Do Supplemental Health Insurance Policies Require Provider Networks?

Supplemental health insurance help defray out-of-pockets that are not covered by major medical insurance, which is subject to network restrictions.

Do the same network restrictions apply to my supplemental health insurance policy?

The answer is no. The advantage of a supplemental health insurance policy is it provides coverage regardless of the network restrictions under the comprehensive health care policy.²

Most supplemental health insurance policies pay a lump sum at the time of the event for which the insurance policy is designated.

Some supplemental insurance policies will pay out as the medical expense arises. Either way, supplemental health insurance is not affected by the network you are in.

Critical illness insurance

Critical illness insurance is a benefit that pays specifically for a diagnosis of a covered critical illness which may include any of the following:

• Major Organ Transplant;
• Heart Attack;
• Stroke;
• Total Loss of Eyesight;
• Total Loss of Hearing; and
• End-Stage Renal Failure.

A supplemental health insurance policy helps with costs not covered by your primary insurance including hospital stays, transportation to hospitals, or even childcare.

Today, a major organ transplant can range from $400,000 to $1 million. Having supplemental insurance can help with costs.³

Cancer insurance

With cancer being one of the leading causes of death worldwide, taking out supplemental cancer insurance can be an added support with treatment costs.⁴

Upon a diagnosis, most cancer insurance policies will pay a lump sum amount to help the insured with costs not covered by primary health insurance. The advantage of a lump sum amount is it gives the insured the ability to choose where the benefit payments will go. If you need transportation, or hotel stays, or helping with additional costs of longer term treatments, a cancer insurance policy can help.

Accident insurance

Lost wages, extra medical costs, and hospital stays are some of the results of accidental injuries that may cause temporary or lifelong disabilities including:

• Amputations and lost limbs;
• Fractures and dislocations of bones; or
• Neck and back injuries.

An accident insurance policy covers single and multiple injuries. Some accidental and death insurance policies also pay for accidental injury, loss of limbs, and death caused by an accident.

These policies would include a beneficiary in case of a death benefit claim. There may be two types of payment for the benefit payment:

1. A lump sum payment where the insured upon the incidence of the qualifying injury is paid a lump sum; or
2. A hospital stay benefit where payments are made for a hospital stay up to a maximum amount and or a maximum number of days in the hospital.

Financial stress is common when dealing with unexpected illnesses and accident-related injuries. Being prepared by buying supplemental health insurance can help when challenged with an illness or accident.

Sources:

1. https://www.healthcare.gov/choose-a-plan/plan-types/
2. https://www.healthinsurance.org/glossary/supplemental-insurance/
3. https://consumerhealthratings.com/?healthcare_entry=how-much-does-an-organ-transplant-cost
4.  https://www.cancer.org/cancer.html