Other Health-Related Policies

Supplemental Health Insurance
These policies provide coverage beyond, or in addition to, what your basic policy provides. You should use these policies as supplements, rather than substitutes, for basic medical insurance. Some policies include elimination periods, which means companies will pay benefits only after you stay in the hospital for a specified number of days.

Hospital confinement indemnity insurance
These policies pay a fixed amount or indemnity for each day, week or month you stay in a hospital. Such policies pay a flat amount for benefits.

Disability income insurance
These policies pay a weekly or monthly income for a specific period if you suffer a disability and cannot continue or obtain work. The disability may involve sickness, injury or a combination of the two. Most disability insurance plans coordinate with Social Security benefits and workers’ compensation to eliminate duplication of coverage.

You may select a disability policy that includes an elimination period, or length of time that you must wait after a covered illness begins, before receiving benefits. The longer the elimination period, the lower your premium. Premiums may also vary depending upon your occupation (and the risks involved) and your age. For example, a high-rise construction worker would likely pay higher premiums than a florist.

When buying a disability policy, you should find out the company’s definition of a disability and the requirements that must be met. Individual and group disability income policies must provide coverage for a policyholder or eligible dependent who becomes disabled. This coverage applies during the first 12 months of the disability, but only if the person can no longer perform material and substantial duties of his or her occupation. After the first 12 months, the company may base the continuance of benefits on the person’s ability to perform any work for which he or she is reasonably trained.

An insurance company paying for a disability claim may require the policyholder to provide a written doctor’s report. The frequency of this requirement depends upon the particular policy. For example, a given insurer may require such medical updates every month. In addition, the insurer may monitor certain public activities by policyholders who file claims. Insurers may do so to fight fraud and keep insurance costs down.

Accident insurance
These policies cover death, disability, hospital and medical care resulting from an accident. A common variation called “accidental death insurance” can pay additional benefits for death due to motor vehicle or at-home accidents.

Limited benefit insurance
These policies cover certain expenses from specifically named illnesses, injuries or circumstances. For example, cancer policies pay benefits for the actual treatment of cancer. Some also pay benefits for conditions or diseases caused or aggravated by cancer or its treatment.

Long-term care insurance
Long-term care encompasses a wide range of medical, personal and social services. A person may need this care if they suffer from prolonged illnesses, disabilities or cognitive impairment. Private insurance companies offer individual or group long-term care insurance policies that provide benefits for a variety of services not covered by your regular health insurance, or by Medicare or Medicare supplement insurance.

Home health care policy
This type of policy covers services prescribed by a physician and from a Medicare-certified or state-licensed home health care service. The care must help with activities of daily living or the supervision or protection of a patient with cognitive impairment (such as Alzheimer’s disease or senility). Some policies offering nursing home coverage automatically offer home health care as well. Some companies offer home health care as an option or rider to a long-term care policy. A few companies offer policies covering only home health care. You may obtain more information about policy options from your agent.

Nursing home care policy
This limited-benefit insurance policy offers an alternative for some people and covers either one level or several levels of care. In Florida, the levels of care include custodial, intermediate and skilled (defined in the Glossary). Cognitive impairment or the inability to perform one or more of the activities of daily living will activate the benefit trigger of this care.

You may obtain the free guide Long-Term Care and Other Options for Seniors by calling the Consumer Helpline toll-free at 1-800-342-2762, or by downloading it from the DFS Web site at www.myfloridacfo.com.

For definitions of deductible, coinsurance and copayment, see the Glossary.