Hospitalization Insurance and Health Insurance: What Are the Differences?

Even if you are young and in good health, the risk of accident or serious illness exists and exposes you to more or less long hospitalization, with costs that can reach very high amounts. Even if the Health Insurance always takes care of part of the hospitalization costs, a complementary health insurance will then prove to be very useful to support you financially. 

Hospitalization insurance, which will cover only your hospitalization costs and not your city medical costs, is therefore an interesting and less expensive option than health insurance.

What Does Hospitalization Insurance Cover?

What Are the Costs Incurred by Hospitalization?

When you are hospitalized, the costs incurred are partially covered by Health Insurance – provided that you go to a public or contracted hospital.

Health insurance then covers 80% of the agreed care rates in force. This operation is valid whatever the cause of your hospitalization: illness, accident, pregnancy or childbirth…

However, the costs incurred by hospitalization are often not limited to care. Health Insurance does not cover the following costs:

  • The remaining 20% ​​on the amount of care, which is called the “ co-payment  ”;
  • Any excess fees , quite common in hospitals, for medical or surgical procedures performed;
  • The daily hospital fee , a fixed contribution due for each day spent in hospital – its amount is fixed by decree and is currently $21.73 per day;
  • Any comfort costs, for example if you wish to benefit from a private room, a television, etc.;
  • Pre or post-operative care, for example in the event of rehabilitation;
  • Loss of income caused by your hospitalization.

Be aware, however, that the Health Insurance will sometimes cover 100% of the care, in particular in the following cases:

  • You are hospitalized for more than 30 days;
  • You are hospitalized for a long-term illness (ALD);
  • You are pregnant less than 4 months from delivery or less than 12 days later, or your newborn is hospitalized within the first 30 days after birth;
  • You are hospitalized as part of an occupational disease or an accident at work.

Daily Allowances, Co-payments… What Hospitalization Insurance Covers

To be reimbursed or covered on a larger part of your hospitalization costs, you will need to have taken out supplementary health insurance.

Hospitalization Insurance Thus Covers All or Part of Your Hospitalization Costs. Basic Plans Will Generally Cover the Following Costs:

  • The co-payment
  • The daily hospitalization fee
  • Fee overruns
  • Certain comfort options (in particular the private room)

The insurer will also pay you a daily allowance  for each day spent in hospital.

The Following Fees or Services Are Generally Optionally Included:

  • Pre and postoperative care
  • Certain ancillary costs incurred on an outpatient basis such as radiological examinations or biomedical analyzes
  • Childcare or home help in the event of long hospitalization
  • Compensation for lost wages…

The content of hospitalization insurance can vary from one insurer or from one formula to another: remember to always check the exact extent of the guarantees in the general conditions of your contract.

Why Take Out Hospitalization Insurance Alone?

Hospitalization Insurance: How Much Does It Cost?

The price of hospitalization insurance will depend mainly on the level of guarantees you have chosen. In particular, it is the level of reimbursement for medical procedures that will determine the amount of your insurance premium.

For each medical or surgical procedure, the insurer provides in its formula for a certain percentage of reimbursement in relation to the agreed rates of the Health Insurance: this amount will correspond to the maximum amount of compensation.

A good formula provides for example a refund of 150 or 200% of the agreed rate . This makes it possible to take charge of any overruns in fees.

As a general rule, conventional hospitalization insurance will thus cost you between $10.86 and $43.45 per month – sometimes a higher amount for the most complete formulas or providing for reimbursement known as “at actual costs” (corresponding to the total amount of costs invoiced by the hospital). 

Hospitalization and Health Insurance: What to Choose?

The main advantage of hospitalization insurance compared to comprehensive complementary health insurance logically lies in its cost, a few tens of euros per month where health insurance can easily cost you double (depending on the levels of cover chosen).

However, keep in mind that hospitalization insurance alone will not cover all your other health costs!

Taking out hospitalization insurance alone is therefore relevant in the following cases:

  • If you are in good health and rarely ill , especially if you are under 35;
  • If you do not need optical, hearing or dental care  (the coverage of which is one of the main benefits of complementary health insurance);
  • If you are old but cannot afford comprehensive health insurance;

If you practice certain risky activities, in particular sports (extreme sports, etc.). It is therefore up to you to decide between the different formulas available and to limit yourself to the protections that seem most essential to you.

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