Let’s describe what I mean by traditional insurance as a manner to start. The traditional policy on health insurance is made up of:
The deductible-This is the amount you need to pay for a medical event before you start paying your health insurance. The deductible in today’s world is often $3,000 or more.
Coinsurance-Most policies require the insured to pay a percentage of all medical costs up to a maximum after the deductible has been met. Usually the insured pays from 20% to as much as 50% of every billed dollar anywhere.
The copays –In an attempt to make routine health care accessible, many policies include a copay for doctor’s visits and prescriptions instead of meeting a deductible. The $10 office visit copay is an instance of this.
Maximum Out – of-Pocket Costs-This is the most an insured can expect to pay irrespective of how big the medical bills are. As a general rule, an individual’s maximum out – of-pocket costs are restricted to about $7000. This can be a very inaccurate number as it assumes all your suppliers are in your network. Your expenses can be considerably greater if they’re out of the network.
And lastly the “Network”-Virtually every traditional personal insurance policy is linked to a provider network. The smaller the network of healthcare, the reduced the premium. For this article, there’s too much wrong with “networks.” It’s enough to say “networks” are the healthcare consumer’s (you) foe.
The Problem Facing Working Americans
The problem is simple: for most working Americans, health insurance premiums are too high in the absence of a subsidy, and in combination with extremely high deductibility and out – of-pocket costs, health care becomes inexpensive. Let’s look at a few examples in North Carolina right here.
A non-smoking couple aged 62 and 63 discover their smallest premium choice with NC’s BCBS to be $1999 a month for a $13,300 non-copayable family deduction. It would cost $2682 per month to have a plan with a $7000 deductible and $25 office visit copays.
The annual price would be $23,988 annually, assuming the least costly scheme. And if either person had a medical event like cancer, $37,288 would be the actual cost to health care. You must ask: “Why do you have health insurance?”
A 30-year-old non-smoking pair discovered the least costly scheme costing $787.84 a month for a $13,300 family deductible with no copayments. The least costly scheme that included copays was $1056.88 but had a deductible of $7000 and the network that was the most restrictive. Assuming the least costly scheme, the complete annual price (deductible + premium) of either member of this young family would be $16,454.08 if they had a medical event. For a young pair, that’s a disastrous amount of cash.
A fixed benefit health insurance is the easy answer to this issue. A Fixed Benefit Health Insurance Policy states exactly how much will be paid for each specified service, unlike a major medical policy where the policy pays for all eligible expenses after the deductible and out – of-pocket maximum. Examples of designated services may include: daily24-hour in-hospital advantage, particular dollar advantages for designated surgery, a particular benefit for doctor visits, and other defined fees. A large fixed benefit health insurance policy will have very solid advantages, a broad range of covered fees stipulated, a very extensive surgical schedule and more. The most significant service that can be included in Fixed Benefit Health Insurance Policy is negotiating medical bills, a service that can considerably decrease out-of-pocket costs.
What is really good about this kind of policy is that the insured is empowered to be a better consumer. Knowing how much you’re going to pay for a specific medical service enables you to shop better and negotiate the price. But this policy’s really excellent thing is the affordable premium.
The couple ages 62 and 63 are a real mine client who, as a consequence of the elevated premiums, had been uninsured for 5 years. I could placed them in a solid Fixed Benefit Health Insurance Policy with a lifetime benefit of $5,000,000 per month for $683. That’s a $15,792 annual savings. The Fixed Benefit Health Insurance Policy will do a excellent job, as I explained to my client, covering 70 percent to 80 percent of all that can occur. If they actually saved the $15,792 premium difference, with very little out of their own pocket, they would have incredible access to health care.
I was diagnosed with colon cancer back in 2014 and had partial large intestine removal (CP44205). I was covered by a traditional significant medical policy back then. My complete cost of out-of-pocket was over $7,000. If I had the Fixed Benefit Plan that I sell today, my expenses would not only be zero, but I would have received a $4619 insurance check from the insurance company. Not every medical incident would have led to a check and many could have resulted in several thousand dollars out – of-pocket costs, but the savings would have more than offset those expenses in particular.