Are Hospital Indemnity Benefits Right for You?

Jenifer Dorsey
2018-09-12 October 21st, 2013 |
Read time: 10 minutes

Healthcare has a number of moving parts: preventive care, urgent care, mental healthcare, physical therapy, rehabilitative services, emergency care, and everything in between. And while your Obamacare health insurance plan includes benefits that help pay for such healthcare, you will still be responsible for some share of these expenses out of pocket. Or, if you are in between Obamacare coverage, you may have to pay for all of your healthcare costs completely out of pocket. Under such circumstances, hospital indemnity benefits can be an asset to your personal benefits portfolio.

Hospital indemnity plans, also known as hospital and surgical health insurance plans, can be a temporary solution for individuals and families without a traditional health insurance plan as well as long-term supplemental coverage for those who do and want some extra benefits. This type of plan pays  a predetermined amount in the form of lump-sum cash benefits for specific services and care. It is important to note that hospital indemnity does not cover catastrophic care and is not intended to be a replacement for ACA-compliant major medical insurance.

What is a hospital indemnity plan?

Considered a supplemental insurance product, hospital indemnity plans provide first-dollar fixed benefits for medical expenses related to hospitalization, surgery and outpatient therapy services. That means the plan pays up to the stated benefit amount for a service without any additional copay, coinsurance or deductible; however, it is important to note that first-dollar benefits only kick in after the deductible, if there is one, has been met.

You can also get hospital indemnity benefits through other types of supplemental coverage, including medical gap insurance plans.

What do hospital indemnity benefits cover?

Hospital indemnity benefits cover certain hospital and surgical services and pay a fixed amount based on the coverage level you select.

Benefits may include:

  • Inpatient services (paid per day) such as
    • Inpatient hospital confinement
    • Accident benefits
    • Inpatient physician visits
    • Inpatient ICU/CCU confinement
  • Inpatient surgical services (paid per surgery)
  • Outpatient surgical services (paid per surgery)
  • Maternity (lump sum benefit)
  • Ambulance (per trip)
  • Chemotherapy and radiation (per treatment up to a lifetime maximum)
  • Per injury or illness deductible
  • Critical illness benefit

Again, hospital indemnity plans and other supplemental plans that include hospital indemnity benefits are not major medical insurance and do not include Obamacare essential health benefits. This type of coverage is not subject to provisions under the Affordable Care Act and does not fulfill the requirement that most Americans buy health insurance or face a tax penalty.

What do hospital indemnity benefits cost?

Metal Gap and Metal Gap 2 premiums tend to be relatively low compared with Obamacare health insurance plan premiums. Metal Gap plans tend to cost as little as $1 per day, which lets you select a plan design affordable for your household budget.

Consumers choose any doctor or hospital, and no matter what the provider charges, the plan pays the fixed benefit amount selected.

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What Does Metal Gap 2 Cost?

Who is this type of coverage ideal for?

Securing a supplemental health insurance plan with hospital indemnity benefits is another way to reduce medical bills and pick up where your medical insurance leaves off. If you anticipate needing hospital or surgical services, this type of plan can provide some financial relief at a budget-friendly rate.

This type of coverage might be the right fit if you are looking for additional financial assistance for unexpected hospitalization or surgery charges. Those who are in relatively good health, do not have a major medical plan and need to save money might consider this as a short-term safety net to assist with costs related to hospital or surgical services. Those who see a doctor regularly or take prescription drugs may find this coverage too limited.

Discussing your healthcare needs and the amount you can afford to pay for insurance with health insurance producer can help you arrive at the best solution for your circumstances.

Are hospital indemnity plans still relevant in the age of Obamacare?

Absolutely. They offer additional financial protection on top of your Obamacare coverage. Once you gather monthly premium quotes and have considered how you might use your health insurance in the upcoming year, consider the benefits included, the deductible you might select and any anticipated out-of-pocket costs.

At a relatively small cost, a Metal Gap or Metal Gap 2 plan with hospital indemnity benefits may help you save more in the event you need hospital and surgical services.

To learn more about the hospital indemnity benefit offered with Metal Gap and Metal Gap 2 plans, call 866-278-1464 to speak with an IHC representative.


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Originally Published On October 23rd, 2013