Affordable Choice Hospital Indemnity FAQ
What is Affordable Choice Hospital Indemnity Insurance?
Hospital Indemnity (HI) is a plan that provides specific, fixed benefits regardless of actual costs that go directly to the policyholder (unless otherwise assigned). It does not coordinate benefits. This plan can supplement a major medical plan, in order to cover deductibles, and pay directly to you for lost time and wages. With four plan options available, you can choose the coverage that works best for you - whether you're an individual or if you have family.
FAQ Table of Contents:
Is Hospital Indemnity Insurance the same as a Major Medical Plan?
Do I have to answer medical questions to enroll in this coverage?
How long is the waiting period?
How long is the waiting period on pre-existing conditions?
Is there a network and do I have to use it?
How long does the claims process take?
Can I use this plan if I'm retired?
Are pre-existing conditions covered?
Does it cover doctors' office visits?
What about prescription drugs?
Does this plan cover any outpatient benefits?
Are benefits paid to the provider or to me?
If I am admitted to the hospital, what will Affordable Choice pay towards the daily room charges?
Is Hospital Indemnity Insurance the same as a Major Medical Plan?
No. This is a fixed benefit plan, not major medical. We pay you the flat amount listed as scheduled and there is no deductible. This may be used as a supplement.
Can I enroll anytime?
Yes, 365 days a year.
Do I have to answer medical questions to enroll in this coverage?
Yes. Affordable Choice is an underwritten product.
Is there a waiting period?
No. Everything is covered from day one with the exception of pre-existing conditions as outlined during underwriting.
How long is the waiting period on pre-existing conditions?
If underwriting has determined a condition to be pre-existing, coverage for that condition begins 12 months after the policy has been issued.
Is there a network and do I have to use it?
While there is a Multi-plan network, you are not required to use it. However, using it will give you access to network discounts.
How long does the claims process take?
Our goal is to pay eligible claims in 7-10 business days of receiving all necessary documentation.
Can I use this plan if I’m retired?
You can apply for this plan through age 64. This plan will terminate at the end of the month you attain the age 65. You may not have this plan at the same time as Medicare.
Are pre-existing conditions covered?
Yes, after a 12-month waiting period.
Does it cover doctors’ office visits?
Yes. Our Elite Plus plan covers 10 visits per calendar year at $100 per day, and our Classic plan covers 6 visits per calendar year at $50 per day. All our plans include a rollover feature - rollover unused visits from one calendar year to the next! You can save up to 15 visits.
What about prescription drugs?
Our Elite Plus plan offers a $75 per day benefit, and our Classic plan offers a $25 per day benefit. Regardless which of our plans you choose, the overall maximum is $750 per calendar year.
Is there a military discount?
No. Participation in the military service of any country or international organization will not be covered under this plan.
Does it cover pregnancy?
Generally, no. But it may cover complications due to pregnancy.
Does it cover newborns?
Yes. The first 31 days of a newborn are covered. Within that first month, you must provide notice of birth and additional premiums for them to be covered from their date of birth. **Some states may vary. Please see your policy for verification.
Does this plan cover any outpatient benefits?
Yes. All of our plans pay for some laboratory, radiology services, and preventative services.
Are benefits paid to the provider or me?
The policyholder receives the claim benefits unless otherwise assigned by the policyholder.
Is there a surgery benefit?
Yes. There are daily surgical benefits for both inpatient and outpatient surgery with a max of $50,000 per calendar year. Please ask your agent or our customer care center to review the surgical schedule with you.
If I am admitted to the ER and discharged within 24 hours or if I go in as an outpatient, will this plan cover me?
You must be admitted for 24 hours to receive the inpatient benefit. Otherwise, the emergency room visit benefit would be payable.
If I am admitted to the hospital, what will Affordable Choice pay towards the daily room charges?
With the Elite plan, we will pay $2000 for the first inpatient day per year PLUS the $3000 confinement benefit for a total of $5000 on the first day. Thereafter, you will receive $3000 per inpatient day with a $1,000,000 cap per calendar year.
With the Classic plan, you will receive $1,000 for the first inpatient day per year PLUS the $1,500 per confinement. Thereafter you will receive $2,000 per day with a $1,000,000 cap per calendar year.
Visit our Hospital Indemnity Plans page for more information.