Why You Need Health Insurance

Even before the Affordable Care Act (ACA) became the law of the land in 2012, there were people who had serious issues with the mandate that everyone must have healthcare coverage or face a financial penalty. There were several people who felt that they shouldn’t be required to purchase health insurance, regardless of what the law says.

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Below are some of the reasons that people give for not wanting to purchase health insurance:

 

Reason One: I can’t afford it.

Health insurance is not cheap. In fact, it one of the most expensive types of insurance you can get. Even if you could find an individual policy with a low premium, it could have a very high deductible and offer very little usable coverage. Even if insurance was available through an employer, it could still be way too expensive.

The ACA was designed make health insurance more affordable for people who would otherwise not be able to purchase a policy, by providing a subsidy. For the employed, the ACA requires companies that have more than 50 employees to offer affordable healthcare, which should be less than 9.5 percent of your income.

Unemployed individuals can qualify for Medicare, or could qualify for a subsidy through the marketplace to cover most of the cost.

 

Reason Two: I’m healthy, I don’t need insurance.

Regardless of your health status now, things can turn on a dime. You could have an accident, you could get bitten by a tick, you could find out the hard way that the measles vaccine you got as a child has worn off. Additionally, health insurance also covers preventative care, which means you can have a yearly physical, and vaccinations, to make sure you stay healthy.

 

Reason Two: I have a pre-existing condition

In the past having a pre-existing condition meant you couldn’t get health insurance, or if you did that there were riders stating they wouldn’t cover any treatment that could because by your condition.

For example a woman who had a previous bad Pap smear could have a rider that states the insurance company won’t cover any gynecological treatments, even routine care.

Thanks to the ACA, you can now get coverage, even with a pre-existing condition. Better still, the insurance companies can’t charge you more, and can’t issue riders against covering certain services.

 

Reason Three: I don’t want the government controlling my health care.

The ACA is not a health insurance plan, its legislation designed to make health insurance more accessible and affordable to all, and to ensure that all Americans have the same basic access to care. Even with Medicaid, the plans are still administered by individual companies, the government just subsidizes it.

So the government is not going to tell you what type of care you can get and there are no death panels.

What the government will do is make sure that the insurance company is using your money for your care, and make sure the insurance company is meeting the required minimum for coverage.

 

Reason Four: I don’t like the contraceptive provision.

Whether or not to use hormonal contraceptives is a very personal decision between the individual and her doctor. Contraceptives aren’t just used to prevent pregnancy, they’re also used to treat certain medical conditions like in endometriosis, acne , and PMDD.

Rest assured that if you personally do not wish to use contraceptives, you don’t have to. The contraceptive provision just make sure that those who do need, and do wish to use them, have access to the medication they need, the same way a diabetic has access to insulin.

 

Finding Healthcare Coverage

Here are some things to consider when looking at insurance plans:

  • The type of coverage offered. All health insurance should have the same basic coverage. However, some insurers offer additional services that could be of benefit to you. For example, USH Advisors offers life insurance in addition to health coverage.
  • Premiums and Deductibles. The premium is the amount of money that you pay each month for your coverage. The deductible is the amount that you have to pay out of pocket to get coverage for certain services, such as hospital stays, non-preventative diagnostic tests, and outpatient treatments. Generally, a lower premium means a higher deductible; and deductibles can range from $0 to $10,000.
  • Copays. Copays are what you pay at the time of service. It is separate from your deductible and usually applies to sick visits to the doctor and emergency room visits. Some insurance plans have no copay at all and require you to pay toward the deductible, others could charge anywhere from $0 to $50.
  • Coinsurance. Coinsurance is the percentage of the cost that our insurance company will cover, after you have met the deductible. Some insurance plans offer 100 percent coinsurance, meaning everything is covered once you meet the deductible. However many companies only pay 60, 70, or 80 percent, making you responsible for the remaining 40, 30, or 20 percent.

 

  • Consumer ratings. It’s always a good idea to check with rating agencies like A.M. Best or Consumer Reports to see how your insurance company stacks up. To stick with our example from above, companies like USH Advisors might also have listings with your local Better Business Bureau.

 

These are just a few of the things that you should consider when finding a health insurance plan. Ultimately, it depends on what you can afford to pay each month, how much you think you will need to use it. If you are fairly healthy and don’t go to the doctor often, a plan with a low premium and a high deductible, higher copays, and lower coinsurance could be the way to go. If you aren’t certain, you should talk to an insurance broker in your area to help you find the plan that’s best for you.

 

Article by Jennifer Smith

3 Comments
  1. January 12, 2015

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