Do I need a Hospital Indemnity Plan if I have Medicare Advantage? What if I am hospitalized twice in the same year?

Question

Rebecca Bilbrey · Accepted Answer

A hospital indemnity plan to work with your Medicare Advantage plan is a good idea. Your Medicare Advantage plan will have daily copays (or at least per-stay copays) and the hospital indemnity plan can pay those for you. Most policies will pay more than once in a year as long as you have been out of the hospital for a set amount of days (differs per policy) before needing to go back in the hospital. Hospital indemnity policy premiums are usually inexpensive.

Answered by Rebecca Bilbrey on April 17, 2025

Broker Licensed in TX, AL, CO & 6 other states

Answered by Rebecca Bilbrey Medicare Insurance Agent

Steven Graves · Answer

In many cases, yes, a Hospital Indemnity Plan can be a valuable add-on if you have a Medicare Advantage plan. Here's why:

 Why?
Medicare Advantage plans often come with daily copays for hospital stays—for example:

$300 per day for the first 5 days of inpatient care

$0 after day 6
That’s up to $1,500 per hospital stay just in copays, not including ambulance, rehab, or observation status costs.

A Hospital Indemnity Plan pays you a cash benefit (often $100–$500 per day) when you're admitted to the hospital. You can use that money to cover:

Hospital copays

Transportation

Lost income (if you're helping a spouse or family)

Other out-of-pocket costs

 What If You’re Hospitalized Twice in One Year?
Here’s where a Hospital Indemnity Plan really pays off:

Medicare Advantage plans charge you copays each time you're hospitalized.

A good indemnity plan will pay benefits for each separate hospital stay (as long as they're separated by a specific number of days—usually 60, but it depends on the plan).

That could mean double the financial burden from your Advantage plan—but also double the benefit from your indemnity plan, if structured correctly.

 When It Makes Sense to Add It
Your Medicare Advantage plan has high inpatient hospital copays

You’re concerned about unexpected hospitalization costs

You’re on a fixed income and want predictable, prepaid protection

You’ve had hospital stays in the past or have a chronic condition

Want Help Deciding?
It’s best to review the exact details of your Medicare Advantage plan and compare them to the indemnity plan benefits available in your state. Plans and payouts can vary significantly.

Would you like help reviewing your Advantage plan and seeing how an indemnity plan might fill the gaps? I can help guide that process.

Call us, we are here to help

Steven Graves

William Gray · Answer

It's not necessary but you could face pretty high out of pocket costs.

Advantage plans have deductibles and copays. The indemnity plan pays you a set amount by plan

Rodney Powell · Answer

Advantage plans have a maximum out-of-pocket limit, which helps cap your hospital and outpatient medical costs.

If you don’t have enough in personal savings or an HSA, a hospital indemnity and catastrophic illness policy can be a good safety net.

These policies usually pay per hospital stay, so two hospitalizations in one year are typically covered, BUT always check the details of any plan before signing up.

Antonio Espino · Answer

1. Do you need a Hospital Indemnity Plan... No. You don't need it at all. But it would cover the gaps in your Medicare advantage plan. Hospital Indemnity will cover the hospital stays as well as outpatient services, and emergency room visits. You can add other coverages like a cancer policy as well. 

But do you need it... no. Will it help... Yes.

2. If you have a hospital indemnity plan and you are hospitalized twice, then the policy will pay you (however the way the policy was set up. I.E per day or lump sum). If you don't have a HI plan, then you just pay the Medicare advantage copays.

Steven Bleicher · Answer

Unless you or your family have a history of officially being hospitalized, you may be needlessly worried about double occurrences in one year. However, since Hospital Indemnity Plans are worth it in my opinion, ask your agent if they can provide coverage for more than once a year? There also is a rule where Medicare breaks up the calendar year into six periods or 60 days each. What that means is: if you are re-admitted to the same hospital after being released within that same 60 day period, that second admission may be automatically covered. But, be sure to check on that!

Answered by Steven Bleicher on June 8, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Steven Lovell · Answer

It's not required but a Hospital Indemnity Plan can be a valuable addition to Medicare Advantage. It can help cover out-of-pocket expenses during hospital stays. If you're hospitalized twice in the same year, a Hospital Indemnity Plan can still provide benefits, as it typically pays a set amount per day of hospitalization, regardless of the number of hospitalizations.

Answered by Steven Lovell on May 11, 2025

Broker Licensed in GA, CA, FL & 7 other states

Answered by Steven Lovell Medicare Insurance Agent

Mary Salmon · Answer

A Medicare Advantage plan requires Medicare beneficiaries to pay copays for many services including in-patient hospitalization. A hospital indemnity plan can provide financial assistance by paying you a specified amount for each day you are admitted to the hospital, up to the maximum benefit period you have chosen when selecting your hospital plan.

Answered by Mary Salmon on April 23, 2025

Broker Licensed in TX & OK

Answered by Mary Salmon Medicare Insurance Agent

Hannah Skinner · Answer

A hospital indemnity plan is a great way to cover some of the gaps in your Medicare Advantage plan. Hospital copays can reach up to $3000/stay. If you area discharged and go back the next week, this number will reset. 

Most hospital indemnity plans reset after a 30-60 benefit period. This means that it can be used upwards of 6 times a year.

Mal Varlack · Answer

If you don’t want to expose yourself to potentially paying the Max out of pocket on a plan, or exposing yourself to paying a $200 some odd daily skilled nursing benefit after the 20th day of rehab or other copays that may hurt financially and emotionally to pay; then YES. I would highly recommend taking out a Hospital Indemnity Plan to offset expenditures you are subjected to pay in the Medicare Advantage Plan. Namely the 2 expenses I mentioned but there are others: cancer meds administered in hospital, as an outpatient or doctors office; ambulance rides are not free either. Hospital Indemnity Plans can be structured to cover some or all of the out of pocket costs of these as well. Even if you go twice a year. They pay you directly and some are what are called Guarantee Issue. That means depending on the carrier and your age you don’t have to answer health questions to qualify.

Answered by Mal Varlack on April 17, 2025

Agent Licensed in FL

Answered by Mal Varlack Medicare Insurance Agent

Fred Manas · Answer

While Medicare Advantage plans generally cover hospital stays, a hospital indemnity plan can offer additional protection, particularly if you're concerned about potential out-of-pocket costs or a second hospitalization in the same year. Hospital indemnity plans provide a cash benefit for each day of hospitalization, which you can use to cover expenses like co-pays, deductibles, or other costs not covered by your Medicare Advantage plan. 
Here's a more detailed look:
Medicare Advantage Coverage:
Medicare Advantage plans cover most hospital stays as part of their benefits package, similar to Medicare Part A. 
Potential for Out-of-Pocket Costs:
Despite coverage, you may still have co-pays, deductibles, or other out-of-pocket expenses for hospital stays, especially with some Medicare Advantage plans. 
Hospital Indemnity as a Supplement:
Hospital indemnity plans can help fill these gaps by providing a cash benefit for each day in the hospital. 
Second Hospitalization:
If you are hospitalized again within the same year, your Medicare Advantage plan might start a new benefit period, meaning you could incur another deductible and co-pays. A hospital indemnity plan would likely continue to provide benefits during the second hospitalization as well. 
How it Works:
Hospital indemnity plans generally have no deductibles or pre-certification requirements, making it easy to access the benefits when needed. 
Choosing a Plan:
You can customize your hospital indemnity plan by choosing the benefit amount and the maximum benefit period to match your needs and budget. 
In essence, a hospital indemnity plan can provide an extra layer of financial protection alongside your Medicare Advantage coverage, particularly if you're concerned about potential out-of-pocket costs or the possibility of multiple hospitalizations in a year.

Vachik Chakhbazian · Answer

Yes, you may still need a hospital indemnity plan even with Medicare Advantage, as it can help cover out-of-pocket costs like copays and deductibles for hospital stays. If you are hospitalized multiple times in a year, the hospital indemnity plan can help manage the cumulative financial impact, especially if your Medicare Advantage plan has cost-sharing requirements that reset with each new benefit period.

Answered by Vachik Chakhbazian on July 29, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Jaye Maxx Alexander II · Answer

You don't need a hospital Indemnity Plan, but I strongly encourage you to have one. With an MA or MAPD plan, you will have costs associated with your hospital stay that can place a huge financial burden upon you and your family.

Answered by Jaye Maxx Alexander II on April 21, 2025

Broker Licensed in NC, AK, AL & 47 other states

Answered by Jaye Maxx Alexander II Medicare Insurance Agent

Adam Morillo · Answer

Although it's not mandatory it is highly recommended to have a hospital indemnity plan to cover the high out of pocket per day amount for hospital stays. A lot of carriers offer different plans and budgets to fit your Medicare Advantage plan. Some plans cover unlimited visits for different injuries or sickness or there are 60 days between admissions for the same covered injury
or illness.

Larry Pereiro · Answer

A strong argument for Hospital Indemnity plans is that offset your out of pocket cost for hospital, lump sum cancer and skilled nursing facility stays. The cost of these three benefits in a typical Hospital Indemnity can be acquired for about the 3rd of the cost of a Medigap policy. In essence, a Medicare Advantage plan with a Hospital Indemnity plan produces what I call a Hybrid Medigap policy.

Answered by Larry Pereiro on June 2, 2025

Agent Licensed in IN

Answered by Larry Pereiro Medicare Insurance Agent

Tony Merwin · Answer

If you feel like the hospital copayments and / or annual maximum out of pocket are above your budget, it is worth comparing. A hospital indemnity plan doesn't add new benefits, but helps cover the copayments you experience when using the hospital benefits of your MA plan.

Answered by Tony Merwin on August 18, 2025

Agent Licensed in TX, AR, AZ & 28 other states

Answered by Tony Merwin Medicare Insurance Agent

Bob Nunn · Answer

There are some identifiable gaps in a MaPD . The first days in hospital can add up. Please look at your policy and see the benefit limits and you can get a small policy to fill those in. One strategy could be for a mapd with a give back benefit and use a portion of that to fill in the gaps to limit your out of pocket expenses.

Answered by Bob Nunn on May 2, 2025

Agent Licensed in FL, AL, AR & 36 other states

Answered by Bob Nunn Medicare Insurance Agent

Alexander Lehn · Answer

A hospital indemnity plan is not required if you have a Medicare Advantage plan, but many people choose to have one. These types of plans pay a fixed amount to you if you are hospitalized so you can have any co-pays covered without worry. A cost-benefit analysis can be done to determine if the cost of coverage over 12 months is worth having to offset the potential costs associated with being hospitalized. Many people on a fixed income prefer to have this coverage so the costs are built into their budget and they don't have unexpected large bills associated with their healthcare, just a low monthly cost for the indemnity coverage.

Answered by Alexander Lehn on April 22, 2025

Agent Licensed in NV, CA, FL & TX

Answered by Alexander Lehn Medicare Insurance Agent

Matthew Moreno · Answer

A hospital indemnity plan is meant to fill in the copays associated with hospital stays. You would be paying a relatively high copay per day in the hospital. I'd always recommend a hospital indemnity plan for my clients. However it is still in there own hands if they wish too.

Answered by Matthew Moreno on August 21, 2025

Broker Licensed in IL & TX

Answered by Matthew Moreno Medicare Insurance Agent

Angelique Solomon · Answer

Great question!

Do You Need a Hospital Indemnity Plan with Medicare Advantage?

Yes—it can be a smart add-on.
Medicare Advantage (MA) plans often have daily hospital copays, sometimes up to $300+ per day for the first few days of each stay. A hospital indemnity plan pays cash directly to you for each hospital day, helping cover:
   •   Copays
   •   Deductibles
   •   Lost income
   •   Travel or caregiver expenses

What If You’re Hospitalized Twice in One Year?

A good indemnity plan:
   •   Pays per hospital stay, not just once per year
   •   Resets after a 60-day no-hospital period (varies by plan)
   •   Can cover multiple admissions, even for the same condition

Bottom line: If your Medicare Advantage plan has high inpatient copays or if you’re concerned about unexpected hospital costs, a hospital indemnity plan adds a layer of financial protection.

Want me to review your current plan and show options?

Teresa Scott-Carano · Answer

Great Question. It is important to understand these are 2 very different plans. A Hospital Indemnity plan is not a replacement for your Advantage plan. Review your Medicare Advantage plan (call member services or your agent) so you understand coverage details and potential out of pocket costs for a single or multiple confinements. Then I recommend comparing different Hospital indemnity plans to learn the daily benefit amount, benefit period and cost to meet your needs and budget. Consult with a licensed insurance agent so you can make an informed decision. Thank you!

Answered by Teresa Scott-Carano on June 11, 2025

Agent Licensed in PA & OH

Answered by Teresa Scott-Carano Medicare Insurance Agent

Pamela Walton · Answer

Having a Hospital Indemnity plan in place is a great way to help pay for our pocket cost such as Hospital copays. Often times, the benefit can be used multiple times in the plan year. I recommend these plans to bridge the gap and save you hundreds of dollars in hospital out-of-pocket cost.

Answered by Pamela Walton on May 26, 2025

Broker Licensed in TX, AL, AR & 12 other states

Answered by Pamela Walton Medicare Insurance Agent

Do I need a Hospital Indemnity Plan if I have Medicare Advantage? What if I am hospitalized twice in the same year?

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