Does Health Insurance Cover Long Hospital Stays?

Medical care in the United States has become a major topic of conversation, and one of extreme controversy. For the most developed nation in the world, our healthcare system seems to pale in comparison to other developed countries. President Obama tried to make things better with the Affordable Care Act (ACA, also known as “Obamacare”), but there are a lot of flaws with the plan. Despite his promises to repeal and replace the ACA, President Trump, congress, and all of the other powers that be have yet to come up with a viable solution. In the meantime, many Americans are left guessing what to do about their healthcare coverage.

Since Obamacare went into effect in 2010,  every resident of the United States not only has access to medical insurance, but they are required to carry it. If you’ve recently received your own health insurance policy for the first time – whether it’s through your employer or the ACA marketplace – you’re probably wondering what’s covered and what isn’t. For example, will a long hospital stay be covered? That’s a great question, as it’s important to know exactly what to expect when it comes to things like planned surgeries or emergency treatments that require an extended hospital stay.

Health Insurance and Long-Term Hospital Care

Will a long-term stay in a hospital be covered by your health insurance provider? The answer to that question is yes; however, like most things that are related to insurance, there’s a lot of gray areas. For instance, how much of your stay will be covered, whether or not you will be responsible for co-pays – and if so, how must will they cost – and what other types of costs can you expect, all depend on your specific insurance provider and the policy that you carry.

In an effort to provide more of an understanding of how health insurance will cover a long-term hospital stay, here’s a look at some of the things that you can expect:

• Generally speaking, extended treatment at a hospital will be covered by your health insurance provider; however, the amount of coverage you will receive is truly dependent on the specifics of your provider and your individual policy.
• Typically, just like a visit to an emergency room or a short hospital stay, you will be responsible for covering your co-pay (the amount that you are required to pay before your health insurance will kick in). Again, the costs of co-pays vary and depend on the details outlined by your policy.
• You may be required to pay at least a portion of the treatments and procedures you received, as well as incidentals, such as meals and personal care supplies, as well as medications. However, depending on your policy and the health insurance company that has issued your policy, certain expenses may not be covered at all.
• Depending on your health insurance policy and the policies of the hospital where you receive treatment, you might have to pay a portion of your bill upon being discharged. However, most hospitals will offer financial assistance (payment programs), so if you are unable to afford the payments up-front, you can speak with the accounting department to set up a plan that will work for you.

Things to Keep In Mind

Just like anything else related to health insurance, the amount that your provider and policy will cover for an extended hospital stay is completely dependent on the type of coverage you have. Typically, individual insurance plans with low premiums tend to cover less than large group plans that are offered through employers. To find out exactly what type of costs you can expect to accrue for long-term hospital care, it is in your best interest to contact your health insurance provider. If you know that you will be staying in a hospital for an extended period of time, it’s in your best interest to contact your insurance company beforehand so that you have a better understanding of what will be covered. If, however, your prolonged treatment arose out of an emergency, you can speak to the company that issues your coverage during your stay or after you are discharged to find out what type of expenses you will be responsible for.

Speak to a Reputable Insurance Agent

If you are purchasing an individual health insurance policy, it’s in your best interest to speak to a reputable agent that specializes in healthcare coverage. An agent will have the knowledge and insight to answer your specific questions and direct you to a policy that will best meet your needs. If you believe that you will require an extended stay at a hospital, for example, an agent will assist you with finding a plan that will cover as much of the expense as possible to help you offset the out-of-pocket costs.