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Do Supplemental Health Policies Have Deductibles?

Do Supplemental Health Policies Have Deductibles?

Supplemental health insurance comes in all shapes and sizes

The type of supplemental health policy you purchase determines whether you may or may not have a deductible.

Supplemental health plans are generally categorized by what the policy covers are:

  1. For medical expense costs outside comprehensive medical coverage
  2. Disability Income and Accidental Death Insurance
  3. Add-on benefits
  4. Group retiree supplemental health insurance

Supplemental health insurance outside of major medical coverage

There are several reasons to buy supplemental health insurance, also known as supplemental medical expense insurance. With medical costs rising each year, and major medical premiums rising, supplemental medical expense insurance is a wise choice for helping with out-of-pocket medical costs and high deductibles. It can be purchased individually or offered by an employer, union, or association as a group benefit.

As an example, the insured's major medical plan has an annual deductible of $5,000. The insured is out-of-pocket $5,000 before the major medical coverage pays benefits.

The insured can buy a supplemental medical expense policy to bridge the "gap."  If the insured incurs costs of $5,100 for an emergency medical procedure resulting from an accidental injury on January1, the insured has to cover the first $5,000 (the deductible) in order to get the $100 paid. If the insured has a supplemental medical expense policy, it may pay some portion of the $5,000 deductible to help offset the cost.

Are there deductibles on a supplemental medical expense insurance policy? It depends on the policy. The purpose of this policy is to help with the deductible of major medical coverage expenses. If there is a deductible, it is likely to maintain lower prices on the supplemental health policy.

Explore Coverage

Learn more about supplemental health products

Who benefits?

If your major medical coverage has high copays and deductible plans, sometimes referred to as catastrophic tier plans, a supplemental medical expense insurance policy can help with these costs.

Other supplemental health insurance

Other supplemental health insurance policies address specific medical concerns and costs:

  1. Critical illness insurance pays benefits for illnesses such as heart attacks, organ transplants, strokes, loss of eyesight or hearing, and other critical illnesses.
  2. Cancer insurance pays benefits for cancer illnesses depending on the policy. Cancer insurance pays benefits upon diagnosis of certain types of cancer named in the policy.
  3. Hospital indemnity is a supplemental health insurance for help with offsetting the costs of hospital stays or certain outpatient treatments.
  4. Accident insurance can supplement the unexpected costs of being in an accident. A lump sum amount is provided for accidental injuries such as dislocations, amputations, and fractures.

Who benefits?

For cancer and critical illnesses, knowing your family history can be an indication of why you may want to purchase a policy. If you or your family members are in high-risk sports, having accident insurance with helpful in case of injury.

Disability income insurance

Disability income insurance is used for when you are not able to work full-time due to a disability. Disability income insurance is often offered as a supplemental health benefit through employers.

Short-term Income disability covers a percentage of your basic earnings (bonuses and commissions are usually not included) for an abbreviated period of time, which can be from 90 days to a year depending on the terms of the policy. It usually pays 60%-70% of your basic earnings.

A long-term income disability insurance benefit continues where short-term disability income ceases as coverage. A long-term income disability may last up to 15 years or longer. There are no deductibles, and the benefit is based on your pay rate at time of the disability.  Depending on the policy, the amount paid is usually 40-60% of your basic earnings.

Because this is a percentage of your income, there is no deductible. The payments may not activate until a physician verifies you are disabled.

Who benefits?

If your profession or job is the primary means of support, having both short-term and long-term disability plans are an excellent choice. Women who are employed but have no maternity pay can use disability income insurance to help income coverage while on birth-related leave.

Accident and Accidental Death insurance

Accident and accidental death insurance provides benefits for both accidental injuries and accidents related deaths. If the death is a result of an accident, the accidental death benefit is paid to a designated beneficiary assigned in the policy by the insured.

Additional supplement health benefits

Additional health insurance benefits such as dental, orthodontic, and eye care insurance can be purchased as supplemental benefits. The policies may cover routine visits and are generally affordable.

There may be deductibles associated with these supplemental insurance plans depending on the service.

Group retiree supplemental health insurance

Group retiree supplemental health insurance is a specialized group benefit. Corporations, unions, and associations have the opportunity to customize a retiree health insurance plan, designed to help cover the costs not covered by Medicare Parts A &B, for retired employees and members.The benefits can be customized to reduce, manage, and share costs.