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The Hospital Copay with Medicare Advantage

With the Annual Election for Medicare over and the little known Medicare Advantage Open Enrollment Period ending on March 31st, you may think: “whew, I’m done for the year”. 

Of course with Medicare questions will always arise and we are here to answer them and solve any issues you may have.  Some folks stayed with current plans this year, many made changes and hopefully everyone fully understands their benefits.  But if you have yet to read deeply into your summary of benefits or you have forgotten what agents told you about copays, the biggest copay in your booklet is usually for the hospital.  

This has always been the case for Medicare Advantage plans.  You have a low or no monthly premium.  Low copays for several services.  Some offer dental, gym memberships, free over the counter items, but when you need the plan most the biggest copay comes up. 

doctor and nurse with patient

Let’s look at an example.  One very popular plan in Southern NJ has a daily hospital copay for days 1-5 of $290 per day and then $0 per day after that.  So if you are admitted to the hospital and are there for 2 days you will have a bill for $580 when you get home.  If you are there 5 days or more that bill will be $1,450. 

One visit can make for a serious bill.  A few visits in one year could be detrimental to your bank account.  So what can you do to plan for this?  Well some put aside money they are saving on premium for a rainy day.  Unfortunately not all of us, including myself, are that disciplined.  What many folks do is plan for this event with Hospital Indemnity.  

Hospital Who?

Hospital indemnity plans are a perfect fit for someone with a large hospital copay.  There are several companies that offer these types of plans with folks like yourself in mind.  Let’s look at an example for a 65 year old female living in NJ, we will call her Jane. 

Jane goes to the for 4 days.  Her plan has a copay of $290 per day meaning she has a bill of $1,160 when she gets home.  Thankfully Jane purchased a hospital indemnity policy that gives an upfront admission payment and then a daily copayment to offset her bill.  In this case Jane’s policy paid $500 up front and then $150 per day for the 4 days. 

That means while Jane has to pay the hospital $1,160 in copays, her hospital indemnity policy is going to send her a check for $1,100.  That makes things a lot easier.  And in this example the monthly premium for Jane is only $31.46.* Not only is Jane’s hospital bill almost completely paid for but it came at an affordable price.  

To find out more about this plan and have it tailored to fit your specific needs, please contact us today.  There is no enrollment period for these plans so we don’t have to wait until the end of the year, we can protect you now!  There is no cost to get a quote and find out if you qualify.

Questions? Call Greg!

Greg Gudis BGA Insurance

Greg Gudis – Charted Advisor for Senior Living®

(856) 324-3527