Have you ever wondered what you're actually paying for with your health insurance? Deductibles, copays, coinsurance, max out of pocket, prescription tiers, pre-authorizations...it's enough to make your head spin! And it seems like every time you look, less is covered but the prices keep going up! Whether you have employer-sponsored insurance or an individual plan, it's all just a big confusing mess that only benefits the insurance companies. Even the doctors can't stand it!
Texans face a strange world of health insurance and employer plans. The belief that good health insurance only comes from employers is widespread. But when policies sound like jumbled fortune cookies in a foreign language, people start questioning their options. So, what do you do if your work health insurance sucks?
During the fourth quarter of every year it seems like almost every company goes through their open enrollment for benefits. And with that process comes the news about what is being done to the health insurance plan to "keep costs down". At that point, the documents stating premiums, deductibles, copays, coinsurance, and maximum out of pocket come rolling through and you feel confused about your coverage options. We have good news. There is a path to comparing health insurance coverage beyond just the health insurance premiums which everyone seems to focus on. Let's look at a plan to see how your level of coverage might stack up against your other options for health care coverage.
What are your guaranteed medical expenses for the year with each plan?
What could be you out in Medical Costs if you had a major health event?
After you have determined your guaranteed costs and what you could be out of pocket, add them up. Take that total for each plan and see what your range of commitment is for each plan that you are evaluating. This will allow you to see not only the recurring, regular costs. But you will also see the downside potential if a major event were to happen on that health insurance coverage. Knowing both the guaranteed costs to expect and the potential that you can be out of pocket will quickly expose if your employer-sponsored health insurance plan actually sucks because you can compare it to other plans available to all Texans. This kind of comparison is more important than just comparing monthly premiums. It will also allow you to do a level comparison against health care coverage that is in the individual marketplace.
f you compare your current work plan to even the policies on the Affordable Care Act Exchange and determine that you can do better, what do you do now? The great news for you is that there are options in Texas that allow you to take control of your health care and the insurance that most feel is necessary to be protected from bankruptcy. When people call our office, they always want to know what their options are beyond the exchange and work plans. So let's take a look at what those are for Texans.
Which alternative path to affordable coverage you should take is a very subjective discussion. If you have a dreaded pre-existing condition it will reduce what type of health insurance options are available to you. But keep in mind that not all conditions are knock outs from coverage, so speak with an independent insurance agent who actually can sell you those kinds of policies.
The reason that we believe that better health insurance is a subjective decision is that not all out of pocket health insurance costs are the same. We have seen local Texans utilize Direct Primary Care Doctors to manage all of their routine medical services in a very cost effective fashion. That concept pairs extremely well with a Catastrophic Health Insurance plan for a very cost effective solution when compared to marketplace coverage, traditional health insurance or even employer-sponsored plans. On the converse of that, Short Term Plans have enough flexibility today to provide you a more traditional copay type situation. And there is always that Traditional Individual Health Insurance plan as well. The important thing to keep in mind are coverage gaps may be more important than just lowering your monthly costs.
We recommend working with a health insurance agent who can present multiple options to you. Having options allows for the agent to work as a fiduciary on your behalf. They can present both the positives and negatives without an agenda to make sure that you can make the best decision for you and your family. As independent insurance agents, Insurance For Texans functions in this kind of role. If you would like to explore your options, just click the button below to see what is available to you.