Speak to an advisor

Do Hospital Indemnity Plans Require In-Network Care?

Do Hospital Indemnity Plans Require In-Network Care?

Posted Apr 28, 2014 by Jenifer Dorsey

In a recent post, we discussed how to use temporary health insurance plan networks. Those who have short-term medical insurance may visit the health care providers and clinics they prefer; however, they have access to discounted services through preferred provider organization networks. Those who have Choice Solutions, the hospital indemnity plan sold through healthedeals.com, may also maximize their benefits by using a PPO network.

Also known as hospital and surgical insurance, hospital indemnity plans provide fixed-dollar benefits that are the same regardless of provider. Plan participants who want to save money on out-of-pocket costs may use Choice Solutions’ MultiPlan Discount Network.
How MultiPlan works
One of the nation’s largest networks, MultiPlan has more than 650,000 providers, including physicians and inpatient and outpatient facilities, in 50 states. These providers have agreed to negotiated discounts, which are reflected on your final bill for covered and non-covered expenses.
Sue must be hospitalized for two days. She has the Choice Solutions Value plan with $0 deductible. She is charged the following:
1. Daily Hospital ICU (2 days)     
            Billed amount: $10,551
            Discount: $2,004.76
            Plan benefits: $6,000
2. Daily Hospital Room and Board (2 days)
            Billed amount: $4,896
            Discount: $930.18
            Plan benefits: $4,000

3. Daily Inpatient Hospital Physician Visits (4 visits)
      Billed amount: $425
            Discount: $42.50
            Plan benefits: $200
Sue’s total billed amount equals $15,872. Her network discount is $2,977.44, and her plan benefits total $10,200. The remaining share that Sue must pay out of pocket is $2,694.56.
Finding and using network providers
Locating a MultiPlan network provider and using your plan benefits is simple:
1.     Visit multiplan.com and click on the “Search for a Doctor or Facility” button located to the right
You may need to refer to your Choice Solutions identification card for network details. When scheduling your appointment, confirm that the provider or facility still participates in the MultipPlan or ACS network, depending on which you plan to use.
2.     Bring your plan ID card to your appointment. It includes the network information needed for the provider to correctly process covered billed charges.
Need more help?
If you have network-specific questions, you may contact MultiPlan using the information provided at multiplan.com.  
For specific questions about Choice Solutions, contact one of healthedeals.com’s certified health insurance agents at 888-839-7679.

The explanation of benefits shown is provided for illustrative purposes only. Plan options selected, the provider’s ZIP code, type of provider, type of service, and other factors all contribute to actual benefit determinations and discounts that may apply. MultiPlan network discounts vary by geographical area and by provider.
Choice Solutions brochure. (2013, May). PDF.

Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.