Hospital Indemnity Insurance

An insurance plan to help with the high costs of hospitalization
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What Does Hospital Insurance Cover?

Hospitalization insurance plans generally provide benefits for medical services associated with being hospitalized due to an injury or illness.

You may also be able to obtain additional coverage for outpatient services like preventive care, urgent care, outpatient services, and diagnostics like X-rays and lab tests or for certain critical illnesses.

What Hospital Insurance Typically Covers
  • Hospital room and board

  • Inpatient physician’s visits

  • Inpatient prescription medications

  • Inpatient surgery

  • Outpatient surgery

  • Ambulance services

What Hospital Insurance Typically Does Not Cover
  • Pre-existing conditions, including pregnancy

  • Preventive care such as routine physicals

  • Any non-medically necessary surgical procedures

  • Outpatient prescription medications

Pros and Cons of Hospital Insurance

  • May be guaranteed renewable – If it is guaranteed renewable that means you won’t be singled out for a rate increase or cancellation based solely on changes to your health.
  • Use benefits however you want – with no benefit coordination, payments may be made directly to you.
  • Apply year-round – There is no official open enrollment period, and you can apply anytime.
  • Flexible Coverage – Choose from various health benefit levels.
  • Keep your doctor – Some policies do not have provider network limitations for fixed indemnity plans, which means you can visit your preferred healthcare provider.
  • $0 deductible plan options may be available.
  • Premiums are based on age and health – The younger and healthier you are the lower your monthly premium; conversely, older and sicker individuals will pay more.
  • More exclusions + limitations than major medical – Many ACA-qualifying essential health benefits such as annual doctor’s visits, prescription drugs, vaccinations, and pre- and post-natal care are not covered.
  • Pre-existing conditions are not covered
  • Not ACA-qualifying major medical coverage – Hospital indemnity insurance is not ACA-compliant major medical coverage.

Find Answers to Hospital Insurance Questions

If you are hospitalized, your policy pays a set benefit amount for eligible services regardless of how much your provider charges for the services.[1] The amount paid is per day, per week, per month, per visit or per event, as outlined in the policy you select. Here’s an example of how hospital indemnity insurance works: The hospitalization insurance plan you selected pays $250 per day for hospital room and board charges, and $100 per day for inpatient doctor visits. If you are hospitalized for three days due to an injury or medical condition covered under your plan and you are visited each of those days by a doctor in the hospital, you will receive $1,050 in benefits. Be sure to carefully review your policy for more specific details about what benefits will be paid for eligible hospitalization charges you incur.
You may choose to receive your benefit payments directly,[2] or you may ask your insurer to pay the benefit amount to your provider. Hospital indemnity benefits typically do not coordinate with any other health insurance coverage you may have, like major medical. That means that no matter what your major medical policy pays for a covered illness, injury or healthcare service, the hospital plan will pay its fixed indemnity benefit as indicated in your policy.
No, you have the flexibility to use your benefit payments in any way you choose, whether it’s to cover costs of your medical treatment or for other expenses like housing, transportation, groceries or childcare.

Have Questions? Speak to an Agent

Speak to a licensed health insurance agent during business hours for help understanding your options and enrolling in coverage.

Call 888-855-6837

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