Posts tagged "health insurance"

Pay a Higher Deductible or a Higher Premium?

May 11, 2018 Posted by health insurance 0 thoughts on “Pay a Higher Deductible or a Higher Premium?”

It’s the ultimate insurance debate: pay a higher deductible or higher premium? With many employers looking for ways to cut costs, the question to increase your monthly health insurance premiums or to pay a higher deductible is a concern you may be facing sooner rather than later.

First, let’s clarify the difference between a premium and a deductible.

  • A premium is the amount of money charged by your insurance company for the plan you’ve chosen. It is usually paid on a monthly basis, but can be billed a number of ways. You must pay your premium to keep your coverage active, regardless of whether you use it or not.
  • A deductible is a set amount you have to pay every year toward your medical bills before your insurance company starts paying. It varies by plan and some plans don’t have a deductible.

In 2017, more employers than ever included a high-deductible option on their 2017 menu of health plan offerings. An August survey of 600 U.S. companies by benefits consultancy Willis Towers Watson found that by 2018, nearly half will offer these plans exclusively. In 2006, high-deductible plans covered just 3 percent of workers. Fast-forward to 2016, and that figure was 29 percent, benefits consultancy Mercer found.

High Deductible Health Plans (HDHPs): Pros and Cons

HDHPs work differently than traditional POS (Point of Service) or PPO (Preferred Provider Organization) plans in that all healthcare expenses are paid out-of-pocket until the deductible is met. The concern with high deductibles is that it causes patients to not seek medical treatment because they fear the expense. Ultimately, this causes more extensive issues later on, such as those relating to diabetes, hypertension, depression, even cancer.

HDHP Pros:

  • Premiums are typically lower than with POS or PPO plans
  • Networks are not necessarily narrowed, as with HMOs
  • People who rarely use their health benefits may save money
  • If you are not on expensive medications, your monthly bills may be lower
  • Out-of-pocket expenses are not the market rate, but the negotiated rate between the healthcare provider and insurance company
  • Policyholders can open a health savings account (HSA), which never “expires,” to help cover out-of-pocket expenses

HDHP Cons:

  • People managing chronic illnesses find that their out-of-pocket expenses are high
  • Prescriptions, office visits, and diagnostic tests are completely out-of-pocket until you reach your deductible
  • If you need surgery, you will need to hit your deductible before the insurance company will pay anything
  • If your monthly out-of-pocket expenses are high, you aren’t taking full advantage of your HSA
  • Your deductible can be quite high (sometimes as much as $13,000 for families)

Those who initially lean toward higher insurance premiums are usually looking to save money in the long run, while those who originally gravitate to the higher deductible plans are looking to put more money in their pockets right now. However, sometimes it’s not that simple.

A 2011 study by the Kaiser Family Foundation found American families are increasingly paying more and more out of pocket for their health care costs – a whopping $15,073 for a family health insurance plan. However, it’s unlikely you’ll pay that full amount. With most employer-sponsored health care plans, your company pays a hefty dose of the premiums.

The Bureau of Labor Statistics reports that in 2008, private sector companies paid as much as 71 percent of family health insurance premiums. Public sector employers dished out even more – up to 73 percent.

While a high deductible plan and its subsequent lower premiums can put more money in your pocket, as well as your employer’s pocket, right now, it isn’t always the best choice. The Kaiser Family Foundation study also determined that the average deductible on these consumer-driven plans was nearly double that of traditional health insurance. On top of that, plans with a high deductible often come with a higher out-of-pocket max as well, sometimes as high as $10,000 a year for a family insurance plan.

Which plan is right for you?

As health insurance is not a one-size fits all item anymore, each person has to weigh the pros and cons of high deductible health plans against how they might need to use the policy. A person without an extensive medical history and unmarried without children might be able to risk such a plan. However, if an individual or someone in the  family sees a doctor once a month or needs to manage a medical or mental condition, perhaps a PPO would be a better.

Ultimately, choosing the right plan for you and your family can seem like you’re gambling with both your health and your money. If you are unsure of the insurance plan your company is offering you, a licensed insurance agent can assist you in finding a plan directly from the best health insurers.

Medicaid Coverage for Mental Health

May 7, 2018 Posted by medicare 0 thoughts on “Medicaid Coverage for Mental Health”

Approximately 29% of people who receive health insurance coverage through the Medicaid expansion either have a mental disorder (e.g. schizophrenia, bipolar disorder, clinical depression, anxiety) or a substance use disorder (SUD) such as alcoholism or opioid addiction, or both. As mentioned in our blog post “Mental Health Insurance,” 1 in 5 Adults have a mental health condition. With the concern for mental health becoming increasingly important, how does Medicaid, the nations largest insurer, support those suffering with mental illness as well as the growing prevalence of Americans with mental health problems?  (more…)

Mental Health Insurance

May 2, 2018 Posted by health insurance 1 thought on “Mental Health Insurance”

Since 1949, Americans have observed May as Mental Health Awareness Month. Mental health can be an uncomfortable topic of discussion, not only for those suffering with mental illness, but for those closest to them as well. After all, no one wants to be labeled as “crazy” or have that stigma often associated with mental illness. However, mental health problems are a daily concern for millions of Americans. In fact, Mental Health America reports that 1 in 5 Adults have a mental health condition – that’s over 40 million Americans. (more…)

The Case For Health Insurance

April 11, 2018 Posted by health insurance 0 thoughts on “The Case For Health Insurance”

Most people don’t want to pay for health insurance. For those below the age of thirty living healthy and active lifestyles, health insurance is viewed as an irrelevant, unnecessary cost. The reality is no one plans to get sick or hurt.  When given an option to spend money on insurance (and the related costs thereof) or spending money to enjoy themselves, the choice is relatively simple to make. A night out on the town, or monthly premiums for insurance coverage? (more…)

Could Walmart be the next face of American Healthcare?

April 5, 2018 Posted by health insurance, news 0 thoughts on “Could Walmart be the next face of American Healthcare?”

Amazon could do a lot to fix the US health-care system – but Walmart could do more. Walmart, the nation’s biggest employer, is trying to redesign how U.S. health care works. It’s one of the few companies that has the power to succeed. (more…)

Amazon’s First Steps Into Healthcare

March 28, 2018 Posted by health insurance, news 0 thoughts on “Amazon’s First Steps Into Healthcare”

Amazon is getting into health care. That’s not speculation, at this point. The company hasn’t spoken much about its plans, as it’s still determining the scope through a series of brainstorming sessions with experts in the space, but its hiring trends and recent product development hint strongly at where it could go. (more…)

Which industry workers are least likely to have health insurance?

March 23, 2018 Posted by health insurance 0 thoughts on “Which industry workers are least likely to have health insurance?”

Most would agree working in the insurance industry is relatively physically safe, aside from the sedentary lifestyle.  Let’s be honest, our biggest risk is exposure to sick people (although no where near healthcare workers) and possibly paper cuts.  We’re fortunate enough to have health insurance coverage should something like that happen.  However, there is a group of working professionals that lead the pack regarding the lack of health insurance coverage.  These workers are also at a very high risk of injury and illness.

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Health Insurance Carrier Cigna to buy Express Scripts

March 8, 2018 Posted by health insurance, news 0 thoughts on “Health Insurance Carrier Cigna to buy Express Scripts”

Health Insurance Carrier Cigna said on Thursday it would buy pharmacy benefits manager Express Scripts for about $54 billion, the latest deal in the sector aimed at tackling soaring healthcare costs. The move follows the $69 billion merger of insurer Aetna and drugstore chain CVS Health announced last December, and highlights a sector-wide trend toward deals between companies that do not have directly overlapping operations. The deals seek to lower healthcare costs by bringing under one roof pharmacy and medical claims, and give the combined entities greater leverage in price negotiations with drugmakers. (more…)

What is health insurance?

January 29, 2018 Posted by health insurance 0 thoughts on “What is health insurance?”

Health insurance, health care coverage, health coverage… so many words for the same thing but what exactly do they refer to? Is it really necessary to have? Although it’s difficult to capture the many details surrounding health insurance in the United States into a short, summarized article, we’ll do our best to make it easy to understand. (more…)

Record flu season get to you? Skip the doctor’s office.

January 15, 2018 Posted by health insurance 0 thoughts on “Record flu season get to you? Skip the doctor’s office.”

We’re in full swing of the flu season, as it is widespread throughout the United States, according to reports to the Centers for Disease Control and Prevention.  As of mid-December, at least 106 people died from the flu.  In addition, states across the country are reporting higher-than-average flu-related hospitalizations and emergency room visits. So what should you do if you get the flu?  One thing you don’t have to do is visit your doctors office. (more…)

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