Hospital Indemnity

Hospital Indemnity  

Overview

Even with good medical coverage, the cost of a hospital stay can really add up. MetLife’s Hospital Indemnity insurance provides you with a lump-sum payment to use as you see fit if you experience a covered event and meet the policy and certificate requirements. This payment can help you focus more on getting back on track and less on the extra expenses an accident or illness may bring.

Enrollment

Add hospital indemnity insurance to help offset hospitalization expenses that may not be covered under your employer’s existing medical plan.
Contact Us

 Phone:
1-800-626-9065

Si usted prefiere hablar de esto en 

español, llame a este número.

 Hours
 M-F 9a-6p ET
 Email
customer.service@mercer.com

How It Works

 

* 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.

FAQS

Answers about the plan, including eligibility, options, enrollment and customer service.
  • What is Hospital Indemnity Insurance?

    Hospital Indemnity Insurance pays a daily benefit if you 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. Payments are made directly to you, not to the doctors, not to the hospitals nor to any other healthcare providers. Hospital Indemnity Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.


    Features of Hospital Indemnity Insurance include:

    • Flexibility: You can use the benefit money for any purpose you like
    • Payroll deductions: Premiums paid through payroll deductions
    • Cost-effective coverage: Rates are typically lower when you purchase coverage through your employer
    • Portable: Should you leave your current employer or retire, you can take the policy with you and select from a variety of payment plans3
    • Guaranteed4 coverage: As long as you are actively at work, your coverage is guaranteed without any medical exams to take or health questions to answer
  • How can Hospital Indemnity Insurance help?

    Below are a few examples of how your Hospital Indemnity Insurance benefit could be used (coverage amounts may vary):

    • Medical expenses, such as deductibles and copays
    • Travel, food and lodging expenses for family members
    • Child care
    • Everyday expenses like utilities and groceries
  • Who is eligible for Hospital Indemnity Insurance?

    • You—must meet actively-at-work definition
    • Your spouse/domestic partner5
    • Your child(ren)— to age 26. Coverage is available only if Employee coverage is elected

 

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]

Forms

Hospital Indemnity - Plan Overview

Mercer's Role & Compensation

Details of the Mercer disclosure of the compensation.