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Qualifying Admissions

A qualifying hospital admission means an unscheduled admission to an accredited facility,* such as a hospital, ER or surgical center that is:

  • the result of a Covered Procedure
  • medically necessary;
  • based on an approved Admitting Diagnosis
  • occurs within the 30-day period which beginning immediately upon the administration of either general anesthesia, or intravenous sedation in preparation of a Covered Procedure(s). Benefit amounts vary upon length of treatment.

Qualifying Admitting Diagnosis

Cardiopulmonary Related Complications:

  • Myocardial Infarction
  • Rule Out Myocardial Infarction
  • Arrhythmia
  • Hypoxia
  • Pulmonary Dysfunction
  • Pulmonary Embolus
  • Rule Out Pulmonary Embolus
  • Fluid Overload
  • Cardiac Arrest
  • Shock
  • Deep Vein Thrombosis
  • Rule Out Deep Vein Thrombosis

Surgery Related Complication:

  • Hemorrhage
  • Infection**
  • Hematoma***

Anesthesia Related Complications:

  • Severe hypotension (systolic BP equal to or less than 80, three hours after the Covered Procedure).
  • Severe hypertension (systolic BP equal to or greater than 200 or diastolic BP equal to or greater than 100, three hours after the Covered Procedure).

*Accreditation requirements include JCAHO, AAAHC, AAAASF or Medicare approval.

**Infections that are related to the Covered Procedure.

***Hematomas that are related to the Covered Procedure.

This is only a brief description of the coverage(s) available under policy series S30418NUFIC. The Policy will contain reductions, limitations, exclusions and termination provisions. Full details of coverage are contained in the Policy. If there is any conflict between the contents of this document and the Policy, the Policy will govern in all cases. Insurance underwritten by National Union Fire Insurance Company of Pittsburgh, Pa., a Pennsylvania insurance company, with its principal place of business at 175 Water Street, 18th Floor, New York, NY 10038. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19445. Coverage may not be available in all states.