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Health Protect - Program Parameters:

       Age Eligibility

       Limitations and Exclusions

       Incremental Rate Difference And Excess Charges


Incremental Rate Difference And Excess Charges  

Same Room Category

If a Member avails of a hospital room within the same category but of a higher rate than the member’s allowable benefit, the Member shall pay the incremental and excess charges as follows:  

Bill Difference
Incremental Charges
Less than or up to 200
NONE
201 - 300
15% of all hospital charges
301 - 400
20% of all hospital charges
401 - 500
30% of all hospital charges
501 - 600
40% of all hospital charges
Above 600
50% of all hospital charges
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