What Is Secondary Medical Insurance?
Secondary insurance is coverage that is available in addition to a primary health insurance plan and covers gaps in traditional health insurance coverage. Since most major medical plans do not cover all of your costs, supplemental plans can be purchased to cover missing services (such as dental and vision plans), or to use in conjunction with your primary insurance to cover additional costs (like critical illness or hospital insurance).
Supplemental Health Insurance Plans
These plans are designed to help pay for some of the healthcare costs that your primary plan does not cover. This can include copayments, coinsurance, and deductibles. In many cases, the benefits are paid directly to you, not the medical provider, so that you have less financial burden when it comes to things like out-of-pocket medical costs, lost wages, or other unexpected expenses resulting from illness or injury. Plans can also be purchased to cover areas of health that might not be included in your primary plan benefits. A supplemental vision or dental plan can help you pay for things like routine dentistry work and eyeglasses.
Can I Purchase Supplemental Health Benefits in Place of Major Medical Insurance?
Secondary health insurance plans are meant to complement, not replace, primary medical benefits. A Qualified Health Plan (QHP) is an insurance plan that is certified by the Health Insurance Marketplace and meets the Affordable Care Act’s (ACA's) coverage requirements. Supplemental health plans are not considered qualified coverage and, therefore, are not ACA compliant. This means that if your state requires everyone to be covered by a QHP or pay a tax penalty, a secondary or supplemental health plan will not keep you from being penalized.
How Does Secondary Health Insurance Work?
Secondary health insurance often works by paying you directly. Your primary insurance provider pays your healthcare provider directly for medical expenses. But with secondary health coverage, cash benefits get paid directly to you if you experience a qualifying event. These benefits can be used for a variety of expenses.
What Are Some of the Things Secondary Medical Insurance Will Cover?
Secondary insurance is purchased to cover known medical expenses that are not covered by a primary policy and contain a wide array of included services. If purchasing a vision or dental plan, eyeglasses and dental visits are just some of the routine items that could be a part of your coverage. If purchasing an accident or critical illness plan, you can get paid cash in the event you experience one of the covered scenarios.
The great thing about having secondary insurance benefits is that you have a second chance at paying medical expenses. Bills that may not be paid in full by your primary insurance can be paid for using the cash benefits you receive from your secondary insurance company. Having this second layer of protection helps to insulate you against mounting medical bills. In the case of supplemental eye and dental coverage, it helps cover expenses that would normally be paid by you.
Does Secondary Insurance Cover Deductibles?
Yes, you can use secondary insurance to pay your deductibles. Plans that offer cash benefits can be used to pay for out-of-pocket costs such as deductibles and copays. In fact, they can be used for any number of expenses you’d like to cover such as rent, utilities, and transportation costs.
Types of Supplemental Health Insurance Plans
Supplemental healthcare plans come in all different shapes and sizes. There are plans that cover:
- Dental care
- Critical illness
- Long-term care
Below, we take a more in-depth look at some of these insurance options and explore how this coverage could be valuable to you.
Supplemental Dental and Vision
Major medical insurance does not often include dental or vision coverage. Tooth fillings and repairs, and visits to the optometrist for glasses or contact lenses, can be very expensive when paid for out of pocket. But skipping routine eye and dental exams can be even more costly to your overall health. Did you know that when you get your eyes checked it's not just your vision that's being evaluated? During a comprehensive eye exam, your eye doctor does more than just determine your prescription for eyeglasses or contact lenses. He or she will also check your eyes for common eye diseases and evaluate your eyes as an indicator of your overall health. Chronic diseases such as high-blood pressure and diabetes can be detected through an eye exam.
Proper oral care and hygiene is an equally important part of a person's health and well-being. Having a routine dental check-up is not just about your teeth being cleaned. Your dentist or dental hygienist is likely to evaluate your gums and check your mouth for any indications of oral cancer, diabetes, or vitamin deficiencies. He or she is also likely to examine your face, bite, saliva, and the movement of your lower jaw joints (TMJs).
Unfortunately, dental coverage such as this is not a required benefit for adults through the ACA. The good news is that dental visits, including routine checkups and cleanings, may be covered with supplemental dental insurance. Purchasing a dental or vision insurance plan in addition to your primary medical coverage can help ensure you get preventive and corrective care at affordable prices.
Accident InsuranceSecondary health insurance that covers accidents could help when unexpected, unbudgeted events occur. Did you know that in 2019 an estimated 4.4 million people were injured in automobile accidents? While that's an alarming statistic, car crashes aren't the only risk you face each day. Something as simple as a trip or fall on the sports field can lead to hundreds or even thousands of dollars in medical expenses. For example, a broken leg can cost up to $7,500. If you or your children lead an active lifestyle or play sports, it may be wise to consider some form of accident insurance.
Cancer and Critical Illness Insurance
No one wants to think about developing a serious disease or condition. But the reality is that a disease such as cancer can leave a patient stranded with thousands of dollars in unpaid medical bills. Depending on the severity of the condition, a person can miss work, or even lose their job, resulting in loss of income. The purchase of a disease-specific or critical illness insurance policy can help offset medical bills and other costs associated with the illness. Many of these plans pay the insured a one-time cash benefit. Others pay benefit amounts over a period of time. This can be used to help pay for home health care, childcare, living expenses, and even lost wages. To see how a cancer or critical illness plan could help, take a look at Frank's story in the video below.
The most common critical illnesses covered by these types of secondary health insurance plans include heart attacks, life-threatening cancer, stroke, advanced Alzheimer's disease, major organ transplants, and end-stage renal failure (ESRD).
Who Should Buy Critical Illness & Accident Insurance?
Because no one knows if or when they will become sick, critical illness insurance is an option for everyone. Everybody knows someone who has battled cancer or another major illness. We've all seen the devastating financial consequences that a serious disease can bring. If you carry insurance with a high deductible, you too may also be a prime candidate for secondary health insurance.
A study found that only 39% of Americans have enough savings to cover an emergency totaling $1,000 or less—which is not nearly enough to help cushion the blow of a job loss, medical emergency, or other unexpected event. According to Federal Reserve data from 2019, 22% of adults incurred a major unexpected medical expense during the year, and 18% had unpaid debt from medical care.
Long-Term Care and Other Plans Tailored for Seniors
Since there are many gaps in health care for older citizens, seniors commonly choose to have secondary health insurance plans. Having additional coverage for their unique medical needs protects them from having large out-of-pocket health expenses. For example, long-term care plans are a popular choice for those looking to protect their savings should they find themselves in need of care at an assisted living facility or nursing home. It is believed that 52.3% of people who reached the age of 65 between 2015 and 2019 will need long-term care at some point in their lives. Receiving cash benefits could help insulate against having to exhaust personal savings.
Dental and eye plans remain a popular choice amongst seniors for the same reasons as young people. Seniors often lack coverage in their primary medical care. Purchasing supplemental dental and vision insurance helps seniors receive necessary check-ups with fewer worries about out-of-pocket costs.
Who Needs Secondary Health Insurance?
With healthcare costs on the rise,1many employers and individuals have elected to go with high-deductible health insurance plans (HDHPs). A recent survey showed that in 2019, 30% of all workers were enrolled in a HDHP with a savings option. This is a dramatic increase from 2012, when 19% were covered HDHPs. The average annual medical deductibles for employees in 2019 was $1,242. Supplemental health insurance could make financial sense for anyone who fears getting hurt or sick and getting stuck with a high deductible to pay.
What Does Supplemental Health Insurance Cost?
Supplemental health insurance is often priced very affordably. For example, a critical illness plan for an individual is about $6 to $68, depending on health, age, and coverage factors. While each coverage type and set of benefits differs, the small investment is often worth the peace of mind and protection it delivers.
Why Should You Consider Supplemental Health Insurance?There are lots of reasons to consider a supplemental health insurance plan. One sobering statistic names medical expenses as the number one reason for bankruptcy in this country. Second on the list is job loss. Put the two together, job loss resulting from a serious medical condition, and it makes for a very powerful case for purchasing some kind of secondary health insurance.
Luckily, supplemental health plans are a great protection option for anyone looking to safeguard themselves against the unknown. Plus, they are a great addition for individuals and families who have major medical insurance that doesn't cover all their needs.
How to Buy Secondary Insurance
HealthMarkets can help you purchase secondary health insurance for you or your family. We use our experience and industry knowledge to help find solutions to our customers' coverage dilemmas.. Find the right dental or vision plan for you online now, and pick up a hospital or cancer plan for extra protection. We are available to help 24/7, and our service comes at no cost to you.
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