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Hospital Room (Semi-Private / Private)

Hospital room coverage pays for the cost of upgrading from a standard ward room to a semi-private or private hospital room. This benefit allows greater privacy and comfort during inpatient stays.

Plans generally cover the difference between the ward rate and the upgraded room rate, subject to daily and annual maximums. Some basic plans include only semi-private coverage, while others let you add private room options as riders.

Example:

If a private hospital room costs $250 more per night than a ward room and your plan covers up to $200 per night, you pay $50 out of pocket.

What to Watch For:

Hospital room benefits do not cover extra physician charges or uninsured services. Always check maximums and whether pre-approval is required.

Related Terms

Short-term Disability Insurance

Short-term disability (STD) insurance provides temporary income replacement when you are unable to work for a limited period due to illness, injury, or surgery. It helps protect your income during the early stages of a disability, usually before long-term disability (LTD) benefits begin. This coverage ensures financial stability while you recover and are expected to return to work within a few weeks or months.

Spouse / Partner

A spouse or partner is the person legally married to or living in a committed relationship with the insured plan member or policyholder. In insurance terms, a spouse includes both legally married and common-law partners who meet the eligibility requirements defined by the insurer. Common-law partners are generally recognized after living together continuously for a specific period, often 12 months or longer, in a relationship similar to marriage.

Hospital Cash

Hospital cash is a supplemental benefit that provides a fixed daily payment when you are hospitalized, regardless of the actual cost of your care. It offers financial support to cover incidental expenses such as transportation, meals for family members, or other non-medical costs during recovery.

Premium

A premium is the amount of money an individual or organization pays to an insurance company in exchange for coverage under an insurance policy. It is the cost of maintaining protection against financial loss and ensures that the insurer can pay claims, manage risk, and cover administrative expenses. Premiums can be paid monthly, quarterly, semi-annually, or annually, depending on the policy and payment arrangement.

Anniversary Year

An anniversary year is a 12-month benefit period that begins on the date your insurance coverage takes effect rather than on a standard calendar year. This means your plan’s annual maximums, deductibles, and claim resets follow your personal enrollment date instead of January 1 to December 31.

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