Hospital Indemnity

A hospital Indemnity plan is additional insurance to help you with copays or coinsurance that your Medicare Health Plan or Medicare Supplement does not cover.   Note: This plan is only available for people ages 64 ½ years old and 85 years old.  There is also underwriting.  That means that with some health conditions, you might not qualify for coverage.  You can check the health conditions on the quote request form.  

A Hospital Indemnity plan can help you with your portion of the payments for:

+  DAILY HOSPITAL CONFINEMENT

+  AMBULANCE TRIPS

+  CANCER

+  OUTPATIENT SURGERY

+  SKILLED NURSING FACILITY

Let examine each of this benefits:

DAILY HOSPITAL CONFINEMENT

If you have a Medicare Advantage plan, for example, from any of these companies: (Humana, AARP United Healthcare, Cigna, Aetna, Bright Health, or others) and as well as with some Supplement insurance plans, you will have to pay a portion of the bill when you get admitted to the hospital.  This cost can add-up sometimes to thousands of dollars.   If you have a hospital indemnity plan, you would not have to worry about the hospital bills.

AMBULANCE TRIPS

Every Medicare Advantage plan and some Medicare Supplements have copays for ambulance rides.  This plan can pay up to $200 for each ambulance trip with.  This is a very affordable optional rider (about $3.36 per month).

CANCER

With a Medicare Advantage plan, you must pay 20% of Chemotherapy treatments.  These treatments can cost you thousands of dollars.  Luckily, most Medicare Advantage plans have what is called a Maximum Out-Of-Pocket (MOOP).  However, depending on your plan, the MOOP can be as much as $6,700 per year.  So, a Cancer option can protect you against your MOOP in case you are diagnosed with cancer.

OUTPATIENT SURGERY

The Outpatient Surgery option will pay procedures in an ambulatory surgical center or outpatient hospital facility.  It will pay a maximum of two procedures per year.

SKILLED NURSING FACILITY

Skilled nursing facilities are very expensive.  A Medicare Advantage plan typically covers 100% of this cost for the first 20 days in the facility.  That is usually good enough to recover from many situations.  However, with a stroke for example, a person will need more time in a skilled nursing facility to recuperate.  Depending on your plan, you will have a Skilled Nursing Facility copay of around $175 per day after the first 20 days.  The Skilled Nursing Facility benefit rider will pay $120 per day from days 21-100 if you are confined to a skilled nursing facility.   It is important to know that the benefit is only paid if you are admitted to a skilled nursing facility after having been confined to a hospital for three consecutive days or more. 

How does it work?

Let say you get hospitalized (for example, for schedule surgery, an emergency, an accident or any other reason).  Under most Medicare Health Plans like Medicare Advantage, you are responsible for a copay for the first 5 to 6 days in the Hospital.  If you stay 4 days and your copay is $260 per day (for example, your actual copay depends on what plan you have), you will owe the hospital (4 x $260) or $1,040.   A lot of times people leave the hospital and within a short period of time end up going back again.  You will have to pay another copay to the hospital depending on how many days you stay there.  Let say it is another 4 days, then you owe an additional $1,040.  Of course, this amount could be more or less depending on how many days and how many times you end up in the hospital.    If you don’t have enough savings or if you don’t want to spend most or all of your savings at once, most people call the hospital financial department and arrange for payments to the hospital.  Those payments tend to average around $100 per month.   

Instead of making payment to the Hospital (that sometimes seem like they never end), you can buy a hospital indemnity plan for less than a hospital arranged payments.   For example, for a 68-year-old person, to cover $260 per day in the hospital, it will cost a monthly premium of $30.03.   You decide how much of the copay you want to cover.   If you think you can handle a copay of $100 per day in the hospital, you can buy the reminder of your copay (in this example, $160 per day).  Then for a 68-year-old, it will cost $21.52 per month.

Then, after you submit a claim, the Hospital plan will send you a check for $2,080 (8 days @ $260 per day).  The plan pays the benefits directly to you regardless if you owe the money or not.  That means you can do whatever you deem necessary with the money.  You can pay it to the hospital or you can still arrange for hospital payments and use the money for other thing you might consider more important. `

Important things to know before you buy

1. Your monthly premium depends on your age.
2. Not everyone qualifies for a plan. The application has medical questions that you must answer and if you have a condition they don’t like, you are not accepted in the plan.  However, there is period that you will get a “guaranteed acceptance” even with a health condition they don’t normally accept.  That period is for one year and it starts 6 months before you turn 65 years old and ends 6 months after you turn 65 years old.
3. If you are accepted, the plan will not pay a claim for the first 6-months after your effective date if you were admitted for a condition you already have (The plan will still pay claims for any new conditions or an accident). After the 6-months period, the plan will cover all conditions. 
4. You must pay a one-time application fee of $20 payable on the first month only. Spouses will pay only one application fee if they apply at the same time.

To find out if you qualify and to get a free no-obligation quote fill out the following Qualification & Quote Request Form.