Surgical and hospital health insurance plans are intended primarily to pay expenses incurred by having surgery and hospital stays. Coverage options and costs vary depending on the specific policy purchased.
Deductibles and Co-pays
Most surgical and hospital health insurance plans have deductibles and co-pays that need to be paid by the insured. Common co-pay percentages are 20 percent for in-network providers and 40 percent for out-of-network providers. Common deductibles are $2,500 for in-network providers and $5,000 for out-of-network providers.
Premiums are generally lower for a plan with higher deductibles and co-pays. Premiums will be higher for plans with lower co-pays and deductibles or additional benefits.
There is usually a network of providers that the insured can utilize for services for lower co-pays and deductibles. Out-of-network providers can still be utilized but the insured will pay higher co-pay and deductible amounts.
Blood tests, X-rays, prosthetics, orthotics, emergency room costs, ambulance fees, urgent care facilities and medical equipment are usually covered in addition to costs associated with surgery, but the insured must pay co-pays and deductibles.
Routine physicals, check-ups, allergy immunizations, and preventive care in general are not usually covered with a hospital and surgical plan. A basic health insurance plan should be purchased to cover these types of expenses.
Health Insurance Online: Blue Cross Blue Shield of Florida BlueOptions Limited Benefits - Hospital and Surgical Plan 72 Plan Information
GO Insurance Rates.com: Hospital Care Insurance Facts