COVID-19 & Hospital Indemnity Plans

Written by Jessica Adkins

March 30, 2020

During these unprecedented times, the Coronavirus (COVID-19) is all around us.  As we continue to practice social distancing, your clients may be worried about the costs that would be associated with a positive diagnosis.  Depending on the type of coverage your clients may have, they may have exposure to copays, deductibles, and out-of-pocket costs.

If you should need treatment for a Coronavirus diagnosis, most people will be responsible for paying at least some of the expenses, the biggest of which could be meeting their deductible, especially if you’re in a high deductible plan or a plan with copays and other out-of-pocket costs such as a Medicare Advantage plan. Some of the other costs associated with a positive diagnosis include bills if you are hospitalized and/or require ambulance transportation.

Medical treatment costs will likely include fees for doctors, hospital stays, testing and the cost of medication — all of which can vary dramatically depending on whether you have health insurance and, if so, how that plan is structured. Depending on what type of insurance coverage they have, this can range from hundreds to thousands of dollars.

Those clients that are in a Medicare Advantage plan or a high deductible health plan will experience some gaps in their coverage as well as out-of-pocket costs for hospitalization and outpatient procedures.

Most seniors live on a fixed income. And while many Medicare Advantage plans offer $0 premium, they often include high inpatient hospital copays.  Most seniors could not easily afford the out-of-pocket cost of hospital admission.

This is where a Hospital Indemnity plan comes in.

This type of plan will help fill the gap left in coverage by most Medicare Advantage plans and high deductible health plans.  These plans are extremely affordable.   This plan will work with other health insurance coverage and pays in addition to other coverages your client may have.

What Does It Cover?

A hospital indemnity plan can offer the following benefits:

  • Ambulance Transportation
  • Primary Care Doctor Office Visits
  • Annual Wellness Benefits
  • Preventative Care
  • Hospital Confinement Coverage
  • ER Coverage
  • Lab & Radiology Benefits
  • Skilled Nursing Benefits

Optional benefits can be offered with these plans as well and could include:

  • Outpatient Surgical Procedure Coverage
  • Lump-Sum Cancer Benefit
  • Outpatient Rehabilitation Benefit

The Centers of Medicare and Medicaid Services have stated that a Hospital Indemnity Plan can be discussed and sold during a Medicare Advantage appointment as long as it was agreed upon in the Scope of Appointment form.

Enormous Market Opportunity

Cross-Selling a Hospital Indemnity plan to Medicare Advantage clients as well as those in high deductible health plans is and will continue to be an enormous market opportunity.

According to the Kaiser Family Foundation*:

  • 34% of Medicare Beneficiaries are in MA Plans in 2019
  • Total Medicare Advantage Enrollment in 2019 is 22 Million
  • The Average Premium for Medicare Advantage Enrollees is $29 per month
  • MA Enrollees’ average out-of-pocket limit for in-network services is $5,059 (HMO’s and PPO’s) and $8,818 for out-of-network services (PPO)

There are many beneficiaries, right now, who could benefit from Hospital Indemnity plans.


Stay in Touch with Your Clients. 

They are likely concerned/unsure about the current environment.

  • Talk to them about their current coverage
  • Explain what their current or potential plan covers and what it does not
  • Explain potential out-of-pocket costs

Ask the question: “Would you say you live on a fixed income? Would you be able to afford a visit to the hospital? How about a hospital stay lasting for several days?”

Agent Pipeline has a broad portfolio of Hospital Indemnity plans available in every state and all plans are available to sell over-the-phone via an e-platform.  Give us a call today and we can help you figure out the best plans available in your markets.  We can also help develop and provide marketing programs to help you attract new clients. Call Agent Pipeline, Inc. Today! 800-962-4693

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