What Is Hospital Indemnity?

What is hospital indemnity and how does it work? Read on to find out.

As of late, hospital indemnity insurance has gained some solid ground. This kind of insurance has been around for some time. Nonetheless, not until the quickly expanding deductibles, coinsurance, and copays with health care coverage plans under the Affordable Care Act, has hospital indemnity insurance been at the center of attention. Considering progressively higher cash-based costs, individuals are going to hospital indemnity insurance for cost help and some mental peace.

Numerous individuals get health care coverage through their employers; indeed, an investigation in 2019 demonstrated that practically half (49%) of Americans rely upon their workplaces for health care coverage. Regardless of whether your health care coverage is through your (or your spouse’s) work or you buy it through a private lender, this coverage gives significant monetary insurance if you have a serious mishap or infection. Individuals who don’t have health care coverage are bound to be under a pile of debt or close to bankruptcy because of the significant expense of medical care.

Individuals frequently do not pay attention to how much clinical consideration can cost. For instance, the public average for a hospital stay is 4.5 days, at an average expense of $10,400 each day — that is a sum of $46,800. Health care coverage can help shield you from high, surprising costs like this. Most health care coverage will cover a hospital stay to an extent. However, even the best health care coverage will have limits. You may in any case get yourself answerable for costs your insurance doesn’t cover, especially in case of a long hospital stay or one requiring specific treatment.

Almost 50-74% of individuals are living from one paycheck to another. In addition to this, nearly three out of 10 adults say they have no emergency saving funds by any means. One of every four families making $150,000 or more a year report they rely upon their next check to keep their heads above water. How might you respond in the event that you ended up confronting a monstrous hospital bill? Before that occurs, you should seriously mull over investigating hospital indemnity insurance. Is hospital indemnity insurance worth the cash? In this article, we will talk about what is hospital indemnity insurance and whether it is even worth it or not.

What is hospital indemnity?

Hospital indemnity insurance (also known as hospital confinement insurance or simply hospital insurance) is supplemental medical insurance coverage that pays benefits if you are hospitalized. While health insurance pays for medical services after copays, co-insurance, and deductibles are met, hospital indemnity insurance pays you if you are hospitalized, regardless of any other coverage you may have. In addition to this, the plan provides coverage for employees who are admitted to a hospital or ICU for a covered sickness or injury.

Every hospital indemnity plan is different and unique to the customer who is purchasing it. Common examples of the type of benefits these plans may offer are a fixed benefit for admission to the hospital, a fixed benefit for an overnight stay, and a fixed benefit for each overnight stay in an intensive care unit. Moreover, hospital indemnity insurance policies may include other types of benefits as well. Among those is a benefit for treatment in an emergency room, and a benefit paid for certain outpatient procedures. Some hospital indemnity insurance policies may even pay a benefit for certain specified diseases or accidents, but normally people purchase separate indemnity policies (cancer, critical illness, or accident, etc.) as specialized policies offer more robust benefit amounts.

You must remember that hospital indemnity insurance is designed to complement traditional health insurance, not replace it. Plans typically provide benefits to you when you are admitted to a hospital or ICU for a covered sickness or injury. However, there are some policies that will also pay a benefit for outpatient surgery, emergency room visits, stay in a rehabilitation facility, and ambulance services. Hospital indemnity policies typically pay a lump sum directly to you, not a hospital or medical facility. That means you can use the benefit for any purpose, whether to cover the cost of care or for a non-related purpose.

As deductibles, co-insurance, and copay fees become increasingly expensive, more people and even employers are turning to hospital indemnity insurance to cover the expenses they’ll have to pay from their own pocket if they are hospitalized. Some employers who cannot afford lower deductible policies for their employees are including hospital indemnity insurance or health indemnity insurance as an added benefit to offset the cost of high deductibles. These plans help keep costs down for employees and are less expensive for employers to provide than lower deductible plans. While these gap plans have helped cover medical costs and are valued by many, they also do have their drawbacks.

Moreover, critics point out that health indemnity insurance plans are not regulated by health care laws, which means the insurers can do things that are prohibited by the Affordable Care Act, such as denying coverage for pre-existing conditions. While hospital indemnity insurance only provides coverage in the event of hospitalization, other types of health care indemnity policies pay the policyholder when they experience other medical events, such as being transported by ambulance, having surgery, or getting a diagnosis for specific illnesses.

How does hospital indemnity insurance work?

You pay month-to-month premiums for your hospital indemnity insurance plan. In the event that you are conceded to the hospital for a physical issue or sickness, your hospital indemnity plan makes cash installments to you. Furthermore, the fact that you get the installments directly means that you can utilize these crisis assets to pay for costs that are not covered by your health care coverage, health care coverage deductibles, copays, coinsurance, childcare costs while you are in the hospital, or average cost for basic items costs as you recuperate. For most plans, there are no deductibles and you are not restricted to supplier organizations. The following are different contemplations with respect to hospital indemnity insurance:

  • Like other different kinds of insurance, you can purchase your strategy or, if accessible, buy through your employer’s group plan.
  • There is a wide scope of expenses for hospital indemnity insurance. It will change based on what amount is covered, what the loan sum will be, whether you want dependent family members on the arrangement, and whether you purchase an individual or gathering strategy. It tends to be just about as reasonable as $7 per month or as much as $463.
  • The amount of coverage that you need is normally found on the basis of the number of days you are hospitalized. For instance, an approach that pays $250 each day will give you a singular amount of $750 in the event that you go through three days in the hospital. There might be a limit to how long the strategy will repay you for; for instance, a 30-day limit.
  • Approaches additionally once in a while give an Initial Confinement Benefit. This is a sum you would get simply by being conceded before the per-day advantage is thought of. For instance, if in the above situation you have an underlying confinement advantage of $500, you would get a $1,250 complete benefit.
  • Plans may have a discretionary advantage to incorporate labor. Contingent upon the strategy, a hospital indemnity strategy may cover the mother’s admission to the hospital for normal labor and delivery, together with a sick baby’s visit to the neonatal emergency unit.

A Hospital Indemnity Insurance strategy is adaptable and can be custom fitted to your requirements and spending plan.

  • There are no organizations, copays, deductibles, or coinsurance limitations. Regardless of which hospital you pick, you’ll be covered.
  • To apply, simply answer a couple of yes or no inquiries concerning your medical history.
  • Policies are accessible for those who are 50 – 85 years old and can incorporate coverage for you, you and your life partner, and additionally your children.
  • Fixed benefit dollar sums are paid in the event that you have a covered hospitalization due to an injury or disease that is covered for.
  • Coverage proceeds after the primary hospitalization, so you’re covered for future hospital stays.
  • Your approach is guaranteed renewable for as long as you live, paying little heed to your age or changes to your wellbeing.

Riders offer coverage for explicit circumstances and can be added for an extra month-to-month sum. Riders can be added for:

  • A Specified Disease
  • Lump-Sum Cancer and Recurrence
  • Accident Fixed Indemnity
  • Lump-Sum Heart Attack, Stroke, and Restoration

Alternative types of hospital indemnity insurance

“Skinny” hospital indemnity insurance plans exist. They may exclude the entirety of the benefits that are talked about in the article above, yet they give coverage to cash-based clinical expenses at a lower premium. One sort is essentially a decreased benefit variant of the hospital indemnity insurance plan that was discussed earlier. This arrangement will cover expenses if you are admitted to the hospital, confinement, surgeries, and so on. For instance, an arrangement may cost $64 each month for a similar 40-year-elderly person living in Illinois.

Another well-known arrangement is a gap health care coverage plan that will settle up to your yearly cash-based maximum and that’s it. The benefits are self-evident. If you have a $3,000 cash-based bill from a hospital stay, the arrangement pays $3,000. The disadvantage of this is that you don’t get anything more, yet the premium is again half the expense. You simply need to choose a “container of cash” that addresses your total maximum cash-based expenses on your essential medical coverage for the year. The $8,000 cash-based maximum for the 40-year-old Illinois occupant costs around $77 each month.

At long last, there are indemnity plans for a particular circumstance. For instance, accident insurance is a famous indemnity plan. These plans are truly reasonable yet will only pay on a covered mishap. Same with a basic ailment or a cancer plan. These plans will pay you cash depending on a diagnosis as well as therapy of a basic ailment like coronary illness, cancer, or some other ailment like ALS. These plans are normally reasonable also.

Hospital indemnity insurance example

Gloria and her family get health care coverage through her manager’s arrangement. Her deductible is $1,500 per individual or $3,500 for the whole group of four. To help cover costs should one of the relatives be hospitalized, Gloria and her life partner shop for a hospital indemnity strategy. They buy a strategy for $30 each month that will pay $250 each day in the event that one of the relatives is hospitalized. After two years, Ann is hospitalized for 10 days for inconveniences from a medical procedure. The arrangement pays her $2,500. This covers her deductible and helps counterbalance the expenses of the extra costs brought about.

Some facts about hospital indemnity insurance

It isn’t health insurance, but it makes health insurance better

Health care coverage pays for explicit clinical benefits after the deductible or copayment sums are fulfilled. On the other hand, hospital indemnity insurance triggers installments when explicit occasions related to hospital visits happen. A sort of supplemental insurance, hospital indemnity plans payout when a policyholder looks into a hospital for an overnight stay, qualifying him for guaranteeing a specific sum – say $250 – against the arrangement. For each extra night’s visit, he can add another $250 on top. A three-day stay at the nearby clinic would qualify him for $750, etc. Notwithstanding a hospital routine set of expenses, a more hearty arrangement may highlight installments per rescue vehicle excursion, medical procedure, or maternity visit, or expanded installments for exceptional infirmities like stroke or malignancy. Benefits can dispense in single amounts for short inductions or on a day-by-day or week after week premise during longer visits.

You can use it to pay your deductible or anything else

Hospital stays in the U.S. cost, on average, $10,400 in 2012. Not modest – positively sufficiently high to top the yearly deductibles of most significant clinical plans. Indemnity insurance payouts can be utilized to cover health care coverage deductibles; so for a policyholder, going through four days in the hospital visit could mean dealing with significant health-related cash-based costs for the whole year. Truth be told, installments can be utilized for whatever reason the recipient picks. That is on the grounds that, in contrast to clinical medical coverage, hospital indemnity plans are not attached to explicit administrations yet rather pay policyholders upon the event of specific occasions.

It’s great for families to use

Family coverage offers a help valve for when a parent or spouse should go on vacation to keep an eye on the consideration of a hospitalized life partner or kid. Almost one of every six hospital visits are made by kids and young people, most of whom are newborn children, with an average induction of almost four days and an expense of more than $6,000. What’s more, is that hospital indemnity insurance is phenomenal for pregnant women. On average, new moms go through 1-4 days in the hospital in the wake of conceiving an offspring, with average cash-based costs for labor surpassing $3,400.

It’s affordable

Nobody at any point blamed a hospital indemnity plan for making them bankrupt. Month-to-month costs for individual hospital indemnity coverage for the young and sound starts at about the expense it would take you to purchase a sandwich. Premiums increment as policyholders age and add relatives. For instance, a 30-year-old individual with a $100-per-night hospital indemnity plan can hope to pay under $5 each month to look after coverage. Conversely, a 55-year-old family man with a $250-per-night plan may settle up to $40 or more. While it can’t make you quit stressing over your friends and family, joined with the right wellbeing plan, hospital indemnity insurance can make the sudden more passable to experience.

What does a hospital indemnity plan cover?

Each transporter has a subtlety or two with regards to a hospital indemnity plan. Be that as it may, they all for the most part have the accompanying ascribes and attributes:

  • hospital outpatient – pays for hospital, observation unit, or surgical facility for stays less than 23 hours
  • hospital confinement lump sum – payable on the first day when you are confined in a hospital for 23 hours or more for a covered mishap or disease
  • ambulance – for travel in a ground or air ambulance
  • emergency room – for treatment in the emergency room or urgent care
  • waiver of premium – you won’t have to pay a premium if you are in the hospital for X amount of days, usually 30, but depends on the carrier
  • rehabilitation – pays for rehab at a qualified facility under doctor’s order
  • preventative care – pays for procedures defined under the Affordable Care Act
  • physician care – pays for visits to the doctor’s office for covered accidents and illnesses
  • labs, x-rays, imaging, diagnostics – pays for these services when connected to a covered illness or accident

Is hospital indemnity insurance worth it?

You are living under a stone in the event that you haven’t seen that clinical expenses are expanding at a disturbing rate. I’m certain you are feeling monetary imperative, even with employer-supported medical coverage. How would you change your monetary circumstance? All things considered, there are numerous ways. You could cut costs somewhere else like cutting your link bill. You can do a full monetary “analytic” test on your circumstance, checking whether there are approaches to cut costs.

On the off chance that you need the greatest insurance against unforeseeable occasions, you might need to think about purchasing each of the three kinds of coverage. This is particularly evident in the event that you have a high-deductible health care coverage plan that will expect you to meet a huge deductible before your medical advantages kick in. Simultaneously, if you trust you have sufficient crisis investment funds to cover what your health care coverage will not, you may not require it. This is particularly obvious in case you’re conveying a sizable equilibrium in a wellbeing investment account (HSA).

One way individuals cut is simply the medical coverage. Numerous essentially drop coverage or lower their coverage, subsequently expanding the potential for cash-based expenses. Without a doubt, you have a lower premium, however a possibly higher cash-based expense. How does that take care of you? At the point when you need medical coverage the most, you’ll face a bigger bill. This is the reason we think hospital indemnity insurance merits the cash.

Furthermore, you can essentially save the deductible and the cash-based most extreme on your arrangement. As such, you can set up a crisis investment account and hold a suitable measure of cash for medical care costs. These circumstances point that your essential health care coverage will not absolutely cover you. You need extra help. This is the reason we feel hospital indemnity insurance merits the cash spent. We examine underneath how much cash you can hope to pay on premiums.

In the same way as other supplemental insurance plans, hospital indemnity insurance is normally lower in cost, contingent upon the arrangement and coverage. Reasonable hospital indemnity plans merit considering if your current wellbeing insurance plan has limits on hospitalization coverage. On the off chance that you are beginning a family, a hospitalization indemnity plan can help cover the expenses of hospital labor and post-labor hospital stays. Likewise, as you become more seasoned, the potential for hospitalization may increase. A hospital indemnity plan offers true serenity security for the unforeseen.

For instance, suppose you are in an awful auto crash and break your leg. You have a medical procedure and are admitted to the hospital for 2 days. The hospital charges $10,000. Your Gold arrangement pays $7,600 and you need to pay $2,400 ($500 deductible + $9,500 X 20%). You don’t have that sort of money lying around. Then again, your Bronze arrangement pays $2,400 and you pay $7,600 ($6,000 + $4,000 X 40%). However, you have a hospital indemnity plan which pays:

  • $2,000 for the hospital admittance
  • $6,000 for the 2 days in the hospital
  • $1,000 for surgery costs
  • $100 for the x-ray
  • $250 for the ER visit
  • $100 for the ambulance

Total paid: $9,550.

You get a check for $9,550. You take care of the $7,600 bill from Blue Cross Blue Shield and utilize the distinction to pay for different expenses identified with the injury. Note: you will not have an excess without fail (this is insurance) yet hospital indemnity insurance will help pay for those cash-based costs. This is a basic model that shows why we feel hospital indemnity insurance merits the cash.

How much does hospital indemnity insurance cost?

The cost of a hospital indemnity insurance plan can differ. These are the factors that play a part:

  • state you reside in
  • tobacco use status
  • your age
  • include family members
  • underwriting status – discussed next

Here’s an example utilizing a 40-year-old single, male living in Illinois. A hospital indemnity insurance plan may cost somewhere in the range of $130 and $170 each month relying upon the arrangement. Keep in mind, a greater part of Americans can’t pay for a huge hospital expense. Taking a gander at accessible choices, a Blue Cross Blue Shield “Gold” plan costs $500 each month and has a cash-based limit of $7,900. It’s anything but a $500 deductible and 20% coinsurance. Coinsurance is a lot of the expenses after you pay the deductible. Altogether, the cost that you have to pay from your own pocket is $13,900 ($6,000 yearly premium + $7,900). Would we be able to improve a hospital indemnity plan?

There is a Bronze arrangement accessible, for $380 each month. It’s anything but a $6,000 deductible and a $7,900 cash-based most extreme with 40% coinsurance. In the event that you needed to remain at the $500 spending plan, you could choose the $130 each month hospital indemnity insurance plan. The hospital indemnity insurance plan almost clears out or clears out all of your cash-based expenses including the deductible for $10 more each month over your spending plan.


Now that you have read this article, you know all about what is hospital indemnity. Hospital indemnity insurance supplements your current health care coverage by aiding pay costs for hospital stays. Contingent upon the arrangement, hospital indemnity insurance gives you cash installments to help you pay for the additional costs that may come while you recuperate. Plans commonly pay on the basis of the number of long periods of hospitalization.

We trust you discovered this article instructive. We feel that hospital indemnity insurance merits the cash. As we would like to think, it’s anything but a “safety net”, keeping you from encountering conceivably high cash-based expenses with your medical services. Without a doubt, you may have to spend somewhat more every month, except realizing that your medical services deductibles, copays, and coinsurance are totally, or almost covered, should give you true mental peace.

Sandra Johnson

Sandra Johnson

Sandra Johnson was a few years out of school and took a job as a life insurance agent in California, selling coverage door-to-door for Prudential. The experience taught her about the technical components of insurance and its benefits for individuals and society, as well as the misunderstandings people often have about insurance. She has over ten years’ experience in the insurance industry, having worked as both a Broker and Underwriter, assisting clients across a broad range of industries. At Insurance Noon, Sarah diligently gathers all the required information and curates up pieces to provide meaningful insurance solutions. Her personal value proposition is to demonstrate a genuine interest in always adding value for clients.Her determined approach to guiding clients has turned her into a platinum adviser to multiple insurers.

Insurance Noon is the world's leading source of insurance related content on the web, focusing on industry news, buying guides, reviews, and much more.