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Real-life example · Hospital indemnity
Linda’s 4-day hospital stay: how the money works
For ages under 65
Linda, 62 · retired early · Marketplace health plan
Linda wakes up struggling to breathe. An ambulance takes her to the hospital, and she is admitted for four days with pneumonia. Her health plan pays the hospital the way it always does. Her hospital indemnity policy pays Linda, separately, on top of that.
What happened
Follow the money
Step 1: Add up what the policy pays Linda
Step 2: What’s left after her biggest hospital bill
Where Linda’s $4,500 goes
The takeaway
Her health plan still paid the hospital. The policy didn’t replace that; it paid Linda in addition. Her deductible was covered, with $1,500 to spare for copays, coinsurance, or anything else.
The $3,000 deductible is a made-up example. Check your own plan’s deductible and hospital copays.
These are illustrative examples with made-up names. Dollar amounts come from one sample plan design and are shown only to explain how the benefits work. Your actual benefits depend on the plan and options you choose, your state, and the terms, limitations, exclusions and waiting periods in your policy.
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This page is educational and is not an offer of coverage or a recommendation of any specific policy. The policies described are individually underwritten supplemental (indemnity) insurance. They are not major medical coverage, not Medicare Supplement insurance, not long-term care insurance, and not “minimum essential coverage” under the Affordable Care Act. Benefits, benefit amounts, riders, availability and eligibility vary by state and are subject to the terms, limitations, exclusions, waiting periods and pre-existing condition provisions of the actual policy and its outline of coverage. Senior Benefits Hub is an independent insurance agency; licensed since 2013. Not affiliated with or endorsed by any government agency.