Skip to content
  • There are no suggestions because the search field is empty.

4. Real-World Example: Jill's Hospital Stay

This example comes directly from the Optimum brochure. Use it on every plan review call when explaining hospital benefits.

 

Jill's Story

Jill has a 2 Unit (Plus) plan with a $5,000 deductible.

She suddenly becomes ill and is admitted to an in-network hospital for 3 days.

Hospital Admission Benefit (Day 1): $2,000
Hospital Confinement — Sickness (Days 1–3): $18,000 ($6,000 x 3)
Total Benefits: $20,000
Minus Deductible: – $5,000
Net Benefits: $15,000

Estimated 3-day hospital stay cost: $7,272
(approx. $2,424/day — Kaiser Family Foundation avg.)

Excess Indemnity Benefit paid to Jill: $7,728

Her plan paid MORE than the hospital charged.
And her monthly premium? A fraction of what ACA would cost.