Fill Medicare and Medicare Advantage Gaps with Hospital Indemnity Riders

Hospital Indemnity insurance riders offer Medicare and Medicare Advantage policyholders a way to lower out-of-pocket costs

By Jessica Catignani

Out-of-pocket medical costs can add up quickly when you go into the hospital. Medicare and Medicare Advantage (MA) cover some expenses associated with a hospital stay, but not all of them. The good news is Hospital Indemnity insurance¹ and its riders can supplement these plans, helping to fill coverage gaps and lessen financial stress.
 
Hospital Indemnity insurance, also known as hospital insurance, pays a benefit directly to you if you’re hospitalized. You may use the payment however you want, which allows you to spend the money where it is needed most. The best Hospital Indemnity plan will have no deductible or pre-certification process, making it easy to obtain and access when necessary. Plus, you can add riders to help you customize your Hospital Indemnity plan for your unique situation.

How Hospital Indemnity Insurance Fills Medicare Advantage Gaps

What is a Hospital Indemnity rider?

When you enroll for Hospital Indemnity insurance, you choose the number of days and the cash benefit per day. A rider is an optional add-on that provides extra coverage for such things as ambulance services and skilled nursing facility care.²
 
Erin Bueltel, product specialist for Medico Insurance Company, says, “Most riders can be easily added to your Hospital Indemnity plan to create additional value.”
 
For instance, when you enroll for Medico Insurance Company’s Hospital Indemnity insurance plan, you choose the number of days and the cash benefit per day, which ranges from $100 to $600 in $25 increments,* depending on what you select and what is available in your state. The base plan includes inpatient mental health services, observation unit monitoring, and emergency room services.*
 
You can add a variety of riders, but the Outpatient Surgical rider and Outpatient Therapy rider are especially helpful for Medicare and MA policyholders. Medicare and most MA plans pay for outpatient services differently than for inpatient services. And more and more doctors are placing patients under “observation,” an outpatient status, instead of admitting them to the inpatient ward. That means more seniors are facing unexpected out-of-pocket expenses when MA and Medicare’s observation billing doesn’t land in their favor.

What is an Outpatient Surgical rider?

When you consider one in four seniors age 65 and older falls each year, and falls are a leading cause of hip fractures, it’s not surprising then that nearly 450,000 hip replacements are performed every year in the United States. Medical advancements are making hip and knee replacements easier and more commonly performed as outpatient surgeries. Yet, their progress doesn’t translate to financial benefits for patients with Medicare and MA plans. Fortunately, Medico’s Hospital Indemnity insurance plan with an Outpatient Surgical rider pays a designated benefit of $250, $500, or $750 per surgery, up to two times a year.* It’s designed to meet most MA plans’ copays for outpatient surgeries.

What is an Outpatient Therapy rider?

Following surgery, an injury, or a stroke, you may need outpatient therapy services. Medicare and MA may not cover all the costs. This is where Medico's Hospital Indemnity insurance plan with an Outpatient Therapy rider provides value. It can alleviate some out-of-pocket costs to ensure you get the help you need, whether it’s through speech, occupational, or physical therapy or chiropractic care.
 
“Medicare has specific requirements in order to pay for chiropractic benefits,” Bueltel says. “However, with an Outpatient Therapy rider, people in need would have additional coverage, and some of those costs could be paid for with this insurance.”
 
Bueltel says it’s rare for insurance carriers to cover chiropractic care through an Outpatient Therapy rider, but Medico does to limit out-of-pocket costs for its policyholders.*

Choosing the right Hospital Indemnity plan and riders for you

Bueltel suggests looking at the benefits of your policy to identify potential Medicare and Medicare Advantage gaps in coverage. You will likely see a need for Hospital Indemnity insurance and its optional riders to increase coverage and decrease out-of-pocket costs down the road for your financial and emotional well-being.
 
To learn how Medico’s Hospital Indemnity insurance plan can help fill your coverage gaps and if it’s available in your state, visit the Hospital Indemnity page. You may also request a personalized, free quote, or call 877-257-2663 to speak with an agent.

Find a Medico agent in your state

Policy provisions and benefits may vary from state to state. Please see the policy and riders for complete details.
*For costs and further details of the coverage, including exclusions, restrictions, or limitations and the terms under which the policy may be continued in force or discontinued, see your producer or contact Medico. The policyholder has 30 days after receiving the policy to examine it and return it to Medico or to the producer if they are dissatisfied. Medico will refund the premium, less any claims paid, and void the policy (may vary by state). This webpage is intended to provide a general description of the policy benefits. Pre-existing conditions are not covered during the first six months after the policy date (may vary by state). To be eligible for benefits, you must receive medically necessary covered care, as defined in the policy.
 
This is a solicitation of insurance, and a licensed agent/producer may contact you. THIS IS A LIMITED POLICY. If there is a discrepancy between the webpage and the contract, the contract language prevails.
 
This policy is not major medical insurance and is not a substitute for major medical insurance. It does not qualify as minimum essential health coverage under the Federal Affordable Care Act. If you purchase this policy only, you will not satisfy the federal requirement that you have health coverage, which has been in effect since Jan. 1, 2014.

1. This policy is called “Hospital Confinement Insurance” in AR, “Fixed Indemnity Insurance Policy” in CO, “Hospital Confinement Indemnity Insurance” in PA, “Hospital Limited Benefit Indemnity Insurance Policy” in UT, and “Limited Benefit Hospital Indemnity Insurance Policy” in VA.

2. Optional benefit riders may not be available in all states and benefits may vary by state. The rider names may vary by state.