There are more choices for health insurance coverage than ever before in history. If you are responsible for finding and paying for your own coverage, the best advice is to shop all available programs, carefully compare benefits, options and costs and make as informed a selection as possible based on your individual family’s needs.
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Those covered by health insurance group plans through their employers may also have coverage and premium options through their company programs. Contact a human resources representative for further information.
Why are health insurance programs so confusing?
Affordable and cost effective health insurance coverage, once taken for granted by anyone with a full time job, has become:
- A tangle of competing agencies
- Hard to understand programs
- Bureaucratic rules and regulations
Most consumers were happy accepting whatever coverage employers offered and gladly paid their respective share of monthly premiums. However, today, most budget-conscious Americans cannot rely on employer group insurance. Finding affordable health insurance can be a daunting task as many employers have reduced or eliminated health care benefits as cost saving measures.
For many who are unemployed, work only part-time, or work for companies that offer no health benefits, health insurance has become a luxury.
So how can I save money on health coverage?
In order to reduce monthly premiums, preferred provider groups offer what is known as a high deductible option. In exchange for lower monthly payments, a subscriber must pay all initial medical charges up to a maximum amount. This is usually in the range of $12 hundred to $15 hundred dollars. Once this amount is reached, normal “per visit” co-pays begin.
But beware! Any front-end savings usually means a trade-off somewhere down the road. If you have no claims during the year, you’ll come out ahead. Otherwise, you could easily end up paying more during the year than if you had selected the regular premium with lower deductible payments.
Another cost saving measure is to waive certain kinds of coverage you probably won’t need such as mental health services, counseling, or other behavioral programs.
Prescription drug coverage is also a costly item that might not be necessary to fill your current medical needs. The same might be true for vision or dental coverage that could be eliminated, thereby reducing monthly premiums.
What coverage do I really need?
Sometimes finding low cost insurance is not the goal, rather finding insurance that reduces the total annual out-of-pocket medical expenses. As mentioned above, lower premiums usually mean higher deductibles and greater out-of-pocket costs. Reduced premium policies can also indicate reduced coverage for many items.
Where can I get helpful information about health care options?
Insurance companies themselves can be helpful in sorting through options and making informed choices. All provide educational materials aimed at consumers. These materials are written in simple easy-to-understand language and provide the latest industry news and guidelines.
Insurance companies also provide side-by-side comparison charts of their own, and often their competitors’ products, which can be very helpful in choosing a suitable insurance program.
Consumers who have access to computers may review all of this helpful information on line. They may also download fact sheets, pamphlets, and brochures to review at their leisure. For those without a computer, insurance providers have information that can be picked up at their local offices or mailed out on request.
Regional and national groups, such as police and firefighters associations, trade unions and organizations such as AARP, for adults 50 and older, can provide helpful information about a variety of insurance and supplemental health programs. A discount on insurances and other services is also one of many benefits that come with membership in these organizations.
What government programs are available?
Some people will qualify for government sponsored and subsidized programs such as Medicaid. These programs are based on income guidelines established on national or regional levels. The application process for Medicaid is generally months long with no guarantee of approval. Once approved however, Medicaid pays for 100% of covered medical expenses.
It is important to accurately track all medical expenses during the application process because once approved, Medicaid will retroactively pay for covered expenses. For more information visit the federal Medicaid website,or contact your local office.
What if I don’t qualify for Medicaid but I still can’t afford health insurance?
Many states offer basic affordable health insurance programs as alternatives for lower income individuals and households such as Healthy New York.
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