Medical - Inpatient Hospital Services

exam room

Patient responsibility for inpatient hospital room & board expenses (services & supplies)

(Medical, Mental Health, & Maternity)

Network Provider

Non-network Provider

$250 co-pay; then 10%1, 2

$500 co-pay; then 50%1, 3

1Inpatient hospital services are subject to the $450 deductible (per plan year).

2No cost-sharing for covered medical expenses, including prescriptions, incurred for the treatment of hypertension, diabetes, pre-cervical cancer, and cervical cancer with in-network providers.

3If services are rendered with a non-network provider, SHIP covers 50% of the usual and customary charge after the deductible is met. All costs over the usual and customary charge is the member's responsibility. 

Note: Inpatient hospital care in connection with childbirth will be covered for at least 48 hours following a normal delivery (96 hours following a cesarean section).