Your deductible
The benefit should at minimum clear the deductible and out-of-pocket maximum on your medical plan.
Supplemental
Critical illness and supplemental
Your medical plan pays the hospital. A supplemental policy pays you, and you decide whether that money covers the deductible, the mortgage or the six weeks you cannot work.
What this actually is
Critical illness plans pay a lump sum on diagnosis of a listed condition, commonly heart attack, stroke and certain cancers. Accident plans pay scheduled amounts for injuries, ambulance rides and emergency room visits. Hospital indemnity plans pay a fixed amount per day of admission.
These are not replacements for major medical and we will never sell them as such. They exist because high-deductible plans moved real money onto households, and because self-employed people have no sick pay. A lump sum that covers a deductible and a month of expenses is a reasonable thing to buy if the premium is small.
The fine print is where these policies earn or lose their keep: which conditions are listed, how the definitions read, whether benefits reduce with age, and what the pre-existing condition exclusion looks like. We read those clauses with you before you sign.
What we do on this line
- Listed conditions and their definitions, read out loud rather than summarised
- Benefit amounts matched to your actual deductible and out-of-pocket maximum
- Pre-existing condition and waiting period clauses flagged clearly
- Whether benefits reduce at a given age, and by how much
- Accident and hospital indemnity compared alongside, so you buy one thing rather than three
- A plain statement of what this does not do, in writing
What moves the number
Price is not random. These are the levers, in the order they usually matter.
Sick pay
Employees may have short-term disability. Self-employed people generally have nothing.
Family history
Relevant to whether a critical illness policy is worth the premium for you.
Premium as a share of budget
If it competes with your medical premium, it is the wrong purchase.
How the appointment runs
- 01
Gap
We start from your deductible and out-of-pocket maximum, not from a product.
- 02
Match
Benefit sized to that gap plus a month or two of fixed expenses.
- 03
Read
Definitions, exclusions and reductions, together, before anything is signed.
- 04
Claim
If you ever need it, we file with you. That is the whole point of a local agency.
Questions we get about critical illness and supplemental
No, and anyone who tells you otherwise should not have a licence. These policies pay cash benefits alongside a real major medical plan.
Usually directly to you rather than to a provider, on proof of a covered diagnosis or event. You choose what it pays for.
It depends on who paid the premium and how. Employer-paid benefits can be treated differently from individually paid ones. Ask your tax adviser; we are not one.
Almost nobody does. Most people are better served by one well-sized policy than by three small ones.
Often bought alongside
Self-employed health cover
Coverage built for 1099 income: variable earnings, quarterly taxes and no HR department to ask.
Read the detailLife insurance
Term and permanent cover sized to the actual obligations you would leave behind.
Read the detailDental, vision and hearing
Standalone cover for the three things medical plans mostly do not pay for.
Read the detailTwenty minutes usually settles it
Bring your prescriptions, the doctors you want to keep and a rough income number. We do the rest.
Our help is free to you. We are paid by the carrier you choose, and the premium is the same whether you use us or enrol on your own.