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Everyone needs supplementary health insurance in addition to primary health insurance period.
We feel confident in saying that every single American need secondary health insurance. If this is a shocking, sweeping statement, then name one person you know who does not need glasses, dental visits, or has never had trouble paying rent or mortgage because of an illness or injury.
Secondary insurance has a few names, such as supplementary or voluntary insurance. Secondary health insurance is a lump sum cash payment that you can use to pay for gas, groceries, childcare any living expenses that are suddenly difficult due to some calamity that has been fallen you.
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Secondary or supplemental insurance is something you opt to pay, and it is usually purchased from a private insurance company on the Health Insurance Marketplace. It is optional, therefore it is not covered by the Affordable Care Act. This means the insurance company can ask for a medical exam and they can ask about pre-existing conditions.
If they agree to insure you, however, you will be very glad for the help if anything happens. Secondary insurance typically pays out in a lump sum cash payment which you can use it for anything you need related to:In 2019, 8 million people were injured in falls, resulting in 39,443 deaths. Falling is the single most common accident, higher even than car accidents or accidental drug overdosing (however these last two were more often fatal).
Why would you need supplemental insurance for accidents? It depends on your lifestyle. If you love outdoor sports or you’re an adrenaline junkie, you’ll want to get this type of insurance. A broken leg can cost as much as $8,000. As that amount does not reach the annual out of pocket limit, you will be on the hook for about $6,000 of it. Plus, if you can’t work or can’t drive your car, your primary health insurance will not help with expenses related to rent, mortgage, or transportation.This one should be obvious, but if you do have a history of illness in your family, you will want to get a secondary insurance plan to cover you for all the expenses related to the illness: being off work, needing childcare or cleaning services, transportation costs, etc. The only drawback is that this can be hard to obtain if you have a pre-existing condition or strong family history of an illness.
There are many critical illnesses that can be covered by these types of supplemental plans including heart attacks, life-threatening cancer, stroke, major organ transplants, coma, and renal failure.
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The pattern should be clear by now. You have a primary insurance plan that covers your main medical expenses (minus the deductible, copay and coinsurance amounts) but you may need some help covering expenses outside of the medical bills. These payments are made directly to you, and in the case of disability, this payment can be received even if you also collect Workers’ Compensation benefits.
You should not expect your primary health insurance plan to cover you for end-of-life care in a hospice or long-term care facility. These facilities cost around $7,000 per month on average, and you may not have that budgeted at present. Think of this supplementary insurance as a small monthly amount that you are socking away for the inevitable. It will make you feel like a responsible adult, and our advice is to start early.
Quite often, these secondary plans are not purchased by you on the Health Insurance Marketplace, and are instead offered through your employer. The important thing to note here is that these types of expenses are typically not covered by your primary insurance plan.
If you are worried about the almost $9,000 per year total out of pocket maximum that you need to pay in the form of deductible payments, co-pay amounts and coinsurance, you may want to get “gap” insurance, or “limited benefits” insurance. These plans help with out-of-pocket costs. If you would prefer to pay a monthly premium instead of a lump sum payment that covers 20% coinsurance amount for a surgery, for example, your gap insurance will provide you with the cash to pay these types of bills.
As you can see there are many reasons why you will need some form of secondary health insurance plan in addition to your primary insurance plan. Note that not all expenses related to your physical well-being are covered: experimental or cosmetic procedures are typically not on the table when it comes to any form of insurance whatsoever.
Claire Smith Claire is a creative entrepreneur with a variety of marketing and content creation skills, including blog and web copy writing, research, and strategy. She has a Masters in Cultural Studies from Queen's University and is known for thinking laterally about marketing, based on her deep knowledge of people and behavior.