Supplemental Health Insurance

Supplemental policies pay benefits in addition to your primary health insurance. The most common products we use:

• Accident — lump sums and per-event benefits for covered ER visits, fractures, dislocations, and lacerations.
• Critical illness — lump-sum cash on diagnosis of covered conditions such as heart attack, stroke, certain cancers, or organ failure.
• Cancer — pays on diagnosis and, depending on the product, through treatment milestones.
• Hospital indemnity — fixed dollar amounts per day for hospital admission and ICU stays.
• Short-term disability — replaces a portion of income when a covered illness or injury keeps you from working.

Exactly which conditions, events, and dollar amounts are covered is defined by each policy's benefit schedule, and those schedules differ meaningfully between carriers. Two accident plans at the same premium can pay very different amounts for the same broken wrist, which is why we read the schedule with you before you apply.

Supplemental never replaces major medical — it works alongside it. If you carry a private PPO or an ACA Marketplace plan with a $7,500 deductible, an accident plan can meaningfully reduce the out-of-pocket impact of a single ER trip.

The mechanics matter: your major medical plan pays providers under its network contracts, while a supplemental policy pays a scheduled benefit that, in most cases, is issued to you. Benefits are typically paid regardless of what your other coverage pays, so the money can go toward the deductible, coinsurance, prescriptions, travel to a specialist, childcare, or the paycheck you missed. Coordination rules can vary by product and state.

We always start with your major medical plan, identify the real exposure, and only add supplemental products that close a meaningful gap.

Pricing is driven by four things: the product type, your age, the benefit amount you select, and whether you're covering yourself, a couple, or a family. Individual accident plans are usually the least expensive of the group; critical illness and hospital indemnity cost more as the lump-sum or per-day benefit rises. Tobacco use and, on some products, medical questions can also affect eligibility or rate.

The useful comparison isn't premium alone — it's premium against exposure. If your family plan carries a five-figure out-of-pocket maximum and you'd have to borrow to cover it, a modest monthly premium buys real protection. If your out-of-pocket maximum is small and funded in savings, we'll tell you to skip it.

Supplemental claims are filed with the supplemental carrier — not your major medical plan — after a covered event. Most carriers ask for a short claim form plus supporting documentation such as an itemized bill, ER record, discharge summary, or a physician's statement of diagnosis. Accident and hospital indemnity claims are usually the simplest; critical illness claims require documentation of the specific covered diagnosis and its date.

Two details cause most delays: missing the diagnosis date and filing outside the policy's claim window. We walk clients through both at enrollment so the paperwork isn't a surprise during a hard month, and we stay reachable if you need help filing later.

Supplemental coverage is a poor substitute for adequate major medical. If the real issue is that your primary plan has the wrong network or a deductible you can't live with, the fix is the underlying plan — not another policy layered on top. In that case we start with a private PPO or an ACA Marketplace review first.

It's also usually the wrong purchase if you already have a low deductible and liquid savings, if an employer already provides accident or disability coverage, or if a proposed stack of three or four products costs more each month than the gap it's meant to protect.

Most supplemental policies are oversold. We won't stack five products on you when two will do. Phil will quote a couple of options, explain what each one actually pays, and let you decide.