What to Know About Insurance Coverage for Chronic Illnesses
What to Know About Insurance Coverage for Chronic Illnesses
May 28, 2020

There are a lot of insurance policies out there, from car insurance to house insurance. Your company might even be subsidizing your health maintenance organization (HMO) insurance, which lets you pay for hospitals and other medical bills in case of an emergency. However, it isn’t always as simple as that — especially for those dealing with chronic illnesses. More often than not, folks with health problems have to take extra precautions to protect themselves and their loved ones.

Here are some things you need to know about insurance coverage for chronic illnesses.

Why do I need insurance for chronic illnesses?


Medical bills are expensive.

The cost of long-term care in California ranges from around $180,000 to $280,000. Of course, the final sum will depend on how long it will take for you to get better and the type of care you need. But for chronic illnesses, know that it’s going to be a battle that can last years. Insurance can help cover part (if not all) of your medical expenses when the time comes.

You’ll get old eventually.

There’s no doubt about it: our bodies get weaker with age. Even if you are perfectly healthy now, there’s a high chance of you catching a chronic illness when you are over the age of 65. True enough, more than 92% of elderly Americans suffer from at least one chronic disease. The most commonly diagnosed ones include cancer, stroke, and diabetes. Moreover, seniors are also susceptible to chronic illnesses brought about by fragile bones, like osteoporosis.

What plans are available?

No policy covers chronic illness specifically, so it’s important to know which ones you need. Here are some policies that you should be looking into for chronic illness coverage.

Critical illness

Critical illness grants its holder a large sum of money after getting diagnosed with specific diseases listed on their policy. Every critical illness coverage should at least cover the following: cancer, heart attack, and stroke. This list can expand to up to 36 types of illnesses and procedures, such as coronary bypass surgery and kidney failure.

But of course, broader coverage means larger premiums. The Balance informs that critical illness is one of the more expensive policies out there, with an average cost of anywhere between $25,000 to $500,000. As a general rule, only choose to cover diseases that you already have or can’t prevent.


Medigap or Medicare supplement insurance is provided by insurers to pay for costs not covered by Medicare. As you know, Medicare is the federal government’s healthcare program that grants tons of health benefits for those 65 and above, including hospital fees and medicine subsidy. However, Medicare services are limited. For instance, it doesn’t cover the first 60 days of any hospital stay. It also does not cover health incidents that happen overseas, as well as most prescription drugs.

This is why a Medigap policy may be necessary. Medigap pays 20% of your coinsurance, for starters. Plus, they add additional hospital coverage and will even pay for emergency care if you are out of the country. This policy has monthly premiums from anywhere between $100 to $500, depending on your health condition when you purchase it.


This policy will provide you with income in the event that you’re unable to work due to a “disability.” This comes in two types: short-term and long-term. Short-term is for those who only need a couple of months to bounce back. It covers three to six months of missed salary.

For those with chronic illnesses, however, Business Insider recommends the long-term option for the expanded coverage. It will support you in case you end up unfit for work while you’re still working (this is not a form of pension for seniors), and touches on certain chronic illnesses like cancer, musculoskeletal disorders, and heart disease. Premiums will be around 3% of your current salary, and your eventual payout will be about 70% of it too.

However, it’s important to note that disability policies only cover incidents that happen after the policy has been issued. If you are already suffering from a chronic illness prior to it, you will not be eligible for payouts.

Life insurance

The main purpose of life insurance is to leave your family financially capable if the worst-case scenario happens to you. However, another major advantage of getting life insurance is the riders. Riders are provisions that add benefits to an otherwise standard policy. Certain providers will offer chronic illness insurance as a rider, whose payouts can be deducted from the total death benefit amount. This may mean that your family will get less when you are no longer here, but it will save them (and you) the grief of having to pay for medical bills upfront.

Life insurance is also one of the few policies that are cheaper the younger you get it. So if you don’t have one yet, allow us at BGA Insurance to guide you through the process.

Chronic disease can strike when you least expect it, so it’s always important to be prepared. Review the policies that you are planning to buy, from its coverage to premiums. Make sure that you never have to shell out more money than what you can offer.

– written exclusively for BGA Insurance by Amy Cooper, a freelance consultant for personal finance. Her clients are mostly middle-class families who need guidance on how to properly manage, grow, and make smart decisions about their personal wealth.