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High Deductible Health Plans and traditional medical insurance may not cover all of the expenses related to the treatment and recovery from a major illness.

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Q: Do you have any examples of how the inpatient medical expense insurance benefits might apply?
Here is an example of how the Inpatient Medical Expense Insurance benefits work.

Example How Medical Expense Insurance Works for Inpatient Hospital Confinement
 
A federal employee age 38 enters into a hospital for an inpatient surgery and hospital stay.  The total charge for the hospital stay is $30,000. 

The employees’ health plan under FEHB has a $250 deductible, 80/20 co-insurance with a $5,000 catastrophic limit.

 

Without Inpatient Medical Expense Insurance

With Inpatient Medical Expense Insurance*

Annual Deductible

$250

$0

Coinsurance 80% / 20% to $5,000

$4,750

$0

Total out-of-pocket

$5,000

$0

You Pay

$5,000

$0

Plan Pays

$0

$5,000

Insurance Carrier Pays

$25,000

$25,000

Total Paid

$30,000

$30,000

 

*Claims examples are for illustrative purposes only. All benefits are subject to the exclusions and limitations outlined in the policy and riders. The examples listed herein assume that all incurred charges are covered under this supplemental inpatient medical expense policy, no incurred charges are excluded, and no limitations have been applied. Also assumes no other benefits have been paid under the Inpatient hospital benefit.