Jane Dotson
Supplemental insurance is additional insurance that you can purchase to help pay for services and expenses that your regular medical insurance does not cover. This includes co-pays, deductibles, and co-insurance. It can also help cover the cost of treatments that are not covered by your primary insurance policy, such as acupuncture or physical therapy. Supplemental insurance is not intended to be standalone insurance but rather a secondary plan to your primary benefits. In Oregon, there are several options for supplemental insurance plans, including fixed indemnity plans, hospital insurance, accident insurance, critical illness insurance, and long-term care insurance. When choosing a supplemental insurance plan, it is important to consider your financial situation and overall health to ensure you are getting the best coverage for your needs.
| Characteristics | Values |
|---|---|
| Supplemental insurance | Secondary health insurance to cover out-of-pocket costs not covered by primary insurance, such as co-pays, deductibles, and co-insurance. |
| How to obtain | Typically through your employer; otherwise, purchased directly from insurance companies. |
| Tax implications | Supplemental health insurance premiums can be claimed as medical expenses on tax returns. |
| Popular supplemental plans | Fixed indemnity plan, hospital insurance, accident insurance, critical illness insurance, long-term care insurance, supplemental life insurance, etc. |
| Best health insurance in Oregon | Kaiser Permanente (top-rated by MoneyGeek and Forbes, five-star rating from HealthCare.gov) |
| Silver EPO plans | Kaiser Permanente is recommended by MoneyGeek with an average plan rate of $504 and a denial rate of 8.5%. |
| Silver PPO plans | PacificSource Health Plans is recommended by MoneyGeek with an average plan rate of $583 and a low denial rate of 3.2%. |
| Gold plans | Recommended for older people or those requiring more healthcare; average cost in Oregon is $715 per month with a deductible of $1,327. |
| Silver plans | Most popular health plan tier with an average cost of $582 per month for 40-year-olds in Oregon. |
| Bronze plans | Average cost of $366 per month for a 27-year-old in Oregon. |
| Medicare | Available for Oregonians aged 65+ or those with a disability/illness; includes Part A (hospital insurance), Part B (medical insurance), and Part D (prescription drug insurance). |
| Medicaid | Available for Oregonians with a household income below 138% of the Federal Poverty Level. |
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What You'll Learn
Supplemental insurance is secondary coverage
Supplemental insurance is not intended to be standalone insurance or a replacement for your regular health insurance. Instead, it is additional insurance that you can purchase to help cover out-of-pocket expenses, such as co-pays, deductibles, and co-insurances, that your primary insurance does not cover. It can also help cover the cost of treatments that may not be covered by your primary insurance, such as acupuncture or physical therapy. Supplemental insurance is often referred to as "secondary health insurance" because it acts as a second insurance plan to your primary benefits or your first health plan.
In Oregon, the cost of medical insurance averages $164 per month after discounts, with Regence BlueCross BlueShield of Oregon offering the cheapest quotes in Portland and its suburbs. Kaiser Permanente is considered the best health insurance company in Oregon, with a five-star rating from HealthCare.gov. However, Kaiser Permanente customers can only receive non-emergency medical services at Kaiser hospitals and clinics, which can be inconvenient for those who don't live nearby.
When considering supplemental insurance, it's important to understand the coordination of benefits. If you have multiple insurance policies, each one is given a "payer" designation, with one being the "primary payer" and the other the "secondary payer." The primary payer covers costs up to its limits and then sends the remaining balance to the secondary payer. If the secondary payer doesn't cover the remaining balance, you may be responsible for the remaining costs.
There are various types of supplemental insurance plans available in Oregon, including fixed indemnity plans, hospital insurance, accident insurance, critical illness insurance, and long-term care insurance. Each plan is designed to meet different needs, such as high-deductible health plans, ongoing health conditions, high-risk individuals, and seniors or those at high risk of specific illnesses.
Supplemental insurance can provide peace of mind and financial protection by helping to cover the gaps in your primary insurance coverage. It ensures that you have additional support to manage the costs of unexpected medical expenses or treatments that fall outside the scope of your primary insurance.
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Supplemental insurance covers out-of-pocket expenses
Supplemental insurance is an additional insurance plan that you can purchase alongside your primary health insurance. It is not intended to be standalone insurance but rather a secondary plan to cover any gaps in your primary insurance. It can be obtained through your employer or directly from insurance companies.
There are various types of supplemental insurance plans, and the specific coverage will depend on the chosen plan. Some plans will directly pay for out-of-pocket medical expenses, while others may provide a cash benefit that can be used for these expenses. Popular supplemental plans include fixed indemnity plans, hospital insurance, accident insurance, critical illness insurance, and long-term care insurance.
In Oregon, companies like Kaiser Permanente and PacificSource Health Plans offer health insurance with supplemental coverage available. The cost of supplemental coverage is not eligible for ACA subsidies, and the average monthly cost of health insurance in Oregon is $610, or $164 after discounts based on income. When considering supplemental insurance, it is essential to understand your personal circumstances, health, and financial situation to choose a plan that suits your needs.
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Supplemental insurance covers additional treatments
Supplemental insurance is an additional insurance coverage that you can purchase alongside your primary health insurance. It is not intended to be a standalone insurance plan, but it can provide extra financial security and confidence. It helps cover the out-of-pocket costs that your primary insurance may not, such as co-pays, deductibles, and co-insurance. For example, if you have a high-deductible health plan, a fixed indemnity plan can help pay for medical expenses.
Supplemental insurance can also cover the cost of treatments that your primary insurance policy does not. For instance, if you require acupuncture or physical therapy, supplemental insurance can help pay for these treatments. It can also be beneficial for cancer treatments and recovery. Cancer insurance, a type of supplemental plan, can provide flexible, direct payouts to reduce the financial burden of cancer treatments and cover recurrence benefits if cancer returns.
Accident insurance is another type of supplemental plan that provides coverage for injuries caused by accidents. It often includes a lump-sum payout that can be used for medical treatment costs, such as hospital bills, or indirect expenses like transportation and childcare. Similarly, critical illness insurance offers a lump-sum payout after a qualifying diagnosis of a serious illness. This payout can be used for medical care, experimental treatments, or other household expenses.
When considering supplemental insurance, it is important to review your primary insurance plan to understand what is already covered. Supplemental insurance can then be tailored to your specific needs, providing additional coverage for treatments and services that are important to you.
In Oregon, Kaiser Permanente is rated as the best health insurance company, offering both high customer satisfaction and quality plans. However, they have a limited number of hospitals and clinics, which may be a drawback for those not living nearby. When considering supplemental insurance in Oregon, it is worth noting that discounts and subsidies are often available, especially for those with lower incomes.
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Kaiser Permanente is Oregon's top-rated insurer
Kaiser Permanente's Silver EPO plans are particularly competitive, with an average plan rate of $504 per month and an average MOOP (maximum out-of-pocket) cost of $9,113. EPO plans may have lower costs when you go to doctors and hospitals in the plan's network. Kaiser Permanente's Silver plans are all EPO plans, and EPO plans do not require you to choose a primary care doctor or get a referral before seeing a specialist.
Kaiser Permanente also offers four Silver CSR EPO plans and three Silver CSR PPO plans in Oregon, making it a good choice for low-income individuals. CSRs help lower what you pay out of your own pocket, such as your deductible, so you can pay less each month and still not have too much to pay when you need care.
Kaiser Permanente has a strong reputation for customer satisfaction, affordability, and trustworthiness. It has been offering telehealth services since before the Covid-19 pandemic and has one of the highest scores for this provision.
However, it is important to note that customers can only receive medical services at Kaiser hospitals and clinics unless it is an emergency. This may be a drawback for those who live far from a Kaiser facility.
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Medicare Supplement Plans are available in Oregon
Supplemental insurance is a secondary health insurance plan that covers the out-of-pocket costs that your primary insurance does not. This includes copays, deductibles, and coinsurance. Supplemental insurance can also help cover the cost of treatments that your primary insurance does not, such as acupuncture or physical therapy. In Oregon, there are several options for supplemental insurance plans, including:
- Fixed indemnity plans: Help individuals with high-deductible health plans cover medical expenses.
- Hospital insurance: Suitable for those with ongoing health conditions.
- Accident insurance: Recommended for individuals at high risk of injury, such as athletes.
- Critical illness insurance: Appropriate for seniors or those at high risk of specified illnesses.
- Long-term care insurance: For individuals planning for the high costs associated with aging.
- Supplemental life insurance: Provides financial protection for family members in case of death.
- Accidental death insurance: Suitable for those with high-risk jobs.
- Disability insurance: Protects against sudden loss of income.
- Vision insurance: Covers annual eye exams and discounted lenses.
Medicare Supplement Plans, also known as Medigap or Medsupp, are specifically designed to supplement Medicare benefits for individuals aged 65 or older, people of all ages with disabilities, and people with specific diseases. These plans are regulated by federal and state laws and must provide specific benefits that fill the gaps in Original Medicare coverage. In Oregon, there are multiple companies that sell Medigap Plans, including CDA Insurance LLC, which offers Medicare Supplement plans to Medicare beneficiaries. It is important to note that Medicare Supplement Plans are different from other insurance plans that may help with out-of-pocket healthcare costs but do not qualify as Medigap plans.
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Frequently asked questions
Supplemental insurance is an additional insurance plan that covers the costs that your primary health insurance does not. This includes co-pays, deductibles, and co-insurances. It can also help cover the cost of treatments that are not covered by your primary insurance policy, such as acupuncture or physical therapy.
Some popular supplemental insurance plans in Oregon include fixed indemnity plans, hospital insurance, accident insurance, critical illness insurance, and long-term care insurance.
When choosing a supplemental insurance plan in Oregon, consider your financial situation and overall health. If you expect to require frequent medical care, a Gold plan may be a good option due to its low deductibles and out-of-pocket maximums. On the other hand, if you anticipate minimal healthcare needs, a Silver or Bronze plan might be more suitable.
