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Consumer attitudes about health insurance must change …

Consumer attitudes about health insurance must change to maximize protection

With the heightened awareness of “Obama Care”, everyone knows that the healthcare landscape has changed significantly in the past decade. Regardless of a person’s opinion about these changes, good and bad, people’s attitudes about health insurance must change. The time has past when an employee of the automotive or education workforce can go to the doctor and have confidence that the procedure they need will be covered.

The concept of consumer-driven healthcare has been around since 2002 when health reimbursement accounts and health savings accounts were introduced. The idea has evolved into the onus of healthcare shifting from the insurance companies to the insured individual.  People cannot assume that anything is covered until they take the time to read and understand their health insurance policy.

Following are just a few things an individual must understand about their health policy:

Co-pays and low deductibles are not the best option for every person

You pay extra for co-pay plans and lower deductibles. Just as you do when you buy car insurance, look at the true cost of all of your options and consider the likelihood that you will need them. Adding a $30 co-pay option to a policy may add $500 or more to the cost of a premium. The discounted rate for seeing a doctor may be $75. This means you would need to see a doctor 10 – 11 times a year to break even on the cost of this coverage?

 You may pay more to go to the doctor or hospital of your choice

If you’ve developed a relationship with your doctor and the hospital he/she serves, then you’ll want to make sure they accept your plan. If you do not have a specific healthcare provider, now might be a good time to take advantage of a lower cost plan, such as an HMO. HMO is not the bad word that it used to be and you can get comprehensive coverage for a lower price. However, you must remember that you will not be covered for service outside of the network unless the insurance company deems the service emergent.

 When it comes to prescriptions, generic is to brand as tissue is to Kleenex

If you go to Walmart and buy great value brand tissues you expect to pay less than you would for Kleenex. The same is true for prescription drugs and many if not most insurance companies force you to use generic drugs when available. If you are currently on a medication, it is your responsibility to check with your insurance company to see if they will cover your name brand drug for an additional cost or if they will make you take the generic equivalent.  Be careful, some drugs may not be covered at all.

 Excluded services and waiting periods

Read the policy and ask questions. The service you may need might be excluded. It is very common, especially in individual plans, for pregnancy to be excluded.  It is even more common for certain procedures to be excluded for a specific period of time.

Choose the plan that is right for youThe cost of an unexpected medical expense could be devastating.  According to an article in Bloomberg Businessweek, by Catherine Arnst, June 4th, 2009; Medical problems caused 62% of all personal bankruptcies in 2007. More startling to the Harvard researchers who conducted the study is that 78% of those filers had health insurance at the start of their illness. In the worst case scenario, make sure you are covered for catastrophic situations. 

Choose a benefit agent that has your best interest in mind

Benefit agents receive commissions for selling you a health insurance policy.  Some companies and plans pay better than others. Find a benefit professional that you can trust and take an active part in the process. If you hold back on the information you give the agent you will not end up with a plan that is right for you.

Like it or not, individuals are more responsible than ever before for understanding and choosing the best health insurance plan for their needs.  In an electronic world where we have become conditioned to scroll down to the bottom of the legal disclosure and selecting accept; it is imperative that you read the small print and understand the implications of your selections.

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