Hospital indemnity insurance
What it does
Pays a cash benefit directly to you if you or your covered dependents are admitted to the hospital, regardless of whether it’s covered by your medical insurance.
How it works
In the event of a hospital admission for a covered sickness or injury, submit a claim to receive prompt payment. Payment is made directly to you, so you can use it as you see fit.
What it doesn't do
Provide payment for hospitalizations prior to your effective date or that aren’t part of the covered list. Check with your benefits representative for your company’s specific plan details.Protection for planned or unexpected expenses
Video transcript:
At Equitable, we help you take steps toward a brighter future, whether that means saving for a child's education, or investing in a new home. It can also mean helping you overcome unexpected hurdles that can derail your financial plans.
This is June, who's always on the go for her job in sales.
One night in Chicago, June has an intense stomach pain that lands her in an ambulance and then the hospital where she has to stay overnight for observation and a CT scan.
Fortunately, the problem is minor and June recovers in time for her flight home. What doesn't recover as quickly is her medical bill. Even though June has health insurance, her plan only covers a portion of the expenses associated with this trip to the hospital, leaving her with $1,200 in bills to pay out of pocket. Thankfully, she had also purchased hospital indemnity insurance through her employer. While every plan is different, hers pays a total of $1,000 once she submits documentation and her claim is approved. She can use this money to pay for things that weren't covered by her health insurance, such as an ambulance trip, hospital stay or medical tests.
Some medical plans may only cover a portion of hospital expenses, so take a moment to speak with your benefits representative about your options for hospital indemnity insurance. It can help offset the cost of unexpected hospital visits so you can stay on track to meet your personal and financial goals.
High costs of hospitalizations may contribute to financial hardships
Hospital costs averaged $2,607 per day throughout the U.S.1
1 Source: https://www.debt.org/medical/hospital-surgery-costs/
Q&A
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What is group hospital indemnity insurance?Group hospital indemnity insurance can be purchased through your employer and this coverage provides cash benefits for stays in a hospital and some related therapies. Our plan pays higher benefits for more serious hospitalizations.
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Why should I buy hospital indemnity insurance?Hospital indemnity insurance helps cover unexpected expenses related to a hospitalization, which can be costly. While major medical insurance covers the majority of costs of a hospitalization, there are typically still out-of-pocket costs, such as deductibles or co-pays, in addition to added expenses outside the hospital due to a loved one’s hospitalization.
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What is a Wellness Benefit?If your group hospital indemnity policy includes a wellness benefit, insureds are eligible to annually receive a benefit amount (default is $50) when they undergo any eligible exam or screening from the covered list.
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Can I enroll for this insurance without having to take a medical exam?Yes. No medical evidence is required for Equitable's group hospital indemnity insurance.
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Do I have to wait before I can access benefits?No. Once you are enrolled and your benefits are effective, you are able to access the benefits. However, some policies may have a 9mo Maternity Waiting Period or a Pre-Existing Condition Limitation that could impact coverage for some claims.
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Are benefits paid directly to me or to my health care provider?All benefits for Equitable's group hospital indemnity insurance are paid directly to you. You can use the payment as you see fit - to cover costs such as out-of-pocket medical expenses, groceries, childcare, or transportation costs.
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What happens if I change jobs? Can I take my coverage with me?Yes. Equitable's group hospital indemnity insurance is portable, which means you can take your policy with you. The coverage and rates will remain the same.
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Is the claims process simple?Yes. We have two claim forms: one for a hospital claim and a second, short form for the wellness benefit (if included in your plan). The forms are designed to be easy to complete and submit to our claims department. Our average turnaround time for claims is 5 days.
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Are there hospitalizations that aren't covered by this insurance?
The policy has exclusions that may affect benefits payable.
Click here for full exclusions and limitations.
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Hospital Indemnity
Availability of this product is subject to state approvals.
This policy provides limited benefits. Exclusions apply and will vary by state. The certificate contains the full list of applicable exclusions that restrict benefit payments for hospitalizations or other insured treatments.
Hospital does not include certain facilities, such as nursing homes, convalescent care or extended care facilities.
The following limitations may apply:
Pregnancy waiting period: An insured must complete the pregnancy waiting period as shown in the benefit schedule before becoming eligible for benefits for normal pregnancy or childbirth under the policy. If the insured receives treatment for pregnancy or childbirth during this pregnancy waiting period, benefits are not payable. If the insured becomes confined as the result of pregnancy or childbirth prior to completing the pregnancy waiting period, benefits will only be payable for any day of confinement that extends after the end of the pregnancy waiting period. This limitation does not apply to complications of pregnancy.
Preexisting condition limitation: We will not pay any benefit for any sickness that is diagnosed or treated during a time specified in the certificate following the effective date of any insured's insurance and results from a preexisting condition. Preexisting condition means during an exclusionary period prior to any insured's effective date of insurance or the effective date of an increase in any insured's amount of insurance, any condition for which any insured: sought medical treatment, consultation, advice, care or services, including diagnostic measures for the condition, regardless of whether the condition was diagnosed or suspected at that time; took prescribed drugs or medicines for the condition.
When newborn children, newly placed foster children or newly adopted children are added to your dependent children insurance within 31 days of the birth, placement or adoption, the preexisting condition limitation does not apply.
Hospital indemnity insurance is a limited benefit policy. It does not provide basic hospital, basic medical or major medical insurance, and does not satisfy the requirement for minimum essential coverage under the Affordable Care Act. This policy is not a Medicare supplement plan. The certificate has exclusions and limitations for certain conditions that may affect any benefits payable. For costs and complete details of the coverage, please see the actual policy or contact your benefits representative. Benefits payable are subject to all terms and conditions of the certificate. This overview is preliminary to the issuance of the policy and certificate. The policy, certificate and rider, if applicable, are subject to state approvals and may vary based on state laws and regulations.
Policy form #s: MOEBP22 HI, AXEBP22 HI and state variations.
NEW MEXICO BROKERS, EMPLOYERS AND RESIDENTS: This advertisement is not currently directed to, applicable to or intended for any person residing in New Mexico.
All group insurance products are issued either by Equitable Financial or Equitable America, which have sole responsibility for their respective insurance and are backed solely by their claims-paying obligations. Some products are not available in all states.