The following information is not advice, it’s just my thoughts and opinions. I’m just a girl on the web, not currently licensed in insurance or anything else in any state. You should absolutely seek the counsel of an insurance agent licensed in your state before taking any action at all. This is only a brief explanation of coverage. Modifications are applicable in some states. Coverages and programs discussed may or may not be available in your state.
Also know that I don’t work for State Farm any longer and am not being compensated in any way for this article. It’s just a good policy.
I love this policy. And them’s some strong feelings about an insurance policy. I promised you all I would tell you about it, so here it is.
I’m not sure if I’d have discovered this policy if I hadn’t been working for State Farm as an insurance agent. It’s not well publicized, but it can be a terrific part of anyone’s health insurance portfolio.
What is it?
If you’ve ever been hospitalized you know that there are expenses your primary health insurance just doesn’t cover. Additionally the inconvenience of simply being hospitalized means additional expenses for you and your family. Things like:
- Deductibles and Co-insurance
- Private Room and Private Duty Nursing Fees
- Child Care
- Lawn & House Care
- Meals Out
- Pet Care
State Farm’s Hospital Income policy helps provide the money you’ll need to pay for those extra expenses when you’re hospitalized. It can offer you an ideal way to supplement your health insurance coverage.
If you are hospitalized for a covered injury or sickness (and really, there aren’t many exclusions) the policy pays the selected hospital income amount (mine’s $100/day*, but I wish I’d taken more!) for up to 365 days of confinement in a hospital.
One of the exclusions is for normal pregnancy and childbirth. However, complications of pregnancy and childbirth are covered. When I had Son I needed an emergency Cesarean Section, so my five day hospital stay was covered. Son had some minor complications so his stay was covered, too. He was automatically covered at birth as long as I added him to the policy (and paid the additional premium) within thirty days of his birth. It also covered his three day RSV induced hospital stay when he was 21 months old – the longest days of my life.
When Intensive Care is needed the policy pays an additional benefit equal to the hospital income amount not to exceed 14 days. So for me that means I get an additional $100 per day if I’m in ICU.
One of my former coworkers has a $200 per day policy. When her daughter was born six weeks prematurely she was in the pediatric intensive care unit for three weeks, then hospitalized another two. With her own hospital stay, her daughter’s hospital stay and the extra $200 per day she received for 14 of the 21 days her daughter was in intensive care my coworker received over five thousand dollars from her hospital income policy – enough so that she could stay home with her, unpaid, until her daughter was off a heart monitor and able to be placed in daycare so she could return to work.
Can you imagine the financial disaster she would have suffered if not for this spectacular little policy?
When Extended Care is needed the policy pays half the hospital income amount (so for me that would be $50 per day) for up to sixty days per calendar year while in a qualified Extended Care Facility. In most states extended care must begin within 14 days after at least a three day hospital confinement.
But that’s not all. And that’s not even my favorite part of the policy.
When you are injured accidentally the policy pays up to five times the hospital income amount (in my case up to $500) for x-rays or emergency first aid if received within 72 hours of the injury. If I have over $500 in emergency room or doctor costs, I get $500. If the bills are less than $500 I get whatever the bill amounts to.
I have used this portion of the policy many, many times. In the last ten years there have been at least three car accidents (none my fault!) that have ended in emergency room visits and one broken arm (on January 7th, so my $500 primary policy deductible had not yet been met). Each of those (and there may be more events I’m just not recalling right now) netted me $500.
There was also an incident, when Husband and I were trying to conceive Son, where I stepped wrong and broke a few toes. I wasn’t sure if it was just my toes or if my foot was broken, too, so I went to the ER (if I’m going to be in so much pain I may as well get paid for it!). I wouldn’t allow them to do X-rays (I could have been pregnant). The doctor assured me my foot wasn’t broken, taped my toes together and billed me $420. My primary insurance paid 90% (I’d met my yearly deductible, and my co-insurance was reduced because I went to an in-network hospital), so after paying my co-insurance I pocketed $378.
Isn’t that fab?
And if you have kids you know how often accidents happen. We’ve already collected from the policy twice for Son, including the incident last summer when he thought it would be fun to shove a rock up his nose. That sucker was wedged up there.
And there’s more.
When outpatient surgery is needed the policy pays the hospital income amount ($100 for me) for outpatient surgery not otherwise covered by outpatient benefits.
This is probably the part of the policy we’ve used most. Any outpatient surgery is covered. We’ve collected for all three of my colonoscopies and Husband’s one, his cardiac catheterization, three of my cyst removals, several mole removals, skin cancers. It even covers skin tag removal, which is so much of a nothing I’ve taken them off myself (isn’t aging sexy?).
So if I really needed some money one month I could, if I were so inclined, go to the dermatologist and pay my $25 co-payment, have her remove a skin tag or two and file a claim under my Hospital Income policy. I’d make $75 on the deal. And have fewer skin tags. Not that I’ve done that just because I’m short of money.
But I could.
Yes. I get paid to go to the doctor. Isn’t that smashing?
What else to like about this policy?
The benefits start from the first day of confinement. No waiting period!
The money is paid directly to you, unless you say otherwise. You decide how the money is spent. Use it to pay your deductible, you coinsurance or go on a trip to Tahiti. You decide!
The money isn’t taxable income. It’s insurance policy proceeds, so not counted as income (There may be some odd rule somewhere that I’ve never heard about that may make this taxable some minute fraction of the population, so please ask your tax advisor for a definitive answer. After all, if I wanted to know everything there was to know about taxes I’d have become an accountant like my father!).
Family coverage is available. You can cover just yourself, or add your spouse and kids. Remember that newborns are covered automatically as long as you notify the company and pay the premium.
It’s not expensive. We cover all three of us for about $280 for the year, and we’re oldish. The premiums will vary based on your age(s) and the policy amount chosen. I’ve not had a year yet that I didn’t collect more than I’ve paid. Of course if it was that way for everyone the company couldn’t offer it! Also know that the premiums can and do increase periodically as you age.
The policy is Guaranteed Renewable. Except in the event of fraud, material misrepresentation, nonpayment of premium, or expiration of the policy.
This policy is a great supplement to today’s high deductible plans, and also a great option for anyone with a HSA plan (State Farm also offers one of those). It should obviously not be your only coverage. If you have State Farm Auto and no other insurance with them you’ll also get a discount on your auto insurance for buying this policy.
You do have to medically qualify for the plan, and there are exclusions. The medical qualification is the only thing that keeps me from increasing our policy amount – with Husband’s diabetes and Son’s asthma we’d get denied. Dadgummit!