The Catastrophe Major Medical Insurance Plan, endorsed by NYSUT Member Benefits Trust, is designed to help pay catastrophic bills that can push expenses beyond what basic health insurance allows. It provides coverage for extraordinary medical expenses not covered by hospitalization, HMO or major medical insurance, including Medicare.

For this reason, the plan includes a $25,000 deductible. Eligible medical expenses paid within a 36-month period by basic health insurance, as well as those paid out-of-pocket, count toward meeting the deductible. Once the deductible is met, the plan provides up to 100 percent coverage for reasonable and customary eligible expenses, up to $2 million in benefits for up to five full years from the date the first eligible expense was incurred toward the deductible.

The catastrophe plan’s coverage includes some nursing home and home health care benefits once the $25,000 deductible has been met. It provides up to $500 per week for convalescent or custodial care received in a nursing home, for up to three years ($80,000 lifetime maximum benefit). It also offers coverage for up to 300 visits per year for part-time or intermittent home health care for home health care aide services (maximum four hours per visit).

Bargaining unit members who are eligible for payroll deduction of NYSUT Member Benefits Trust-endorsed programs can use this payment option to save 10 percent on the cost of the Catastrophe Major Medical Plan’s premiums. Retiree members save 10 percent on the premiums by using pension deduction.

For more information, contact NYSUT Member Benefits at (800) 626-8101, e-mail benefits@nysutmail.org or visit www.memberbenefits.nysut.org.

For information about contractual expense reimbursement/endorsement arrangements with providers of endorsed programs, please contact NYSUT Member Benefits Trust or refer to your NYSUT Member Benefits Trust Summary Plan Description.

Agency fee payers to NYSUT are eligible to participate in NYSUT Member Benefits Trust-endorsed programs.