Kaiser Health News reported on a 44-year-old teacher from Austin, Texas who suffered from a heart attack. After four days in the hospital, the treatment cost $164,941; insurance covered $55,840, the remaining balance totaled $108,951.31. One of the reasons the balance was so high was due to the nearest emergency room is considered as out of network. Stories like this cause many to consider how to protect themselves from that kind of situation?
Once the story aired the hospital offered to accept a payment of $782.29 to pay the outstanding balance, but many faced with the same scenario may not be as fortunate. Sadly, this scenario is growing more common. Luckily, as a Medicare beneficiary, there are safeguards in place to protect you from these types of charges. The protections include limitations on balance billing, participating provider program (or in-network), and private contracting limits.
The practice of “balance billing” still affects a small portion of Medicare beneficiaries. Balance billing is where you are responsible for the difference between the hospital’s charges and the insurance coverage amount. An additional form of protection to consider is in the form of hospital indemnity insurance. Hospital Indemnity is supplemental insurance that you purchase that helps you pay out-of-pocket expenses that can accrue during a hospital stay.
Most Medicare Advantage clients will face out-of-pocket cost during a hospital stay. Many $0 premium Medicare Advantage plans have high inpatient hospital copays. Alternatively, you may live on a fixed income and could face hardship when trying to pay for the out-of-pocket charges. A Hospital Indemnity plan can aid in alleviating the financial burden.
Hospital Indemnity plans are not health insurance but cover some gaps in your hospital stay. Other optional plan benefits can include; care at a skilled nursing facility, an outpatient surgical procedure, or ambulance services, and rehabilitation. You may be prepared and have your insurance in place, but Hospital Indemnity insurance will keep you from being caught off guard when you receive the bill in the mail while on your road to recovery. Contact your agent at Medicare Pathways at 866-466-9118 to learn more about adding Hospital Indemnity insurance.