Sunday, October 27, 2013

Health Insurance -- Maybe You Need It

We're all hearing about health insurance with the Affordable Care Act -- good news, bad news and all the politics, but if you're an American consumer, you're smart to listen to some of the chatter. 
 
Green anole on green leaf visible in Texas front yard
You're exposed if you don't have health insurance

If you don't have health insurance through your employer, you probably don't have health insurance. Even if you have health insurance through your employer, you may not feel like you have health insurance, as most employers are going to high deductible plans similar to major medical. Maybe you pay the first $2,000 or the first $3,500. That includes prescription drugs, office visits, medical diagnostic tests and everything that isn't preventive medicine.
 
That's the kind of medical insurance you need even if you aren't insured through your work, particularly if you're young and healthy. You need a major medical policy that pays only if you have an expense greater than a few thousand dollars. That's what you can get with the Affordable Care Act, at a lower price than you'd pay for an individual policy. Check out catastrophic medical coverage for high deductibles and low rates. ACA also has the Platinum, Gold, Silver and Bronze plans, all with more coverage and higher premiums.
 
Why do you need medical insurance? You're young, healthy, haven't been to the doctor in years, and have someone in the family who can give you medical advice -- or you can find it online.
 
You need medical insurance for your future. You have plans, dreams and future earnings. If you have a medical expense that you can't pay right away, it will follow you until it's paid. That may be the remainder of your life.
 
Having medical debt is a little like having a child, but even children make a contribution while costing money. You have the expense of children from before birth until at least age 18, but they give joy and pleasure along the way. You won't get that from a medical expense that isn't covered by health insurance. You'll get to pay every month with no visible result. It's a drain on your future.
 
You're smarter than that. It's better to pay for major medical insurance at a low cost than to risk your future without it.
 
I went for a well visit last month, and just got the bills. My doctor's charge was about $300 and the blood work was $560. I can't even afford to be well without insurance. With my insurance coverage, I'll only pay about $325 of the total charges. My cousin recently told me it cost $25,000 to LifeFlight her about 100 miles to a large hospital for treatment. Fortunately, she has Medicare and Medicare Supplement, with little of that cost coming out of her bank account. Can you afford to be without health insurance?
 
You can go to healthcare.gov and shop for insurance, based on your state and county. Your shopping figures don't include credits you may get on your federal income taxes or subsidies from the federal government. A catastrophic insurance policy will probably cost under $200 a month, and protect your future if you have to be life flighted, or if you are hospitalized for a few days. You may get a credit or federal subsidy if your income is below about $45,000 as an individual or about $62,000 for two. The break in pricing seems to be at age 50, so if you're under 50, your insurance will be less than those over age 50. The insurers for each state are different, but you'll recognize names like Blue Cross Blue Shield and Aetna.
 
Health insurance may also protect your family, if you have assets. Generally, your debts get paid before your family gets any assets -- and this includes medical debts. You may be gone, but your failure to have health insurance lives on.
 
As a savvy consumer, keep an open mind and consider the risk of not having health insurance. Take a look at the website and see the cost of a catastrophic policy without any subsidy. Then, create an account and compare the cost with the subsidy. You may find it's  a deal you can't refuse -- when you consider your future without it.
 
See you soon!
 
Linda
 

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