Hospital Indemnity Plans with Accident and Critical Illness Benefits
Benefit Options
| Hospital Indemnity Benefits | PLAN 1 | PLAN 2 | PLAN 3 |
|---|---|---|---|
| Hospital | |||
| Admission Benefit, 1 per year | $500 | $1,000 | $1,500 |
| Daily Confinement, Days 1 to 30 | $500 | $1,000 | $1,500 |
| Maximum number of days per confinement | 30 | 30 | 30 |
| Intensive Care Unit | |||
| Daily Confinement, Days 1 to 15 | $1,000 | $2,000 | $3,000 |
| Maximum number of days per confinement | 15 | $15 | 15 |
| Surgery Benefits | |||
| Inpatient Surgery, up to 1 per year | $500 | $750 | $1,000 |
| Outpatient Surgery, up to 1 per year | |||
| Tier 1 - Physician’s Office | $100 | $100 | $100 |
| Tier 2 - Hospital or Surgical Center | $150 | $200 | $250 |
| Exploratory surgery (percent or Outpatient Surgery) | 25% | 25% | 25% |
| Anesthesia, up to 1 per year | $125 | $175 | $225 |
| Epidural/Spinal (percent of Anesthesia Benefit) | 50% | 50% | 50% |
| Initial Treatment Benefits | |||
| Emergency Room, up to 1 per year | $125 | $150 | $200 |
| Supplemental Care Benefits | |||
| Post Confinement Medical Consultation, up to 5 per | $60 | $70 | $85 |
| Diagnostic Imaging and Testing, up to 3 per year | $60 | $70 | $85 |
| Ambulance Benefits | |||
| Ground 1 per year | $125 | $150 | $200 |
| Additional Benefits | |||
| Pandemic Assistance Once per year | $500 | $500 | $500 |
| RIDERS | |||
| Health Screening Benefit Rider* | |||
| Benefit payable 1 time per calendar year per insured | $50 | $50 | $50 |
What is a Hospital Indemnity Plan?
Hospital Indemnity helps pays for your hospital stay expenses.
What does a Hospital Indemnity Plan Cover?*
Daily Hospital Indemnity Benefit
Daily Hospital Intensive Care Unit Indemnity Benefit
Inpatient and Outpatient Surgical Indemnity Benefit
Outpatient Physician Office Visit Indemnity Benefit
Emergency Room Indemnity Benefit
Diagnostic Imaging and Test Indemnity Benefit
Ambulance Service Indemnity Benefit
* This coverage is not designed to provide the minimum essential coverage required by the Affordable Care Act (ACA).
Not available in all states and limitations and exclusions apply.
Benefits to a Hospital Indemnity Plan
No underwriting - no medical questions to answer
No Deductibles
Cost is determined by the benefits you select
Accident Benefits
Critical Illness Benefits
Hospital Indemnity plans are underwritten by Wellfleet Insurance Company. Wellfleet is a Berkshire Hathaway company focused on delivering customizable, digitally forward benefit solutions through a suite of member benefit products. Wellfleet is proud to be a Berkshire Hathaway company. As their primary Accident and Health carrier, Wellfleet is backed by A++ financial strength ratings—the highest possible—from AM Best.**
The mission of Wellfleet is to deliver customer-centric insurance solutions with quality service and uncompromising ethics. It is executed by six pillars: people, technology, customer centricity, innovation, operational excellence, and quality care.
* This is not are placement for major medical health plans. Major medical required in CA, CT, MA, ND, and VT in order to purchase Hospital Indemnity insurance.
**For the latest ratings, visit ambest.com.
EXCLUSIONS
- Intentionally self-inflicted injury, suicide, or any attempt or threat while sane or insane;
- Participating in war or any act of war whether declared or undeclared;
- Commission or attempt to commit a felony;
- Commission of or active participation in a riot, insurrection, or terrorist activity;
- Engaging in an illegal activity or occupation;
- Dental services or treatment except as a result of an injury;
- Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the earth’s surface, including any travel beyond the earth’s atmosphere except a fare-paying passenger on a regularly scheduled commercial or charter airline;
- Travel in or on any motorized vehicle that does not require licensing as a motor vehicle;
- Practicing for or participating in any semi-professional or professional competitive athletic contest, including officiating or coaching, for which the covered person receives any compensation or remuneration;
- Mental and nervous disorder treatment received on an inpatient and outpatient basis regardless of treatment location;
- Mental and nervous disorder or emotional disorder treatment without regard to organic disease;
- Substance abuse treatment received on an inpatient and outpatient basis regardless of treatment location;
- Travel or activity outside the United States and the territories and possessions of the United States,Canada or Mexico;
- Voluntary intoxication (as defined by the law of the jurisdiction in which such intoxication occurred) due to ingestion or inhalation of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a physician and taken in accordance with the prescribed dosage;
- Operating any type of vehicle while intoxicated (as defined by the law of the jurisdiction in which such intoxication occurred) by alcohol or any drug, narcotic or other intoxicant including any prescribed drug for which the covered person has been provided a written warning against operating a vehicle while taking it;
- Experimental or investigational procedures;
- Care that is not recommended and approved by a physician;
- Treatment associated with an elective or cosmetic surgery within the first 12 month(s) of the effective date;
- Treatment associated with donating an organ within the first 12 month(s) of the effective date;
- Treatment provided to a covered person either by themselves or by a medical professional that is an immediate family member, or has a business or financial affiliation with the covered person or an immediate family member;
- Treatment that was scheduled prior to the coverage effective date.
The Hospital Indemnity Plan with Accident and Critical Illness Benefits are underwritten by Wellfleet Insurance Company. Monthly premium rates are outlined below.
Plan 1: EE-$60.18; ES-$118.63; EC-$105.80; F-$175.03
Plan 2: EE-$91.63; ES-$189.07; EC-$153.02; F-$264.20
Plan 3: EE-$124.16; ES-$261.73; EC-$202.72; F-$357.25