Let's face it, dealing with a hospital stay can be stressful enough without having to navigate complicated insurance claims. If you have a MetLife Hospital Indemnity policy, you're likely looking for a straightforward way to get the benefits you're due. Well, you've come to the right place! This comprehensive guide will walk you through every step of filing your MetLife Hospital Indemnity claim, making the process as smooth as possible.
Step 1: Feeling Better? Great! Now, Let's Get Organized!
So, you've been hospitalized, and thankfully, you're on the mend. That's the most important thing! Now, while you're recovering, let's start gathering the necessary information for your MetLife Hospital Indemnity claim. This initial preparation is key to a swift and successful claim. Don't feel overwhelmed; we'll break it down.
What you'll need at your fingertips:
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Your MetLife Certificate of Insurance: This document contains crucial details about your policy, including your certificate number, covered benefits, limitations, and exclusions. You can usually find this on the MyBenefits portal (mybenefits.metlife.com) under the "Certificate Detail" tab.
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Patient's Name: Ensure you have the full, accurate name of the individual who was hospitalized.
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Admission and Discharge Dates: These are vital for determining the duration of the hospital stay.
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Verified Diagnosis: The medical reason for the hospitalization.
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Room Assignment: Specifically, whether the patient was in an Intensive Care Unit (ICU) or Non-ICU. Many policies offer enhanced benefits for ICU stays.
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Supporting Medical Documentation: This is perhaps the most critical part of your claim. This includes:
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Admission Summary: Details about when you were admitted and why.
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Discharge Summary: Information about your release, diagnosis, and follow-up care.
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Itemized Invoices for Services Received: Detailed bills from the hospital for all services.
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Explanation of Benefits (EOB): If you've received an EOB from your primary medical insurance, include this as well.
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Emergency Room Discharge Papers: If your hospitalization started with an ER visit.
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Any other relevant medical reports (X-rays, CT scans, lab tests, etc.): While not always explicitly required for basic hospital indemnity, having them can support the claim if there are any questions.
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Pro-Tip: Start collecting these documents as soon as possible after discharge. It's often easier to get them while they're fresh in the hospital's system.
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| How Do I File A Hospital Indemnity Claim With Metlife |
Step 2: Accessing the MetLife Claim Form
Once you have your documents ready, the next step is to obtain the MetLife Hospital Indemnity claim form. MetLife offers a few convenient ways to do this:
Sub-heading 2.1: Online via MyBenefits (Recommended!)
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The Easiest Way: The quickest and often most efficient method is to file your claim electronically through the MetLife MyBenefits portal.
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How to Access: Go to mybenefits.metlife.com.
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Register/Log In: If you haven't already, register for an account. If you have, simply log in.
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Navigate to Claims: Once logged in, look for a section related to "Claims," "Submit a Claim," or "Accident and Health Forms."
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Select Hospital Indemnity: Choose the appropriate claim type for Hospital Indemnity Insurance. The online portal will guide you through completing the form digitally.
Sub-heading 2.2: MetLife Mobile App
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Claim on the Go: MetLife also offers a mobile app with similar functionality to the MyBenefits web portal.
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Download: Download the "MetLife" app from your device's app store (iTunes App Store for iOS or Google Play Store for Android).
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Login/Register: Log in or register using your MyBenefits credentials.
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Submit Claim: Follow the prompts to submit your Hospital Indemnity claim directly from your mobile device.
Sub-heading 2.3: Requesting Forms by Phone
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Traditional Method: If you prefer a paper form, you can request one by phone.
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Contact Number: Call MetLife Customer Service at 1-866-626-3705 (Monday-Friday, 8 AM - 8 PM EST).
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Request Form: Inform the representative that you need a Hospital Indemnity claim form mailed to you.
Step 3: Filling Out the Claim Form Accurately
Whether you're completing the form online or by hand, accuracy is paramount. Inaccurate or incomplete information can significantly delay the processing of your claim.
Tip: Avoid distractions — stay in the post.
Sub-heading 3.1: Personal Information
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Certificate Holder Information (Section 1):
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Full Name: Your complete legal name.
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Address: Your current mailing address.
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Certificate Number: This is your policy identifier.
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Date of Birth: (MM/DD/YYYY)
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Social Security Number: Your SSN.
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Gender: Male/Female.
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Contact Numbers: Cell, daytime, and evening phone numbers.
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Email Address (Optional): Highly recommended for electronic communication.
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Employer Name: The name of the employer through whom you have the MetLife policy.
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Patient Information (Section 2):
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If the patient is the same as the certificate holder: Check the box indicating "Same as Section 1."
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If the patient is a spouse or child: Provide their full name, address, date of birth, gender, and Social Security Number.
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Sub-heading 3.2: Hospitalization Details (Section 3)
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Admission Date: The exact date the patient was admitted to the hospital.
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Discharge Date: The exact date the patient was discharged from the hospital.
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Hospital Name: The full legal name of the hospital.
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City and State: The location of the hospital.
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Are you claiming for a Lodging Benefit?: Some policies offer a benefit for a companion's lodging if the hospital is a certain distance from home. If yes, be prepared to submit hotel receipts.
Sub-heading 3.3: Physician's Attachment (Section 7A, 7B, 7C - if applicable)
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Crucial for Verification: Many MetLife Hospital Indemnity claim forms include a "Physician's Attachment" section that your treating physician needs to complete.
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What the Physician Needs to Provide: This section typically asks for:
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Patient's full name and date of birth.
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Chief complaints (reasons for hospitalization).
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Diagnosis.
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How long the patient suffered from the sickness (if applicable).
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Date symptoms first appeared.
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Details of treatment, including any operative procedures.
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Physician's name, address, telephone number, signature, and stamp.
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Your Responsibility: You will usually need to fill out Section 7A (patient information) and provide the entire Physician's Attachment to your doctor. It is your responsibility to ensure your physician completes and returns this section, either directly to MetLife or back to you to include with your submission.
Sub-heading 3.4: Authorization to Disclose Health Information
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Sign This!: This section grants MetLife permission to obtain your medical records from your healthcare providers. Failing to sign this will result in significant delays or denial of your claim.
Sub-heading 3.5: Fraud Warnings, Certification & Signature
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Read Carefully: Always read the fraud warnings thoroughly.
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Certify and Sign: Sign and date the form, certifying that all information provided is true and accurate to the best of your knowledge. This is where you attest to your correct taxpayer identification/social security number and U.S. residency status for tax purposes.
Step 4: Submitting Your Claim and Supporting Documentation
Once your claim form is complete and you have all your supporting documents, it's time to submit!
Sub-heading 4.1: Online Submission (Most Efficient)
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Through MyBenefits or Mobile App: If you completed the form electronically, you'll be prompted to upload your supporting documentation (scans or clear photos of your hospital records, EOBs, etc.).
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Upload Documents: Ensure all documents are clear, legible, and include the patient's name and certificate number on each page (if possible).
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Confirm Submission: You should receive a confirmation or acknowledgement letter from MetLife once your claim is successfully submitted online.
Sub-heading 4.2: Email Submission
QuickTip: Skim slowly, read deeply.
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Email Address: You can email your completed claim form and supporting documents to ahmetlifeclaims@metlife.com.
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Attachment Format: Ensure attachments are in a commonly accepted format (e.g., PDF) and are clearly named.
Sub-heading 4.3: Fax or Mail Submission
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Fax Number: The fax number is typically provided on the claim form itself. A common fax number is 1-855-306-7350.
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Mailing Address: The mailing address will also be on the claim form. A common address is:
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Metropolitan Life Insurance Company
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Attn: Hospital Indemnity Insurance Product
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P.O. Box 80826
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Lincoln, NE 68501-0826
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Keep Copies: Regardless of how you submit, always keep copies of everything you send to MetLife for your records.
Important Note: If this is an additional claim for a hospitalization you've already reported (i.e., you already submitted an initial claim form), you typically don't need a new claim form. Simply include your claim number and/or certificate number on all pages of the additional documentation you submit.
Step 5: Tracking Your Claim
After submission, the waiting game begins. But don't worry, MetLife provides ways to track your claim's progress.
Sub-heading 5.1: Online Tracking via MyBenefits or Mobile App
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Check Status: This is the most convenient way to monitor your claim. Log in to mybenefits.metlife.com or the MetLife Mobile App.
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Claim Status/History: Look for sections like "Claim Status," "Claim History," or "Payments." Here, you can see if your claim has been received, is being processed, or if additional information is needed.
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Correspondence: You can also view any letters or messages from MetLife regarding your claim.
Sub-heading 5.2: Contacting Customer Service
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For Questions: If you have questions or prefer to speak with someone, call a MetLife Customer Service Representative.
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Contact Number: Call 1-800-GET-MET8 (1-800-438-6388), Monday through Friday, 8:00 AM to 8:00 PM EST.
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Have Information Ready: When you call, have your certificate number and any claim reference numbers readily available.
Step 6: Receiving Your Benefits
Once your claim is approved, MetLife will process your payment.
Sub-heading 6.1: Explanation of Benefits (EOB)
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Understanding Your Payment: Upon claim approval, you will receive an Explanation of Benefits (EOB) that details how your claim was processed and the payment amount.
Sub-heading 6.2: Payment Methods
Tip: Reading in chunks improves focus.
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Direct Deposit: You can set up direct deposit of benefits through MyBenefits for faster payment. This is generally recommended.
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Physical Check: If you haven't set up direct deposit, MetLife will send a physical check to the address on file.
General Processing Time: Once MetLife receives all required information, claims are generally processed within 10 business days. This applies to "clean claims" – those submitted with all necessary information and no missing details requiring further follow-up.
Congratulations! You've successfully navigated the process of filing your MetLife Hospital Indemnity claim. Remember, patience and thoroughness are your best friends in this process.
Frequently Asked Questions (FAQs)
Here are 10 common questions related to filing a MetLife Hospital Indemnity Claim, with quick answers:
How to find my MetLife Hospital Indemnity policy number?
You can find your policy or certificate number on your MetLife Certificate of Insurance, often accessible through the MyBenefits portal (mybenefits.metlife.com) under the "Certificate Detail" tab.
How to get a MetLife Hospital Indemnity claim form?
You can download it from mybenefits.metlife.com, through the MetLife Mobile App, or by calling MetLife Customer Service at 1-866-626-3705 to have one mailed to you.
How to submit supporting medical documents for my claim?
You can upload them directly via the MyBenefits portal or MetLife Mobile App, email them to ahmetlifeclaims@metlife.com, or send them by fax or mail to the address provided on the claim form.
How to check the status of my MetLife Hospital Indemnity claim?
Log in to mybenefits.metlife.com or the MetLife Mobile App and navigate to the "Claim Status" or "Claim History" section. You can also call MetLife Customer Service at 1-800-GET-MET8.
Reminder: Reading twice often makes things clearer.
How to ensure my claim is processed quickly?
Submit a "clean claim" by providing all required information and supporting documentation accurately and completely in your initial submission. Ensure your physician completes their portion promptly.
How to get direct deposit for my MetLife claim payments?
You can set up direct deposit preferences through the MyBenefits portal (mybenefits.metlife.com) under your account settings or payment options.
How to contact MetLife customer service for Hospital Indemnity claims?
For general inquiries and claim assistance, call 1-800-GET-MET8 (1-800-438-6388) or 1-866-626-3705 (for claim forms), Monday to Friday, 8:00 AM to 8:00 PM EST.
How to file an additional claim for the same hospitalization?
If you've already submitted an initial claim, you typically don't need a new claim form. Simply send the additional documentation with your original claim number or certificate number clearly marked on each page.
How to know what documents are essential for a Hospital Indemnity claim?
The most essential documents include your MetLife claim form (if it's an initial claim), admission and discharge summaries from the hospital, patient's name, admission/discharge dates, verified diagnosis, and room assignment (ICU/Non-ICU).
How to deal with a denied MetLife Hospital Indemnity claim?
If your claim is denied, review the denial letter carefully to understand the reason. Contact MetLife Customer Service to clarify the denial and inquire about the appeal process or what additional information might be needed.
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