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Fact or Fiction: What they don’t want you to know about health insurance 

questions about fact and fiction of health insurance coverageHealth insurance is a vital part of your health. Having health insurance coverage not only means you can get treated when you are sick, but also means you can be seen when you are well and can stay healthy.

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If you have to opportunity to get health insurance, either through your company, the state you live in, or through a spouse or parent, make sure you take advantage and get health insurance coverage.

Fact or Fiction: I don’t need health insurance because I can be treated for free at an emergency department.

While it is true that an emergency department must treat you whether you have the ability to pay for the care you received, it must be considered a medical emergency. You will most likely not be treated at an emergency department for a sore throat, common cold or other basic illness. Health insurance coverage would allow you to go to your personal physician if you were sick.

Additionally, an emergency department does not take preventative measures to help with maintaining a healthy lifestyle. Having health insurance allows you to receive yearly checkups and physical, flu shots, prescription medication and more.

Of course, you can get treatment at a doctor’s office, be vaccinated against influenza, and pay for prescription medication out-of-pocket, but the cost will be substantially more than if you have coverage through your health insurance plan.

Fact or Fiction: Health insurance is only for people who are employed.

This is fiction, as more and more Americans are becoming eligible for, and taking advantage of, health insurance benefits. In fact, several programs are now in place that gives health insurance coverage to people even if they are not working.

In New York State, several different programs are available for people who either are unemployed or are not offered health insurance at their place of employment. Child Health Plus and Family Health Plus are two different health insurance programs that are offered and come with affordable rates and the ability to get you and your entire family covered with health benefits.

Other health insurance plans are available at little or no cost, including Children’s Medicaid. To find out more about available free or low cost health insurance, speak to your local department of social services, your human resources department if you are employed, or a friend of family member. You can also contact health insurance companies directly and ask if they offer insurance options for individuals and if so, can you get more information about purchasing coverage for yourself and your family.

Fact or Fiction: Health insurance coverage means I will have to pay a lot of money in co-pays.

This is also fiction, and health insurance is available in many different ways. Most health insurance companies have different health plans based on your individual needs and wants. For example, some plans offer a low or no cost co-pay when receiving certain treatments such as annual exams.

In addition, the amount you pay as the co-pay will generally be a lot less than if you just paid cash out of pocket to be treated.

You also have the ability to get a flexible spending plan if the services are offered through your employer. This plan allows you to put money away each pay period for future medical expenses.

For example, if you put away $20 each pay period and you are paid every other week; in a year, you will accumulate more than $500 in flexible spending. This money will be reimbursed to you following proof of services. So for example, if you have set aside $520 in your flexible spending pool and have a medical bill that totaled $500, you can submit a copy of the bill with proof of payment and be reimbursed up to $500.

The benefit to a flexible spending plan is that you can set money aside tax-free, and utilize it whenever you have a medical expense. However, be sure to plan and look at past medical costs to determine the best amount to set aside in the flexible spending plan.

Be careful when setting up your flexible spending plan with too much money because anything that you do not claim and are reimbursed for each calendar year will be lost. This is considered a use it or lose it plan, so it is better to be a little bit short and use your entire flexible spending amount rather than risk losing money.

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