sign the application. In fact, anybody may enroll any eligible person. . New York 65 Major Medical is especially important for sons and daughters. Catastrophic major medical expenses could fall upon them disastrously even though their parents may already have basic hospital or medical coverage. The Major Medical plan pays benefits for hospital or convalescent nursing home charges up to $3600 for each confinement . . . and in addition pays lifetime benefits up to $10,000 for doctor bills and many other medical expenses. • You can keep New York 65 if you move out of the State and continue to live in the U.S. or Canada. . You have 10 days after receiving your Certificate Booklet to decide whether you are satisfied with New York 65. If not, you may return the booklet and your money will be refunded in full. • The Association may modify or discontinue the New York 65 Program, but your coverage cannot be modified or cancelled, nor your premiums increased, unless similar action is taken for all persons enrolled for the same plan. MEDICAL PLAN EXPANDS BASIC PROTECTION New York 65 Major Medical provides health This is how the Major Medical works, assuming After the Basic has paid room and board benefits And after the Basic has paid benefits for 31 days The Major Medical plan pays benefits for these New York 65 Major Medical also provides *You are eligible for the Major Medical plan alone, ENROLL TODAY ENROLLMENT PERIOD APRIL 1 APRIL 30 ONLY! NEW YORK 65 Pays Benefits Up to 31 Days For Hospital room/board up to $18 a day • Miscellaneous hospital charges up to • Doctors fees in hospital (non-surgical) up to $145 $6 per day, first week-$5 per day, PLUS: Surgery, in or out of a hospital, and Same plan available on Optional basis at The important benefits and limitations of NEW YORK 65 MAJOR MEDICAL BENEFITS ($9 a Month) Pays Hospital and Convalescent Nursing Home Benefits (Maximum Benefit $3600 FOR ANY ONE CONFINEMENT) ■ Hospital room and board benefits up to $18 a day after the first 31 days of confinement ■ Benefits for other hospital services and supplies at 80% of the amount by which expenses exceed $150 ■Convalescent nursing home benefits up to $7.50 per day for a maximum of 60 days following at least 5 days hospital confinement (NOTE: After you've been out of a hospital or convalescent nursing home for 90 days, you're entitled to a new maximum benefit of $3600 for any future confinement.) Pays Other Medical Expense Benefits (Maximum Benefit $10,000 DURING YOUR LIFETIME) Pays benefits for the following medical expenses at 80% of the amount by which expenses exceed $75 in a calendar year: ■ Doctor's medical and surgical services for home, office or in-hospital care - with maximum expense equal to the excess of: the established Blue Shield fees in your community for families with maximum yearly income of $6,000, over the benefits payable under other plans for these services. If you have no basic coverage for surgery or doctor fees in hospital, you ■ Private duty nursing services by registered professional nurses, registered visit- ■ Drugs and medicines' which require a doctor's prescription ■Diagnostic x-ray and laboratory examination and out-patient diagnostic services Physiotherapy artificial limbs and eyes trusses and crutches ■Rental of a wheel-chair, hospital-type bed, iron sung, or other equipment for the treatment of respiratory paralysis ■Local ambulance service to or from a hospital or convalescent nursing home Benefits under New York 65 are subject to reduction if you have other hospital, surgical or medical insurance Who is Eligible for New York 65 You are eligible - during any open enrollment period to join New York 65 if you are 65 or over and reside in New York State. Your spouse (regardless of age) may also enroll if you are enrolled. Protection begins upon receipt by New York 65 of your first premium payment. If you became 65 after the close of an open enrollment, or retire and are already over 65, you may enroll within 31 days of reaching 65 or your retirement. If you were confined in a hospital or convalescent nursing home on or during the 31 days prior to the date your coverage in New York 65 would otherwise become effective, your protection will begin 31 days after you are no longer so confined. How to Enroll in New York 65 It's easy to enroll in New York 65 no complicated forms — no long list of questions. Your Agent or Broker will gladly give you specific answers concerning New York 65 - will offer you any assistance you want in enrolling. There is no additional charge for his services. So see him today — or, if you prefer, fill in, tear off and mail the convenient application form printed inside. Expenses not Covered Under New York 65 Expenses during the first 6 months of your insurance—or during any period of hospital confinement commencing in the first 6 months-for any condition for which you received treatment or diagnosis during the 90 days before your New York 65 insurance became effective. Other principal exclusions are: injuries and diseases covered by Workmen's Compensation; care for mental and nervous conditions outside a hospital; dental care; eye examinations and glasses; hearing aids; diseases or injuries arising out of any war; expenses for services and supplies furnished without charge by any government; expenses which you would have no legal obligation to pay if you did not have insurance. Benefits under New York 65 are subject to reduction if you have benefits under other hospital, surgical or medical plans. |