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Increasing health care costs continue to drive the need for voluntary benefits options, also known as supplemental insurance. If you don’t have voluntary insurance already, and even if you do, you may have questions about these benefits and wonder, “What is voluntary insurance?” or “How is it different from my major medical policy?” For many people, voluntary insurance may help solve a number of common concerns and challenges. Even for those with comprehensive major medical plans, medical and nonmedical out-of-pocket costs associated with an illness or injury can be substantial. So, having the right voluntary policies in place can help ensure you have ample financial protection for the things that matter most.

The basics of voluntary insurance

Simply put, voluntary insurance policies help people protect their financial well-being in the event of a serious accident or illness. These policies offer a way to stay ahead of the medical, nonmedical and out-of-pocket expenses that add up quickly after an injury or illness. From emergency treatment and transportation costs to everyday bills, voluntary insurance pays cash benefits directly to the policyholder, unless they designate otherwise.

Gaining more responsibility, but still facing risks

You may have noticed that health care is becoming more customer-focused. From prescription drug commercials to doctor visits, you’re becoming more involved in health care decisions. Employers are also introducing benefit plans that give you more decision power. These plans are often called “consumer-driven health plan options” and include high-deductible health plans (HDHPs) with a health savings account and/or health reimbursement account (HSA or HRA). In many instances, Americans are making more of their own health care choices – including how much to spend on health care coverage and what types of coverage to have.

With so much responsibility, it’s important to calculate risk. It may come as a surprise, but the cost of medical care – even for those with major medical coverage – can be daunting. In fact, 20 percent of American adults are struggling to pay their medical bills, and 3 in 5 bankruptcies are due to medical bills. And despite having year-round insurance coverage, 10 million insured Americans ages 19-64 will face bills they’re unable to pay.1 While no one anticipates the unexpected, injuries and illness pose more than simply health risks; they also pose financial risks. As you become more responsible for your own health care decisions and costs, voluntary policies can help you build a smarter benefits package and a stronger financial safety net.

Discover the real cost: You can learn more about the real costs of injury and illness with Aflac’s Benefits Estimator

How out-of-pocket costs work

Out-of-pocket medical costs are a reality – regardless of changes related to health care reform – and can add up quickly. Some can be very much unexpected, so it’s important to consider where they arise:

Deductible: The amount owed for covered health care services before your health insurance or plan begins to pay. For example, if a plan deductible is $1,000, the plan won’t pay anything until you pay $1,000 toward covered health care services subject to the deductible. The deductible may not apply to all services.2

Coinsurance: The percentage you pay toward each covered health care service. The coinsurance is paid on top of any deductible. For example, let’s say your company offers an 80/20 health insurance plan and the allowed amount for an office visit is $100. Once you’ve met your deductible, your coinsurance payment of 20 percent would be $20. The health insurance or plan pays the rest of the allowed amount.2

Copay: A fixed amount – for example, $15 – you pay for a covered health care service, usually when you receive the service. The amount may vary by the type of covered health care service.2

Nonmedical costs: When faced with a serious accident or illness, there are various nonmedical costs associated with a hospital stay or recovery time, including child care, transportation and reduced take-home pay due to missing work. These expenses can add up quickly, contributing to the overall out-of-pocket cost of being sick or injured.

Limits or exclusions: Pay attention to services not included in your plan, as well as any limitations or exclusions. Due to health care reform, plans will no longer have lifetime or annual limits on essential health benefits, but there may be limits related to other items, such as the number of refills for certain drugs, the number of visits to certain specialists or the number of days covered for certain benefits. These limits or exclusions could mean unexpected out-of-pocket costs.

Out-of-pocket limit: Out-of-pocket costs are different than out-of-pocket limits. Out-of-pocket limits are adjusted annually by the IRS, and for 2016 they are $6,850 for individual coverage and $13,700 for family coverage. This means you will pay coinsurance – in a variety of ways as determined by your health plan – up to your out-of-pocket limit. These limits apply only to covered expenses, so if you or a family member incurs noncovered expenses, they will not count toward your out-of-pocket limit. This adds to your potential unexpected costs.

Voluntary insurance helps support your financial safety net

For many, voluntary benefits options have long been solutions for building a stronger financial safety net:

  • Benefits when you need them most: Unlike major medical insurance, voluntary insurance benefits are paid directly to policyholders when they are sick or hurt, unless they designate otherwise.
  • Affordable benefits for any life stage: If you are like most individuals, you would be hard pressed to pay even small health care expenses that aren’t covered by a major medical plan. Voluntary benefits options offer a variety of levels and types of coverage to meet individual needs and life stages, and you can choose the ones that best fit your lifestyle. Voluntary policies are low cost options that help protect your financial future. For example, Aflac’s most popular policy, Accident Indemnity Advantage®, costs as little as $4.98 per week.3
  • You choose how to use your benefits: With voluntary coverage, you decide how you want to use your policy’s cash benefits. That means you can use them to pay the monthly mortgage or rent, child care costs or even grocery bills. These are benefits that everyone can use.

Gain more with voluntary insurance

Voluntary policies, like those offered by Aflac, work with major medical insurance to help provide financial protection to policyholders. As health care costs continue to rise, these policies serve as important and affordable financial buffers for your family. Unlike major medical insurance, voluntary insurance pays cash benefits directly to you, unless otherwise assigned, if you are sick or injured.

Consider asking your employer about these popular options:

For a more in-depth look at voluntary insurance, check out Voluntary Insurance 101