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How Do I File a Claim on a Supplemental Health Insurance Policy?

Many people have a health insurance policy, either through their employer or through an individually purchased plan. You think you’re good to go from that moment forward, right? Well, you may be one of several Americans who has more out of pocket expenses listed on their health insurance policy than they had previously known. So, what is there to do when you encounter such a situation?

Like all things regarding health insurance, claim filing is a process.

What is Supplemental Health Insurance?
A supplemental health insurance policy is a health care policy designed to help pay for costs existing outside the scope of your original health care insurance policy coverage, such as co-insurance, copays, and deductibles.1 As for how supplemental health insurance policies work, supplemental health insurance policies generally pay benefits out directly to the insured. However, the amount paid varies by policy.1
There are number of different supplemental health insurance plans available, all of which are designed to help cover gaps in coverage left by the original health insurance policy. A few examples of supplemental health insurance include dental insurance for adults, critical illness insurance, travel insurance, and vision insurance.1 While these are general supplemental health insurance policies, there are also a number of supplemental health insurance policies designed to tackle the costs posed by specific diseases or situations, like cancer, accidental death and dismemberment, and Medicare Supplement insurance.1
How to File a Supplemental Health Insurance Claim
You have a supplemental health insurance policy in place, now you need to put it to use – but how do you file a claim? Like all things regarding health insurance, claim filing is a process. Here are a few things you need to know before starting the claim filing process, and a few things you should know about the information that will be required of you when you file your claim.

What are your claim filing options?
There are a couple of ways in which claims can be filed. You can choose to either have your medical services provider submit your claim directly to the insurance company electronically, or you can choose to file your claim manually – filling out the paperwork yourself and submitting it through mail, fax, or online.2 The decision is up to you, though many choose to have their medical services provider electronically submit the forms.2

What information do I need to provide on my claim form?
If you have your medical services provider file your claim electronically, they may already have all the information needed to file your claim. However, in the event that you have to file your own supplemental health insurance claim, there is some information you will need to provide. A claim form will typically ask for the following:2
  • Your insurance policy number, group plan number, or member number
  • Who received the services
  • What the visit was for
  • If there is co-insurance or dual coverage

How to Submit Your Claim in 4 Steps
While filing your claim can seem like a daunting process, the entire ordeal can be broken down into four easy steps.
  1. Get an itemized bill from your medical services provider.2 You will need to attach this itemized bill to your claim. Remember to make sure any and all medications are listed with their itemized costs.
  2. Obtain your claim form from your supplemental health insurance provider.2 This form may have additional instructions as to what to provide in addition to the form. However, filling it out should be relatively straightforward.
  3. Make copies of all the documents you’re submitting.2 Making copies may help eliminate the possibilities of any errors in the claim filing process.
  4. Review all your documents before sending your claim off. After that, all that’s left to do is send it in and wait.2
Whether you’re familiar with supplemental health insurance policies or the claim filing process, filing a supplemental health insurance claim doesn’t have to be difficult. While the documents required may vary by provider, as may the benefit amount, the process in which claims are filed remain generally the same no matter the supplemental health insurance you have. For any questions about filing a claim, we suggest you ask your insurance provider for more information. 
  1. The Balance, The Basics of  Supplemental Health Insurance Plan, 2019
  2. The Balance, How to File a Health Insurance Claim Form, 2019