Even with medical coverage, the cost of a hospital stay can really add up. Hospital indemnity insurance provides you with a lump-sum payment to use as you see fit if you experience a covered event.
Hospital indemnity insurance provides a one-time payment for admission to the hospital and then a daily benefit amount for the length of your hospital stay (up to 15 days).
If you are admitted to the hospital, the benefits you might receive are listed below:
Benefit Type |
Benefit Payment |
Admission Benefit |
$1,000 for the day of admission |
Confinement Benefit (paid for up to 15 days per calendar year) |
$100 per day |
ICU Supplemental Confinement Benefit (paid for up to 15 days per calendar year) |
$100 per day |
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Hours 8am - 6pm Central Time, Monday through Friday, except certain holidays |
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Example
Sarah enrolls in hospital indemnity insurance during annual enrollment, and her coverage becomes effective on January 1, 2020. Sarah is admitted to the hospital on May 1, 2020 and delivers a healthy baby boy. She spends 2 days in the hospital before she is released.
Admission: $1,000
Confinement (day 2): $100
Total benefit: $1,100
As long as the baby is born after the effective date of coverage, the admission and hospital stay for the mother will be covered.
Below are the deductions that would be withheld from your biweekly paycheck if you elect hospital indemnity insurance:
You Only |
You + Spouse / Domestic Partner |
You + Child(ren) |
You + Family |
$5.24 |
$10.68 |
$8.82 |
$14.26 |
* There is a pre-existing exclusion for covered sicknesses. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details. Covered services/treatments must be the result of an accident or sickness as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
** The Admission Benefit is not payable for Emergency Room treatment or outpatient treatment. The payment of the admission benefit requires a Confinement. Hospital Confinement requires the assignment to a bed as a resident inpatient in a Hospital (including an Intensive Care Unit of a Hospital) on the advice of a Physician or confinement in an observation area within a Hospital for a period of no less than 20 continuous hours on the advice of a Physician. Please consult your certificate for details.
What is Hospital Indemnity Insurance?
Hospital indemnity insurance pays a daily benefit if you or your covered dependents have a covered stay in a hospital, critical care unit or rehabilitation facility. The benefit amount is determined based on the type of facility and the number of days you stay.
Note: Hospital indemnity insurance is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
How can hospital indemnity insurance help me?
Below are a few examples of how your hospital indemnity insurance benefit could be used (coverage amounts may vary):
Who is eligible for Hospital Indemnity Insurance?
When can I enroll?
Enrollment is limited to the annual enrollment period. Outside of annual enrollment, you may only enroll in or change this coverage if you experience a Qualified Life Event.
If you are a new hire, you can enroll during your new hire enrollment period.
Will my rates increase as I get older or if I file a claim?
Will I have to take a medical exam to get this coverage?
Is pregnancy covered?
1Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details.
2There is a pre-existing exclusion for covered sicknesses. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details. Covered services/treatments must be the result of an accident or sickness as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
3Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
4Coverage is guaranteed provided: (1) the employee is actively at work; and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.
5Coverage for Domestic Partners, civil union partners and reciprocal beneficiaries varies by state. Please contact MetLife for more information.
METLIFE'S HOSPITAL INDEMNITY INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. Prior hospital confinement may be required to receive certain benefits. There may be a preexisting condition limitation for hospital sickness benefits. MetLife’s Hospital Indemnity Insurance may be subject to benefit reductions that begin at age 65. Like most group accident and health insurance policies, policies offered by MetLife may contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX, GPNP13-HI, GPNP16-HI or GPNP12-AX-PASG, or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In certain states, availability of MetLife’s Group Hospital Indemnity Insurance is pending regulatory approval. Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife's Disclosure Statement or Outline of Coverage/Disclosure Document for full details.
L0122019037[exp0323][All States][DC,GU,MP,PR,VI]
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Hospital Indemnity Outline of Coverage |