Julie’s Got You Covered

Financial Safety Nets: Understanding How Critical Illness Coverage Protects You

• Julie Sears • Episode 12

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How Does Critical Illness Coverage Work? 

Financial stress shouldn't compound the emotional and physical toll of a critical illness diagnosis. Julie Sears dives deep into the world of critical illness coverage, revealing how this often-overlooked insurance option provides substantial financial protection when you need it most.

Julie expertly breaks down who qualifies for critical illness coverage (spoiler: there are no age restrictions!), what conditions are typically covered, and how pre-existing conditions factor into eligibility. She explains the difference between underwritten policies that offer higher benefits versus guaranteed-issue options that provide accessibility for those with health complications. Unlike health insurance that pays medical providers, critical illness insurance puts money directly in your hands—with no restrictions on how you use it.

Whether you're a small business owner concerned about keeping operations running during a health crisis, someone with a high-deductible health plan seeking additional protection, or simply looking to create a more comprehensive financial safety net, this episode provides clarity on a complex but valuable insurance option. 

To learn more about Integrity Health Insurance Advisors visit:
https://www.IntegrityHealthInsuranceAdvisors.com/
Integrity Health Insurance Advisors
469-348-4066

Speaker 1:

Welcome to Julie's Got you Covered, the podcast where Julie Sears, founder of Integrity Health Insurance Advisors, takes the fear out of finding the right health insurance. With seven plus years of experience, she's here to make finding the perfect coverage a breeze. Stay tuned for details on how you can snag a free 30-minute consultation. Tuned for details on how you can snag a free 30-minute consultation.

Speaker 2:

Critical illness coverage can provide financial protection during some of the toughest times in life, but how does it actually work? In this episode, julie Sears explains how critical illness insurance can help you navigate the unexpected costs associated with severe medical conditions. Welcome back everyone. I'm Sofia Yvette, co-host, slash producer, back in the studio with Julie Sears. Julie, how's it going?

Speaker 3:

Good, how are you?

Speaker 2:

I'm doing good, and that is great to hear so. So, julie, everyone wants to know how does critical illness coverage work?

Speaker 3:

So critical illness coverage gives you a one-time cash payout in the unlikely, unhopeful event that you were diagnosed with any type of critical illness, any type of life-changing diagnosis, like cancer, heart attack, stroke, lost a limb it just depends. Each policy can have its own nuances that it covers. I do have a current client that was unfortunately diagnosed with cancer and is getting a $26,000 check so that more than covers their out-of-pocket costs that they have through their plan and gives them a little extra to help with anything else that you know just is necessary during recovery and treatment things that just happen in life and it gives them a little extra peace of mind while she's unable to work and you know can take care of the things that the family needs and just relieve a little bit more stress from their life.

Speaker 2:

Wow. And what type of illnesses are typically covered under critical illness insurance, other than tragic ones such as cancer?

Speaker 3:

Loss of limb, If you lose your eyesight, if you go blind, lose your hearing. It may not pay out the full benefit at that time, but it at least gives you something. If you do have something that's going to severely impact your normal day-to-day life.

Speaker 2:

Are there age restrictions for applying for critical illness coverage?

Speaker 3:

No, typically you're just going to pay more the older you are. So if you get something when you're younger, it's just going to secure a lower rate. You are so if you get something when you're younger, it's just going to secure a lower rate, and you know, obviously it'll increase over time, like everything does, but it does at least ensure your coverage. Most of the time. You do have to be in relatively good health in order to qualify for private options that offer critical illness. There are some policies that may have less restrictions on getting approved, just may have a lower payout. But, of course, even if it's just enough to cover your out-of-pocket expenses in the event of a treatment plan being in place, anything's going to help, right, if your life is going to change moving forward.

Speaker 2:

Julie, can critical illness coverage be purchased in addition to Standard health insurance?

Speaker 3:

Yes, most times it is included with a lot of the private plans that I offer, but it is something that we can add on to any of the public ACA options. Again, it just depends on the qualifications and your age to see whether it's something that's going to be cost effective for where you're at, and obviously it can't be something that you're currently being treated for. We can't wreck the car and then you know, call to get covered, unfortunately, but it's something that I just help in the process and make sure that we've got you properly covered.

Speaker 2:

So, julie, are pre-existing conditions ever covered under critical illness insurance?

Speaker 3:

Just depends on what they are. If you do have high blood pressure, depending on what your readings are and making sure that you're compliant with your treatment, you'll likely get covered and that way, in the event you do have a heart attack in the future, there won't be any exclusions. But if it's something that is a major ongoing heart condition that you've been treated for for a really long period of time and there hasn't been change, the likelihood is very slim that they're going to pick up because unfortunately, the risk assessment would be that the odds are not in your favor. It's insurance. They're going to assess the risk.

Speaker 2:

And how would something like that work? Would they have to have written notes from their doctor, previous medical history demonstrating years of having those conditions?

Speaker 3:

They will pull medical records to see what that history looks like so that they can fully assess the risk.

Speaker 3:

Of course, those are those people that are in the basement running the numbers and crunching all that stuff Definitely not my pay grade, but just running those numbers to see what that risk assessment looks like. There are some that are guaranteed issue. They're just going to pay out a lower benefit amount. Obviously, we want to get the most bang for your buck. If you're going to be paying any type of additional premiums, we want to make sure that, in the event that you needed to use it, you're getting as much benefit to you as possible.

Speaker 2:

Most definitely, and so Julie. What factors should someone consider when deciding whether to add critical illness coverage to their health plan?

Speaker 3:

Just that ratio of what you're paying per month and what you're going to get in return. So you know, in my client's case that payout is huge. So she's more than made up those premiums that she's paid all those years and is definitely going to. You know, can't say reap the benefits, but yes, she is. But at least it was there for her as an additional safety net to that out-of-pocket maximum that she's going to be facing. That's more than four times what her out-of-pocket is looking like. So that at least gives her some money to breathe. That at least gives her some money to breathe.

Speaker 2:

With this situation as an example, how does a lump sum payment from critical illness coverage help during a health crisis?

Speaker 3:

That just gives her some additional peace of mind that her out-of-pocket is covered. It's going to give her some money for those day-to-day just expenses to live and just take care of what needs to be taken care of. They are small business owners, so if they need to use that money to help keep business moving forward while they're receiving treatment, then they can use that money to help pay their employees or pay expenses, whatever they've got to do while they're receiving treatment. So that money is theirs to do with whatever they choose.

Speaker 2:

Julie, for the small business owners that may be listening to your podcast today, are there different qualifications in order for them to get critical illness insurance?

Speaker 3:

No Again. We'll either look at just based on their health history we might be able to get one that's underwritten, so then they can maximize and get a bigger benefit, or if they've had some health troubles in the past that might block them from getting a higher benefit, we can at least get them a minimum guaranteed issue benefit that will pay off in the event that something happens down the road.

Speaker 2:

Well, thank you so much for your insight into this, Julie. We'll catch you in the next episode. Have a fantastic rest of your day.

Speaker 3:

You too.

Speaker 1:

Thanks for tuning in to. Julie's Got you Covered. Ready to say goodbye to insurance stress Head to IntegrityHealthInsuranceAdvisorscom or call 469-348-4066. That's 469-348-4066 to book your free 30-minute consultation With Julie. Health insurance doesn't have to be scary. She's got you covered.