Equations

If Health = Well Being

and Insurance = Financial Protection

then Health Insurance = Well Being + Financial Protection

It all seems so simple, but when it comes to choosing a health insurance plan for you and your family, it can get very complicated.

Here’s another equation for you Economic Downturn = Fewer Employees With Company Supplied Health Plans.  If you are among the many that have lost company supplied health insurance, you probably have a lot questions about coverage for you and your family. 

Let’s look at some basic variables in any health insurance plan.  There are four things that create expense for the insured.  Co-pay + Deductible + Co-Insurance + Premium = Annual Out of Pocket Health Insurance Cost. 

Most health insurance plans include a co-pay, which is the share you pay per designated service.  The deductible is your out of pocket expense for health care services over and above your co-pay up to a specified dollar amount.  So for example, a plan may have a $30 co-pay for a doctor’s office visit, but until your $1,500 deductible is met, you will pay the full cost for any lab work or other services that don’t specifically have a designated co-pay.  Most insurance plans have a maximum designated out of pocket over and above your co-pay and deductible.  This is your co-insurance. 

Generally speaking Higher Deductible + Higher Co-Pay + Higher Co-Insurance = Lower Premium.  The more expense you are willing to cover for your health care, the less the insurance company will likely charge for the premium.  Your premium may also be effected by your over all health status.

If you are considering a high deductible plan, you may want to look at a plan that works with a Health Savings Account.  You deposit HSA money into your designated account before taxes and it can only be used for approved health care costs.  The advantages are that you aren’t liable for taxes on the money you save in your HSA account in a given tax year, you have back up funds for medical expenses and generally speaking your premium will be less.  The money can be held over from year to year.

If you are starting a new health insurance plan, you will need to learn the waiting period for treating preexisting conditions.  Most plans won’t pay for treatment of a preexisting condition for up to one year.  The preexisting waiting period may be waived under certain circumstances if you are transitioning from a group plan.  It’s also important to read your plan exclusions.  If you or a family member has a preexisting condition, you will need to know if the insurance plan will pay for treatment of that condition at any time.  Some conditions are excluded from treatment. 

The initial implementation of the Affordable Care Act has meant that children up to age 26 can be covered under their parent’s health insurance plan and that there is no charge for doctor visits for preventive health care.  More changes are on the way. 

There are several health insurance companies that offer individual and family policies.  Each one has its own characteristics.  With so many things to consider please allow us to assist you in selecting an appropriate plan for you and your family.  

Call 517-423-3400