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Supplemental Insurance Plans: How to Get Better Coverage

Publicado - Por HolaDoctor

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When a person gets their health insurance, they should always find out what the coverage limits are. What does the plan actually cover? What is excluded? Does it cover all possible medical problems? Does it include dental expenses? How about ophthalmologists? How many deductibles and co-pays does it have? The answers to these questions can give you the information you need to purchase the supplemental insurance plan that is right for you.

As you might already know, standard health insurance plans don't provide coverage for all possible circumstances. In fact, they have serious limitations. To ensure they have more comprehensive coverage, people often need supplemental insurance to help cover expenses that traditional plans don't cover.

In this article we will talk about the main types of supplemental insurance plans and what they cover. Read below to find information that will help you in choosing more comprehensive coverage.

Types of supplemental insurance plans: In this article you will find out

What is a supplemental insurance policy?

 To cover the limitations of a conventional health insurance (ACA), you can purchase a policy known as a supplemental plan or ancillary benefits.

These supplemental policies offer specialized coverage for specific situations. For example, dental insurance provides coverage for dental services that are not included in traditional health insurance plans. They cover things like orthodontic treatments or complex maxillofacial surgery. Purchasing a dental insurance plan will ensure that you have the coverage necessary to pay for the high costs of these types of treatments without using savings or going into debt.

These types of supplemental plans are relatively affordable in comparison with the high cost of unexpected care, and will end up saving you money. Keep in mind that standard health insurance can cost you several thousands of dollars more each year. This can include costs such as deductibles, copays and out-of-pocket expenses.

Supplemental plans can also include several family members, which is very helpful in covering any possible issues that may arise with children or other family members in the event of unexpected illness.

It is also important to keep in mind that you can still qualify for supplemental plans even if you don't have medical insurance, meaning that they can be purchased independently from one another. You also have the option of purchasing several supplemental plans. For example, if you have children, you will most likely need dental insurance, but you might also require ophthalmological insurance, especially if vision problems run in your family. The more coverage you have, the more protected your family will be.

Types of Supplemental Plans

There are a wide range of supplemental plans and products available on the market. Regardless of your coverage needs, there is a product that will meet them. Below we talk about the main types of supplemental insurance plans :

  • Dental Plans. Dental plans cover all types of problems that may arise in your mouth. Types of treatments included range from cavities to orthodontic treatments, as well as implants and dentures. Traditional medical insurance offers very limited options with regard to dental coverage, and treatments are very expensive, making dental plans an attractive alternative for helping to pay for dental expenses.

    In general, traditional plans only cover preventative treatment, basic care and the most important types of dental care. In addition, you can purchase different plans according to your specific needs, including preventative medicine providers, preferred providers, and dental plans with a fixed fee per visit.

  • Vision Plans. The same situation as dental care also applies to ophthalmological care. Vision-related expenses are common in families and can be very expensive, including costs for eye exams, glasses, and changes in prescription lenses. The Affordable Healthcare Act (ACA) requires health insurance plans to cover eye exams and certain treatments, but only for dependents under 19 years of age, meaning that many plans do not offer coverage for adults. By purchasing vision insurance, you can avoid having to pay out of pocket for treatments and the necessary materials associated with these, including glasses. With vision insurance you will only pay for a very small portion of the costs for ophthalmological services, and the insurance company covers the rest.
  • Hospitalization Insurance. Another attractive supplemental plan is known as Hospitalization insurance. These are classic insurance plans that offer a fixed payment in exchange for a monthly premium, meaning that if you become ill and are hospitalized, the insurance company pays a set amount for each day you are in the hospital. Keep in mind that this does not replace a main healthcare plan, and does not meet the requirement to avoid the penalty for not having insurance, as stipulated in the ACA.
  • Hospital Expense Insurance. Hospital expense insurance is very helpful if you have reason to believe that you or a family member could ever need hospital care. This plan covers expenses for hospitalization for a single night, which is considered as being under observation, and as such, outpatient care. This is different from a prolonged hospital stay. The policyholder receives a certain amount of money that can be used to pay hospital bills or any other cost associated with treatment or recovery.
  • Critical Illness Insurance. Critical illness insurance is used to cover costs for diagnosing and treating a critical illness. The specific disease must be explicitly covered in the policy, and can generally include some types of cancer, heart problems, stroke, kidney failure, coma, transplant of vital organs, Alzheimer's, and loss of speech and hearing. In these cases, the policyholder receives the amount stipulated as compensation during the entire time they are incapacitated due to the illness. In general, these plans do not have deductibles or copays, meaning that you can use the entire amount covered to pay for any expense you need.
  • Accidental Death and Dismemberment Insurance. Accidental death and dismemberment insurance, or AD&D, is one of the most popular supplemental policies available. It provides compensation in the event that you are the victim of an accident that causes you to be unable to work either temporarily or definitively. It also provides compensation in the event that you lose a family member in the same accident. In general, it covers contusions, fractures, dislocations, burns, coma and the loss of a family member. The compensation you receive in these cases helps to cover medical expenses and other costs, including transport in ambulances, diagnostic tests, in-home medical care and rehabilitation.
  • Final Expense Insurance. Although final expense insurance is usually covered by life insurance policies, they are also considered supplemental plans. These policies provide compensation that can be used to cover expenses derived from the policyholder's funeral, which are very high in the United States.
  • Travel Medical Insurance. People who travel from time to time will require travel medical insurance . This is especially important when travelling abroad, and even more when travelling to countries where healthcare is lacking or very expensive. These policies cover the costs derived from receiving medical aid outside of the country, and in some cases can even include transport home.

How Supplemental Policies Work

The supplemental insurance plans we have mentioned have significant differences in the rules governing how they work, as well as in their characteristics and coverages. Depending on the type of product, different conditions apply, making it important to do your due diligence and carefully read the clauses applicable to each when deciding which one to purchase.

Despite the wide array of options, there are some general similarities in the way supplemental insurance plans work. The main similarities are:

  • Ease of eligibility. Supplemental plans generally do not have strict eligibility requirements, especially if you purchase them when you are still young and healthy.
  • Affordable. In general, supplemental plans are low-cost. Insurance companies spread out risks, allowing them to offer low-cost premiums that are accessible to everyone.
  • Deductibles. Many plans have deductibles. This means that the policyholder is required to pay for some services up front and then the insurance company reimburses them later.
  • Copayments. For some plans, a copayment is required. This means that if a service costs $160, for example, you only have to pay $40, and the insurance company pays the rest.
  • Cash. In contrast to other types of policies, with supplemental plans it is normal for the insurance company to pay the cost for the benefit directly to the policyholder, who can then decide what to spend it on. They can use it to cover costs for treatment, pay for deductibles on their traditional health care plan, or to use it as they deem fit.

As you can see, supplemental insurance plans offer a helpful alternative to guarantee that you have comprehensive, broad and high-quality coverage. Just decide what coverage you need and find a plan that best suits your specific needs.


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