When you enroll in a health insurance plan you make an agreement with your carrier. You agree to pay X amount on a monthly basis (your monthly premium) with the promise that they will cover specific services administered by certain providers at a set cost. It seems simple at face value. However, anyone on the receiving end of any type of medical bill will tell you, it’s not! Understanding the basics will also help you to understand what the costs or repercussions of not having health insurance might be.
Out of Pocket Max
So, of course without health insurance you are responsible for the entirety of your healthcare costs. Many people try to lower tese costs by visiting free or sliding cost clinics and filling their prescriptions at pharmacies which offer free prescription drugs for certain basic drugs (usually basic antibiotics). But, be advised, one of the main areas health insurance can protect you is with the out of pocket max. Health insurance plans have what’s known as an out of pocket max. Once you hit (or if you hit) this number, your plan will pay for the rest of the covered services at no charge to you. This is to protect you from major medical bills. Without health insurance, there is no such protection.
There are a few reasons people avoid health insurance. Health insurance can be expensive. But there are ways to make it less expensive. If you are enrolling in a marketplace plan, you may be able to qualify for premium tax credits by lowering your MAGI. We recommend that you work with an accountant or health insurance broker. There are also catastrophic coverage plans which are much less expensive but will protect you from major medical bills should the worst happen. Additionally, you may be able to enroll in a short term medical plan at a VERY low rate. These plans can last up to three years but they’re not ideal for all people and are not available in all states.
Putting Off Health Insurance
Many young, healthy people look to avoid the cost because they feel they simply don’t need health insurance. It’s a gamble, but it’s your personal decision to make. Young, healthy people should, at the very least, consider a catastrophic coverage plan or a short term medical plan. Again, these are offered at MUCH lower rates but will protect you from major medical debt should you suffer an unexpected injury or illness.
Picking the Wrong Plan
If you’ve been enrolled in a bare bones plan or one that’s simply not right for your needs, it can be incredibly frustrating when you need coverage and it’s simply not there. On top of that, if a claim has been denied, dealing with insurance carriers can be extremely frustrating. It’s certainly not worth it to shell out money on a monthly basis and not have your plan support you when you need it. Unfortunately understanding your plan’s benefits can be very confusing. For this reason, we always recommend working with a broker to pick a health insurance plan tailored to your needs and budget.
In the past, you could be denied or charged more based on your health. Under the affordable care act, this is no longer the case. For marketplace plans, you cannot be denied or charged more. BUT, make sure to enroll during open enrollment or a special enrollment period if you qualify.
Call iHealthBrokers at 888-918-0518 or schedule an appointment today. Our services are 100% FREE!
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.