Supplemental Health Insurance in Florida
Supplemental health insurance in Florida is a non-ACA (Affordable Care Act) compliant insurance that provides supplemental coverage to individuals with traditional health insurance plans. Private insurance companies sell supplemental health insurance to individuals or groups to help them pay for some medical costs that are not covered by their primary health insurance plans. Some of these healthcare costs include copay, coinsurance, lab work, and medication purchases that are not covered by conventional health insurance plans.
In Florida, policy owners can use supplemental health insurance to make out-of-pocket payments for emergency services, cover the deductibles, dental care treatments, vision care treatments, hearing therapy, and many other health care services. Supplemental health insurance does not offer major medical coverage; hence, it should not take the place of a comprehensive health insurance policy.
What is Considered Supplemental Health Insurance?
Supplemental Health Insurance is a health insurance plan that offers an alternative for paying out-of-pocket medical bills for healthcare treatments and services. It pays for expenses not covered by the policy owner’s primary health insurance plan. In 2019, Florida residents with employer-provided health insurance plans paid an average of $500 as out-of-pocket costs for health care treatments. Although this figure may have increased over the years, supplemental health insurance will still reduce the out-of-pocket payments for group health insurance policies and individual health insurance policyholders.
What is the Purpose of Supplemental Health Insurance?
The purpose of supplemental health insurance in Florida is to pay for medical costs of services that do not have health coverage under the policy owner’s primary health insurance policy. It can also provide coverage for specific medical conditions like dental care and critical illnesses like cancer, heart attack, kidney, and lung diseases. For instance, it may be cheaper to buy supplemental health insurance in anticipation of future illnesses than to add more benefits to a primary health insurance plan. An individual may save money by buying a supplemental health insurance plan rather than buying a comprehensive health insurance policy that is more costly.
Supplemental health insurance plans are also convenient for making out-of-pocket payments for medical services, and it pays for deductibles, coinsurance, and copayments.
What is Supplemental Health Insurance for?
Supplemental health insurance plans provide coverage for health care services beyond the minimum essential medical services offered by ACA health plans in Florida. It is also a means for paying copayments, coinsurance, and deductibles, which are out-of-pocket payments for conventional health insurance policies. Some health care costs supplemental health insurance covers in Florida are:
Teeth braces
Eyeglasses
Eye surgery
Hospital stay
ER treatments
Prescription drugs
Lab work
In Florida, a supplemental health insurance plan offers a means of complementing your primary health plan and it allows you to be specific with your coverage needs to avoid over-insurance. A supplemental health insurance plan will cover medical bills that your main health insurance will not pay. Contact a Florida-licensed health insurance agent if you need further clarification on what supplemental health insurance can do for you.
What are the Types of Supplemental Health Insurance in Florida?
There are different types of supplemental insurance coverage plans. The most common types of supplemental health insurance in Florida are:
Dental
Vision
Critical Illness
Hospital Indemnity
Medicare
Disability
Long Term Care (LTC)
Fixed Indemnity
Accidental Death and Dismemberment (AD&D)
Accident insurance
Supplemental dental insurance - Most health insurance healthcare plans do not cover dental health (it is not an essential health benefit) unless medically related or added as an extra benefit. Dental insurance treatments and services like dental cleaning, X-rays, fillings, root canal, and other dental services are paid out-of-pocket. Dental treatments do not come cheap, and costs can easily escalate. Supplemental dental insurance covers the cost of dental treatments for individuals. Family members' benefits may include 100% coverage of dental expenses for preventive care services.
Dental insurance benefits also include diagnostic, basic, and major care services. You can add it to your health insurance plan as a standalone supplemental plan.
Vision insurance - Health insurance plans only provide health coverage for medically necessary vision treatments. To get comprehensive vision care coverage, you need vision insurance. Vision insurance pays part of the bills for eye examinations and prescribed eye lenses and frames.
Critical illness insurance - This type of supplemental insurance provides health coverage for serious illnesses that may turn terminal, including cancer, stroke, heart attack, and major organ transplants. Medical costs for critical illnesses like cancer, heart attack, and stroke are expensive, even with a health insurance plan, the out-of-pocket expenses can be daunting. A supplemental coverage using critical illness insurance is a good way to offset part of the medical costs for serious illness treatments.
Hospital indemnity insurance (hospital confinement insurance or hospital insurance) - The cash benefit of this supplemental health insurance pays the out-of-pocket cost of hospital stays, which is usually purchased along with high-deductible short term policies. Hospital indemnity plan is family-friendly and allows the addition of family members to the plan.
Medicare supplemental plans - This is a beneficial plan to those on the original Medicare plan. It is a vital supplemental health plan for individuals with disabilities and senior citizens above 65 years in Florida. The Original Medicare (part A and part B) plan usually does not provide enough health coverage for all healthcare needs, hence the need for a supplemental coverage Medigap plan. Medicare supplemental plan (Medigap) helps pay for copays, coinsurance, deductibles, and prescription drugs. It also settles the bills of medical treatments for individuals traveling outside the United States. Though Medigap covers some of the gaps in the Medicare plan, it does not offer prescription drug coverage, and only covers one person. For couples with Medicare plans, each partner will require a separate Medigap plan. (Note: Medigap works only with Medicare. It does not work with Medicare Advantage)
Disability insurance - Pays part of the insured’s income if they get injured or too sick and cannot continue working.
Long Term Care (LTC) insurance - Long-term care health insurance pays for the costs of nursing homes for persons who need long-term care. Long-term insurance does not cover only the policyholders but also their spouses.
Orthodontic insurance - You may not have coverage for orthodontic services even if you have dental insurance. Orthodontic insurance offers coverage for braces and teeth alignments. It also pays the cost of teeth correction that may come up in later stages of life. It also covers the cost of a mouth guard to guide against night-time teeth grinding. The cost of orthodontics varies for both children and adult care. The best thing is to find an affordable orthodontic insurance policy that also comes at a cheap cost for adult treatments.
Fixed indemnity insurance - This health plan pays a predetermined lump sum cash benefit to either the policyholder or the healthcare provider in the event of illness or injuries that are part of the plan’s coverage. The beneficiaries are at liberty to spend the money in any way they deem convenient (either on healthcare treatments or other personal matters). Fixed indemnity insurance settles out-of-pocket payments like copays, coinsurance, deductibles, lab works, and costs of medical diagnosis.
Accidental death and dismemberment insurance (AD&D) - This insurance plan is added as a rider to a health or life insurance policy. It covers unintentional death or dismemberment of the policyholder in the event of an accident. Accidental death or dismemberment insurance pays death benefits to the insured’s beneficiaries in cases like traffic death, homicide, drowning, falling, etc. Insurance companies may limit the size of payouts under these circumstances, and payments may not go beyond the limit.
The dismemberment part of the insurance pays a percentage for a loss of limb or loss of use of an important part of the body like speech, sight, or speech. It is uncommon for insurers to pay 100% for any claim other than the loss of major body parts combined with hearing, speech, or vision loss.
Accident insurance - Pays a lump sum cash benefit to a policyholder involved in an accident. The benefits help the insured take care of medical costs, and expenses during the healing process. Accident insurance pays for medical expenses like emergency care, ambulance services, and lab work. It also helps pay living expenses like utility bills and the cost of transportation.
The above list does not include all the types of supplemental health insurance available in Florida; rather, it shows that supplemental health insurance covers different areas of health care.
In Florida, supplemental health plans are not included in the ACA plans but are available to be added to Medicaid and Medicare through private insurers. It can also be bought as a standalone policy to complement an individual’s primary health insurance policy.
Do you Need Supplemental Health Insurance in Florida?
You need supplemental health insurance if you need help with out-of-pocket health care payments because it pays for medical costs that your primary health insurance plan does not cover. For instance, supplemental health insurance provides supplemental coverage to pay for some of your health charges incurred during a doctor's visit, such as copays, coinsurance, and deductibles.
Supplemental health insurance is a good addition to Medicare plans for individuals that want to improve the coverage of their original Medicare. Also, you may need supplemental health insurance if you need extra coverage but realize that adding additional benefits to the existing plan is expensive.
Always seek the advice of a knowledgeable state-licensed health insurance agent before you decide on the type of supplemental health plan to buy. An experienced agent can assess your health insurance needs and explain to you which supplemental insurance is worth it in your specific case.
Why Do you Need Supplemental Health Insurance Insurance?
You need supplemental health insurance to cover the aspects of your healthcare that your health insurance does not cover. Regular health insurance coverage in Florida comes with out-of-pocket payments such as copay, coinsurance, and deductibles that can easily rise depending on the type of treatment.
Most supplemental health insurance plans are not expensive, and the plan’s flexibility will allow you to choose the duration it will run to avoid duplication of health coverage and save costs. If you are above 65 years, you may need to combine supplemental health insurance with your original Medicare plan to get the full coverage you need. You can purchase a Medigap plan together with your Medicare part D drug prescription plan and a vision/dental, supplemental health insurance policy.
If you are below 65 years and do not have a Medicare plan, your health insurance plan may not offer all the health coverage you and your family need, and you may need supplemental health insurance to make up for the shortfall. You may need supplemental health insurance if the out-of-pocket payments you make for healthcare services are overwhelming, which is frequently the case with low-cost/high-deductible short term health insurance plans.
The most common types of supplemental coverages for Florida residents under 65 are: Hospital Indemnity, Critical Illness, and Dental.
When deciding on whether you need supplemental health insurance in Florida, consider the following questions:
If you or any of your family members suddenly fall ill or are involved in an accident, is your current major health plan sufficient to cover all the medical costs?
Do you have enough money to pay out-of-pocket for treatment in an emergency?
What is the probability of you or your family members getting involved in serious accidents or suddenly falling ill?
Will the premium of the supplemental plan make a serious dent in your finances?
Is your supplemental health insurance going to be provided by your employer, thereby reducing its cost?
Supplemental insurance worth. Is it cheaper to pay out-of-pocket for services that do not have coverage under your primary health insurance plan than to get supplemental health insurance? How often will you make use of your supplemental health insurance?
The answers to the above questions will help you decide whether you need supplemental health insurance and why you need it.
Your need for supplemental health insurance may depend on the prevailing situation. Discuss your supplemental health insurance needs with a Florida-licensed health insurance agent to get professional views on available options that may be of help for your situation.
How Much Supplemental Health Insurance Insurance Do you Need?
The amount of supplemental health insurance you need depends on the cost of the required health coverage that is missing from your primary Florida health insurance plan. The cost of your supplemental health insurance increases as the size of benefits increases. You may want to consider your financial capacity and needs before buying a supplemental health plan, can you afford the supplemental health insurance cost? You should also know what your intended supplemental health insurance plan covers so that you do not buy insufficient coverage or more than you need. For example:
A short-term health insurance in Florida can come with a deductible and copayments of up to $20,000. While this type of major medical product serves a vital function of providing affordable emergency coverage, if the insured actually must use the policy, the hefty deductible costs must come from the pocket of the insured, before the rest of the bill is picked up by the insurer. If someone buys short term insurance to save on costs, paying a large deductible will also likely be hard, so a Hospital indemnity plan can help pay the bills in case of a hospitalization. The monetary gap that needs to be supplemented is determined by the maximum out-of-pocket (MOOP) expenses of your plan.
If your profession has a possibility of work-place accidents, you may need to get disability insurance coverage, to guarantee a portion of your normal income, while you are recovering from an injury: Short term disability (STD) to cover short periods of recovery time and Long term disability (LTD) if the recovery term takes months or even years. The range of 60% - 70% of income replacement is the most common in Florida, but the needs will vary between each person and their specific situation.
If you want dental care and your employer doesn't provide you with coverage, you will need to get individual dental insurance coverage. The amount of coverage you need to get corresponds to your average dental needs. Dental insurance usually covers preventive care in full and then in fractional percentages of costs for different procedures. The higher the percentage of costs that it covers, the higher is the cost of the insurance plan. So, if you tend to have frequent dental issues, investing in a high-paying plan may be worth it.
Original Medicare users must assess their current coverages, to see if any of the costs are not being covered by their plan. The Medigap plan is selected based on the gaps that need to be covered. The more frequently you plan to use the coverage, the more you may want to pay. Cheaper Medigap plans come with copays and annual out-of-pocket maximums, while the more expensive plans may be all inclusive and offer additional discounts and wellness perks.
Review your supplemental health insurance needs with a knowledgeable state-licensed health insurance agent for guidance on how to choose a suitable supplemental plan and how much coverage you should purchase to match your needs without overpaying.
What Supplemental Health Insurance Coverage Do you Need?
The type of supplemental health insurance you need depends on what you want to use the plan to achieve. You may need a supplemental health insurance plan for any of the following reasons:
To provide benefits that are missing from your primary health insurance policy
To provide coverage for medical costs of specific health care treatments
To pay for the deductible, copay, and coinsurance (these are not part of the benefits of traditional health plans)
As a means of financing emergency room (ER) treatments
To supplement your Medicare and Medicaid policies
A supplemental health insurance plan can be used in three different ways to provide coverage for Florida residents;
It can be bought as a standalone policy outside the health insurance marketplace (from private insurance companies) to cover the medical costs of specific healthcare needs. Supplemental health insurance plans like dental insurance and vision insurance are some of the health plans you may use as standalone supplemental health insurance to cover your needs. Most insurance companies do not add dental care as part of their benefits for adults, so you need to buy it as a supplemental plan. Supplemental health insurance is a handy policy for treatments, such as dental surgery and orthodontic care, whose costs can rise suddenly.
If you own an Original Medicare plan and the plan does not provide coverage for certain healthcare services, supplemental medicare insurance from private insurers can help cover the coverage gap.
You can use a supplemental health insurance plan as a bundled policy to provide health coverage for multiple health issues. A supplemental health insurance plan covers dental, vision, hospital indemnity, critical illnesses, and other healthcare services.
Contact a knowledgeable Florida-licensed health insurance agent if you need a supplemental health insurance plan.
Is Supplemental Health Insurance Insurance Required by Law in Florida?
Though supplemental health insurance is a good way to save on overall cost of healthcare services in Florida, it is not compulsory to own one. Florida law does not mandate residents to have any of the supplemental health insurance; having supplemental health insurance is strictly by choice.
How Does Supplemental Health Insurance Insurance Work?
How a supplemental health insurance plan works in Florida depends on the type of supplemental health plan. To get coverage under a supplemental health plan, a policyholder must pay a premium when purchasing the policy. The benefits of the plans are either paid to the health care providers or directly to the policyholders. The amount paid as a benefit depends on the type of supplemental health plan.
Some of the named supplemental health insurance plans work as follows:
Hospital indemnity insurance (hospital insurance) - To get paid by this plan, you need to stay in a hospital for a certain amount of days, which vary depending on the insurance companies but is mostly a minimum stay of ten days. The benefits of a hospital indemnity health plan can be a daily, weekly, or monthly cash benefit for a hospitalized policyholder or beneficiary. Hospital insurance pays benefits irrespective of the coverage you have under your other health insurance plans. Some hospital insurance makes an allowance for adding family members, make sure to check the policy terms to know if you can add family members.
Critical Illness insurance (Disease-specific insurance) - Under a critical illness plan, the beneficiaries receive cash payments if certain predetermined diseases afflict them. For instance, an insured or a beneficiary undergoing cancer treatment may qualify for cash benefits which can be paid to the care provider or directly to the beneficiary.
Accidental Death and Dismemberment insurance - This policy has a low premium and pays benefits irrespective of where the accident occurred. An insured can claim a part of the death benefit in the event of loss of a limb, sight, finger, or any part. It also reimburses money spent on treatments in an accident or death.
Accident insurance - This plan pays benefits to the insured if they sustain injuries in accidents. Supplemental accident insurance pays a one-time reimbursement benefit for the money spent on treatments that the policyholder's primary health insurance plan does not cover.
Fixed-Indemnity insurance - A fixed-indemnity plan pays a predetermined benefit to the policyholder or the health care provider when the plan's injuries and illnesses are covered. The benefits of this plan can pay for lab work, deductibles, and copays.
Speak with a Florida-licensed health insurance agent, who can explain how each supplemental health plan works and how it can benefit you.
What Does Supplemental Health Insurance Cover
Let's take a look at what Supplemental insurance covers in Florida:
What is Supplemental Health Insurance Good for?
Supplemental health insurance is good for saving on medical costs of treatments that are not covered by the primary health insurance policy of the policyholder. It is also good for providing coverage for specific medical conditions that the insured may develop in the future. It can act as a backup of your primary health plan.
For senior citizens (65 years and above) with Medicare plans, supplemental health insurance can pay for health care services that Medicare does not cover.
There are many benefits of supplemental health insurance policies. If you are looking to get a supplemental health insurance policy, discuss with a state-licensed health insurance agent who can explain how supplemental plans can benefit you.
What Does Supplemental Health Insurance Typically Include?
Supplemental health insurance is a secondary health plan that acts as an auxiliary plan to your primary health insurance. It fills the gaps in coverage left by primary health insurance.
You may think that you do not need supplemental health insurance if you have a comprehensive health insurance plan. However, comprehensive health insurance plans do not cover the medical costs for all treatments, and they come with out-of-pocket payments. There are different types of supplemental health insurance plans to provide supplemental coverage for different healthcare needs. To avoid over-insurance, the type you buy should be tailored to your needs. Some supplemental health insurance coverage in Florida include:
Coverage for automobile and non-automobile related accidents
Payments for the treatment of critical terminal illnesses, such as cancer, stroke, heart attack, liver, lungs, and kidney diseases
Dental care treatments
Paying for braces and teeth alignment for children and adults who may require them
Paying for eye treatments, lenses, eyeglasses, and surgeries
Taking care of the cost of hospital stay, lab work, and medical diagnosis
Who is Covered by Supplemental Health Insurance?
A supplemental health insurance plan covers the insured policy holder or the beneficiaries listed in the policy document. A group plan provides coverage for all individuals in the group or those listed as beneficiaries.
What Types of Items Does Supplemental Insurance Policy Cover?
Supplemental health insurance covers the following:
Loss of limbs or any part of the body
Emergency room treatments
Accidents
Hospitalization
The lab work and medical diagnosis
Cancer treatments
Kidney dialysis
Heart attack
Stroke
X-rays, ICU treatments
Dental treatment
Does Supplemental Health Insurance Cover Heart Surgery?
Yes, a supplemental health insurance plan covers medical costs for heart surgery to the limit stated in the policy document. As a complementary plan, it supplements the insured’s primary health insurance policy. For instance, if you have an ACA or Medicare insurance plan, you have coverage for surgery as long as it is deemed medically possible to save your life. However, these health plans may not pay all the bills; a supplemental health insurance plan helps fill the gap in payments.
The coverage you enjoy under the primary health insurance plan is limited to what is specified in the policy document. To pay for the out-of-pocket costs, you may need supplemental health insurance. If you have hospital indemnity insurance, it will pay for the cost of hospitalization before and after the surgery.
Does Supplemental Health Insurance Cover Therapy?
No. Supplemental health insurance does not normally cover the cost of therapy sessions. In Florida, mental health treatments are partially covered by ACA compliant health policies, Medicaid, and the Children’s Health Insurance Program (CHIP). The coverage for therapy sessions comes with copays and deductible payments for the policyholders, which can be paid with a supplemental insurance plan.
Does Supplemental Health Insurance Cover Pregnancy?
Yes. Supplemental health insurance provides coverage for pregnancy. In Florida, childbirth is one of the essential care benefits covered by all ACA-compliant health insurance plans, but they usually come with massive deductibles and copays. You can buy supplemental pregnancy insurance (a hospital indemnity insurance plan) to complement an ACA-compliant health plan, bridge the health coverage gap, and reduce out-of-pocket payments. However, unlike ACA health plans, it does not allow pre-existing conditions (pregnancy is considered a pre-existing condition).
Does Supplemental Health Insurance Cover Dental?
Yes. Supplemental health insurance covers dental expenses in Florida. Dental treatment is not among the essential health benefits of ACA health plans. Hence, health insurance plans do not cover it; instead, it is bought as a standalone supplemental health insurance plan.
Supplemental dental insurance operates separately from the primary health insurance plan, and in most cases, insurers offer it together with vision insurance. You may buy supplemental dental insurance from the same insurer providing primary healthcare coverage or from a different insurance company.
What is Not Covered by Supplemental Health Insurance?
Although supplemental health insurance is a good way to cover gaps in the health coverage of an individual’s primary health insurance in Florida, it does not cover the medical costs of certain healthcare services. Generally, supplemental health insurance does not cover:
Cosmetic surgery
Off-label prescription drugs
Fertility treatments
New technology products
You may need to know more about supplemental health insurance, what it covers and what it does not cover; either way, contact a state-licensed health insurance agent to get more information.
What Does Supplemental Health Insurance Typically Exclude?
Supplemental health insurance does not cover every aspect of healthcare services. In Florida, it may exclude services like
Cosmetic surgeries - supplemental health insurance does not cover surgeries that only enhance the external appearance of an individual. Supplemental health insurance and other health insurance plans only offer coverage for treatments and services that are necessary to save lives.
Abortion - supplemental health insurance does not provide blanket coverage for abortion in Florida due to the state abortion law that prohibits abortions for pregnancies that are 15 weeks and over. Abortions for pregnancies older than 15 weeks are only allowed in cases of health or life endangerment of the mother. The state may also allow abortion in cases involving rape and incest. The law has stringent rules to discourage abortion which include:
State-directed counseling with information to discourage abortion
A patient must undergo an ultrasound and show the image of the child before the abortion can be approved
If the patient is a minor, the parent must be notified before an abortion is carried out.
Caregiver services - supplemental health insurance excludes caregiver services. Caregiver services offer help or services you need for daily living, and these services are not considered health issues and do not have coverage under supplemental health insurance.
In-Vitro Fertilization treatments (IVF) - supplemental health insurance does not offer coverage for IVF or any form of fertility treatment.
It is important to know the services that are not part of your prospective supplemental health insurance coverage. Contact a knowledgeable Florida-licensed health insurance agent to guide you when making a purchase.
What is an Example of Supplemental Health Insurance?
There are many types of supplemental health insurance plans you can choose from to meet diverse needs in Florida. Examples include:
Accident and Dismemberment insurance
Critical illnesses insurance
Vision insurance
Dental insurance
Medicare supplemental (Medigap) insurance
Long-term care insurance
Hospital Indemnity insurance
Orthodontic insurance
Disability insurance
Fixed Indemnity insurance
Your supplemental health insurance plan benefits can help you pay the costs of some specific healthcare treatments and services. For instance, orthodontic insurance can help you lessen the high cost of teeth braces for your family. You can also use hospital indemnity plans to make out-of-pocket payments that come with hospital visits and costs like deductibles, coinsurance, and copays.
What is the Most Common Use of Supplemental Health Insurance?
The most common use of supplemental health insurance in Florida is as a medicare supplement insurance (to complement Original Medicare coverage). Original Medicare does not cover all healthcare costs; hence, a supplemental insurance plan may be necessary for extra coverage. The amount of coverage an individual will get depends on the plan type. In Florida, the Medicare supplement plan (Medigap) is the most popular supplemental insurance plan for complementing the original Medicare health plan, and as an alternative to Medicare Advantage. Senior residents use Medigap to cover the costs of deductibles, copays, and coinsurances, and it also takes care of some medical bills that are not part of Medicare coverage.
Generally, supplemental health insurance plans cover costs that are beyond the health coverage of an individual’s comprehensive health insurance plan. It also assists in paying out-of-pocket healthcare costs that you incur if you visit a doctor.
What is the Difference Between Supplemental Health Insurance and Short Term Health Insurance?
Supplemental health insurance provides coverage for healthcare services that are not covered by the primary (major) health insurance policy. It covers the costs of services a comprehensive health insurance policy owner would have paid out-of-pocket. Short term health insurance, on the other hand, is the major medical plan, the gaps in coverage of which are commonly covered with supplemental coverage.
Do I Need Supplemental Health Insurance if I Have Original Medicare Insurance?
Yes, you may need a medicare supplement insurance plan, if you have Original Medicare Insurance. The reason for a supplemental plan is that Original Medicare does not cover all the costs of your medical treatment. For example, Original Medicare plan only provides drug coverage if the drugs are part of inpatient hospital treatment. An Original Medicare plan needs Medicare Supplemental Insurance (Medigap) to complement it. You must have Medicare part A and part B insurance to have Medicare supplemental insurance.
If you are a senior (65 years or older), you may need supplemental health insurance plans to complement your Medicare part A and B plans. A Medigap part D supplement health insurance plan will pay for your prescription drugs, deductibles, coinsurance, and copayments. You may also need to get additional supplemental insurance because Medigap may not meet all your health coverage needs. It does not provide coverage for:
Dental and vision care treatments
Private-duty nursing
Long-term care
Payment for eyeglasses
Hearing aids
Medigap provides coverage only for the insured.
A Florida-licensed health insurance agent can help you decide the supplemental health plan that you may need to add to your Original Medicare plan.
Who Qualifies for Supplemental Health Insurance?
Any adult resident in Florida that needs and can pay the premium for supplemental health insurance qualifies to own the plan, except for Medigap. Medigap requires the applicant to be enrolled in Original Medicare
Who Needs Supplemental Health Insurance?
Anyone who needs more coverage than their primary health insurance plans can provide, needs supplemental health insurance. Also, you need supplemental health insurance if you have a specific health issue, the medical costs for which are not covered by your primary health insurance. For instance, most ACA-compliant health plans do not include dental treatment. Hence, if you require dental care, you will need to buy standalone dental insurance to have coverage for dental conditions.
If you have needs that are not part of the benefits of your main health plan, you need to consider whether it is cheaper to add them as extra benefits or to get supplemental health plans. For instance, you can get:
Hospital indemnity insurance to pay for expenses that come with a hospital stay
Medicare supplemental plan to add additional coverage to your Original Medicare plan, as an alternative to a Medicare Advantage plan
Fixed Indemnity plan to provide coverage for lab works, medical diagnosis, and other out-of-pocket payments
Accident insurance to pay for treatment of injuries in the event of an accident
Accidental Death and Dismemberment insurance compensation for loss of limbs or body parts in an accident. It also pays compensation to beneficiaries of the policy in the event of an accident that resulted in the death of the policy owner
Dental insurance takes care of the dental expenses that come with dental care treatments
Supplemental health insurance covers a wide area of healthcare services. Contact a Florida-licensed health insurance agent before buying supplemental health insurance. A knowledgeable agent can assess your situation and advise you on the plans to meet your needs.
Who Should Get Supplemental Health Insurance?
Supplemental health insurance is of benefit to Individuals who want additional health coverage for healthcare services than their primary health insurance plans can provide. It is also for individuals that need specific health care services but do not want to buy a comprehensive health plan, or add more benefits to their health insurance plans.
PROs and CONs of Supplemental Health Insurance in Florida
PROs of Supplemental Health Insurance
Supplemental Health Insurance is beneficial in the following ways:
It puts the policyholder in a better position to handle out-of-pocket payments for medical treatments and healthcare services.
The benefits of the plan may be paid directly to the insured.
The plans pay for copays, deductibles, coinsurance, and other expenses that may come with medical treatments.
The policy owner determines how the benefits will be spent.
Furthermore, supplemental health insurance comes with a low premium, making it more affordable than conventional comprehensive Florida health insurance plans.
CONs of Supplemental Health Insurance
Supplemental health insurance is generally beneficial to individuals. However, it has some cons, including:
It can not be used as the primary insurance plan (with some exceptions, like Dental and Vision). It only acts as an auxiliary plan and must be used with a comprehensive health insurance plan for coverage.
It provides limited health coverage; for instance, it does not provide coverage for pregnant women and is under no obligation to cover pre-existing conditions.
It is not ACA-compliant and does not cover medical costs of existing health conditions.
Speak to a Florida-licensed health insurance agent if you require extra coverage for health care treatments.
Is Supplemental Health Insurance Worth it?
Yes. Supplemental health insurance is worth it because it fills the health coverage gaps for treatments and healthcare services that are not part of your primary health insurance coverage. Also, it is a cheaper alternative to adding more benefits to the primary health insurance plan. A hospital indemnity plan costs an average of $30 monthly for individuals between 60 and 65 years. Irrespective of age, the bronze plan (the lowest of the ACA health plans metal-level plans) costs between $328 and $482 monthly without government subsidies. Supplemental health insurance takes care of the payments for certain medical treatments. It can also be modeled to meet specific healthcare needs to avoid over-insurance and save on more costly comprehensive health insurance plans.
What Happens if you Don’t Have Supplemental Health Insurance?
If you do not have supplemental health insurance, you will pay out-of-pocket for healthcare services not covered by your primary health insurance. For instance:
if you do not have dental or vision insurance, you will pay out-of-pocket for expensive dental care and eye care treatments, or
If you do not have supplemental insurance to aid the short-term health coverage in case of emergency, you may have to pay high out-of-pockets costs, up to $20,000 per year.
Why is Supplemental Health Insurance Important?
Supplemental health insurance is important because it complements your primary health insurance and provides full coverage for medical conditions. It helps Florida residents in:
Making out-of-pocket payments for medical treatments
Covering the expenses that come with injuries and serious illnesses
Reducing the medical costs of treatments for specific health care services
Providing benefits that are not available in the primary health insurance plan
What Happens When your Supplemental Health Insurance Lapses?
If your supplemental health insurance lapses, the insurance company will terminate the policy, and you will not have insurance coverage for your healthcare needs. Your insurance plan will lapse if you do not pay the premium required for coverage within the 30-day Florida grace period. If you do not have any form of health insurance, you will be responsible for paying all the bills that come with your healthcare treatments and services.
Your supplemental health insurance may lapse for reasons other than not paying a premium, and you can also lose coverage due to policy cancellation. Whatever the cause of your supplemental health insurance lapse, you should seek the advice of a state-licensed health insurance agent to know what your available options are.
