Are Specialized Healthcare Plans Right for Your Senior Clients?

Dave Ramstack
Dave Ramstack
Published on September 16, 2021

With healthcare expenses skyrocketing, senior clients may benefit from purchasing additional coverage in the form of specialized healthcare plans. 

What are Specialized Healthcare Plans?

Specialized healthcare plans are supplemental plans designed to offset out-of-pocket costs like deductibles, co-payments, and coinsurance not covered by traditional health insurance policies. These plans include vision, dental, disability, and serious illness plans. Vision and dental plans can be used to cover some or all of the most common procedures in those areas. 

These plans may have deductibles and yearly plan maximums and may deny coverage or pay less if the policyholder gets care outside of the plan’s provider network. Serious illness plans like hospitalization, cancer, heart attack, or stroke are designed to help policyholders with the costs of the associated covered incident or diagnosis. 

Specialized healthcare plans are not major medical insurance and should never replace a major medical plan. Instead, seniors may benefit from adding specialized healthcare plans to their existing health coverage.

Disability Plans for Seniors

Short-term and long-term disability insurance can be a desirable option for those seniors who still work over 30 hours a week. Unfortunately, this type of coverage is difficult to find as most companies stop issuing policies to individuals at age 60. 

Even employer plans may terminate coverage when the insured turns 65, regardless of whether or not they are still working. Seniors who are still working should speak with their benefits administrator to see what disability options are available.

Hospitalization and Serious Illness Plans

Many insurers offer plans for hospitalizations or cases of serious illness. These are indemnity plans that pay a fixed amount if a policyholder undergoes a specific treatment. The payments may or may not require an out-of-pocket expense to the patient, and they are paid directly to the policyholder in cash. 

These plans may either pay out a one-time lump sum for a diagnosis or individual amounts for certain procedures. If the policy pays for specific procedures or events, a policyholder can collect multiple claims for the same diagnosis. For example, if a cancer plan policy offers payments for an initial diagnosis, hospital stays, and surgery, the insured can claim a payout for each of those instances.

Hospitalization and serious injury plans can help offset the patient responsibility of what Medicare does not pay, making them particularly beneficial to seniors on a fixed income who might not be able to absorb the unexpected expense. The policies are typically available for all ages, though those with a current or former history of the covered condition may not qualify for coverage.

Who Should Get a Specialized Healthcare Plan?

Specialized healthcare plans are best suited for:

  • Seniors whose Medicare, Medigap, or Medicare Advantage Plans still require significant cost-sharing for hospital and physician services
  • Seniors whose current Medicare coverage does not include vision or dental benefits
  • Seniors on a fixed income who would struggle to cover the cost of a serious illness

Final Thoughts

Having the right combination of healthcare benefits is critical to protect seniors against unexpected health costs. American Senior Benefits agents can provide seniors with the knowledgeable guidance they need to help them protect their health and finances. 

As an American Senior Benefits agent, you can enjoy a rewarding career advising seniors on how best to enjoy their golden years.

How do I Learn More?

To learn more about reviewing specialized healthcare plan policies, contact the specialists at American Senior Benefits. Our licensed experts will be happy to answer any questions you have.  

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