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  • Hospital Confinement Policy Application & Change Form

Get Hospital Confinement Policy Application & Change Form

Group Number Dept./Loc. Replaces Policy No. SECTION 1 PERSONAL IDENTIFICATION For Name Change, Give Prior Last Name Name (First, MI, Last) Home Address City State Name of Employer Date Employed Full-Time Social Security # Occupation Birth State or Country Date of Birth Sex Zip County Height (ft-in) Work Phone Weight (lbs.) Home Phone SPOUSE & CHILDREN INFORMATION - Complete if Applying for Dependent s Coverage Date of birth Person Proposed for Insuranc.

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Coverage. Benefit can be used any way the insured chooses – to cover additional medical expenses or for any other out-of-pocket costs. Benefits are paid directly to the insured. Plan pays up to $150/day upon discharge for hospitalizations over three days paid in addition to any other insurance.

What is Hospital Confinement Indemnity Insurance? Hospital Confinement Indemnity Insurance pays a daily benefit if you have a covered stay in a hospital* or critical care unit. The benefit amount is determined based on the type of facility and the number of days you stay.

For those with chronic medical conditions — like cancer, diabetes, or heart disease — hospital indemnity insurance can help cover your frequent hospital visits. You have an upcoming surgery or procedure. You may want hospital indemnity insurance for a scheduled hospital visit, overnight stay, or outpatient surgery.

It doesn't cover prescription drugs and typically won't work for those with pre-existing conditions. Coverage is not guaranteed and there will be limits, which vary from one plan to another.

Payments from a hospital indemnity plan can cover costs from an extended hospital stay, transportation to and from follow-up appointments, and more. Here are a few expenses you might want to use it for: Deductibles and co-payments. Out-of-network care and treatment.

This rider is designed to pay a daily benefit amount for a Hospital Confinement, up to a maximum of 90 days, if you are confined to a Hospital.

CONFINEMENT BENEFIT means if a Covered Person is Confined in a Hospital for treatment of a covered Injury or Sickness, MetLife will pay the Confinement Benefit shown on the Benefit Schedule for each day of Confinement.

A hospital confinement supplemental insurance plan generally pays a daily cash benefit directly to you when you are in the hospital. The money can be used to pay unexpected medical costs or everyday living expenses. The advantages of having supplemental hospital insurance include: No deductibles.

Hospital indemnity insurance supplements your existing health insurance coverage by helping pay expenses for hospital stays. Depending on the plan, hospital indemnity insurance gives you cash payments to help you pay for the added expenses that may come while you recover.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232