shutterstock_36763918I just read “Season’s Greetings, From Obamacare” in US News, another article about the new, not so happy season, when people learn how much their healthcare costs are increasing next year. The author shares the details of the 28% increase in her Bronze plan insurance policy for her and her husband with an $11,000 deductible. This was a great Segway to the next article I reviewed, “Financial Health of Patient’s is an Afterthought” where the author states the (ACA) Bronze Health Plan has an average annual deductible of $5203. He further details how the high cost and high deductibles cause people to delay getting health services. If health services are needed for a major illness, it may, almost certainly, lead to credit problems or bankruptcy for the patient and collection write-offs for the provider.  Some sobering thoughts. Somehow this doesn’t sound like healthcare for everyone.
My question is what happens if you can’t afford even the most basic of policies and you don’t qualify for any subsidies? A single person or a couple with what most of us would consider a modest income don’t qualify. To qualify for subsidies, a single person must have an income under $47,000 a year. An income of $47,000 may provide enough discretionary income in some areas of the US but in California it is barely a living wage. As a single person, I would have difficulty paying $500 a month, ($6000 per year) for a policy knowing if I get sick I must pay an additional $5203 in deductibles before my insurance pays. This’s $11,000 or approximately $14,000 in after-tax income. That’s almost my house payment! I think this is why more and more people are prepared to pay the tax for not having insurance, not because they don’t want it, but because they can’t afford it. The sad truth is for many people the increase in the cost of healthcare has created a lose/lose situation. Healthcare or home? Healthcare or all other living expenses?
Do people have any other options? Yes, a few. First I would keep that gym membership. Staying healthy is the best course of action always. Next get access to a telehealth plan. There are several available, and many offer individual enrollment. Telehealth will provide 24/7 electronic access to a licensed doctor for urgent care situations. The physicians are licensed in your state and can write a prescription. Many telehealth programs come packaged with a nurse help line and a medical advocate. Both can provide pertinent information on care options and disease information. Next talk you your personal doctor and negotiate a cash price. If your doctor doesn’t offer a cash discount than look for cash-only or concierge physician.
“Concierge medicine” is when you pay a monthly or annual premium directly to your doctor and, in return, they become your personal physician, taking direct responsibility for your healthcare needs. The good news is that concierge medicine is no longer a privilege of the rich. Premiums are becoming much more affordable – as low as $200/year – and if you enjoy seeing a doctor and not being rushed, you will feel the additional money for a concierge medicine doctor is well spent.
What about other services, lab tests, MRI’s and x-rays? There is no a set price for these services. Shop around and make sure you ask for the CASH price. Studies have shown there is sometimes a 500% difference. The same policy applies to hospital services. The cost of standard scheduled procedures, like hip replacements, can very widely. Did you know hospitals collect, on average, 10% of the billed amount? If that’s what they collect after the expense of billing shouldn’t they be willing to accept 10% or less as a cash payment? If you don’t have insurance or your insurance doesn’t cover the full bill negotiate. Attached is a link to a Wall Street Journal article to help you figure our pricesWebsites to Help You Figure Out Healthcare Prices Use or RxCut to find the lowest prescription prices.  See our website for more information.National Benefit Partners
If you can’t afford traditional insurance, look for ways to cover the gaps. There are accident and critical illness policies that will cover major events with a cash payment directly to the patient. This money can help with the medical expenses or other related costs. Some offer a rider to cover your mortgage payment. These policies are not a replacement for health insurance, but they are a significant financial boost when there is a health event requiring hospitalization. There are several voluntary benefits options to help with a critical illness or accident.
Be creative. If you can’t pay $15,000 a year for health insurance look into options to give yourself healthcare you can afford and take care of yourself. Set aside money for your healthcare expenses. Look for gap or health event policies and find ways to stay healthy and get the healthcare you need though nontraditional options. You local voluntary benefits agent can help you with policies and telehealth plans. If you are a broker contact National Benefits Partners to grow your business.National Benefit Partners