If your child has an accident or needs medical attention while away at summer camp, will your health insurance coverage cover the expense? Unfortunately, there is no guarantee your insurance will cover medical treatment – it depends on your coverage. But there are steps you can take to protect your out-of-pocket expenses should the unexpected occur.
First, take a look at your health insurance policy. Some health insurance plans pay up to a certain percentage (like 50%) for medical services received outside your provider network. Other plans do not cover out-of-network services at all. It just depends on your coverage and health insurance by state.
If you don’t have out-of-network coverage or just want extra protection for the unknown, you can purchase a supplemental insurance plan for accidents and illnesses. These plans work with every type of insurance as they are standalone policies that pay a flat rate cash benefit for unexpected events.
For example, if your son or daughter breaks their forearm arm while away at summer camp, you will most likely have an emergency room visit, a doctor’s visit, X-ray and medical supplies to set the bone in a cast. The cost for an ER visit with moderate severity can begin at around $2,000, depending on location.*
Be mindful to review the camp’s legal paperwork you sign. Some camps automatically enroll your child in a supplemental insurance plan as part of camp costs. If your child is only heading to camp for a week and there is a supplemental policy included with their enrollment, you might not need to pay the extra cost on another supplemental policy. However, if the coverage is minimal, or your child will be away for a month or more, it could necessitate an additional policy to supplement your existing coverage.
*Prices obtained from FAIR Health Consumer for services in Michigan. FAIR Health utilizes both commercial and Medicare data to create the out-of-network uninsured price.
How Supplemental Insurance Works
There are many different types of supplemental health insurance plans in the marketplace. Here are some factors to keep in mind:
- Covering a child who could encounter multiple situations? An all-encompassing injury policy could be your best option.
- Most policies have a deductible before benefits begin. Compare deductible amounts between plans.
- There could be a waiting period before benefits are paid. Compare plans to see if there are any conditions that might prevent your child from being covered.
If your family experiences out-of-network charges due to an injury or sickness, save all of your Explanation of Benefits (EOBs) and any other receipts or communication you receive from a medical professional and your insurance company. Then, contact the supplemental insurance carrier to start the claims process. The final payout after the deductible can be sent directly to you, or you can assign the funds to a provider for any outstanding medical debt—the choice is yours.
Is supplemental insurance right for you?
- Look at your individual and family insurance policy. Does it cover out-of-network medical expenses?
- If your health insurance doesn’t cover the majority of out-of-network treatment, can you afford to pay thousands of dollars out-of-pocket should an emergency occur?
- When comparing supplemental plans, do they have the following?
- Deductible
- Waiting periods
- Pre-existing condition limitations
- Does coverage start immediately?
It’s important to understand your health insurance coverage details before your child(ren) head off to summer camp. With a little research, you can protect yourself and your little ones.
Need Backup Care This Summer?
If your family does find itself in need of additional caregiving coverage due to injury, sickness, or any other change in plans this summer, Helpr can provide the backup care you need to get back to work. From virtual resources for parents, online support and engagement for kids at home, to our in-home “upload your own provider” backup care offering, families have lots of options to find childcare help within their own communities. We’ve also been able to find long-term solutions for families looking for regular hours (even if for a few hours/week for deep work) via our Core Care program.
Don't have Helpr's care benefits? Refer your employer here.
This post was made in partnership with HealthCareInsider.com.
