How to Use Your New Insurance

Congratulations! You’re the proud beneficiary of a shiny new health insurance policy for 2017. Do you know what to do with it? Or better yet, what it does for you?

The Gift that Keeps on Giving…to Insurers

You pay a premium to your health insurance every month, whether you use any healthcare or not. To make sure you at least get your money’s worth, there is one critical step that you absolutely cannot skip:

Read.

Yes, you really do have to read your health insurance policy. You’ll probably be surprised at all of the free or discounted services it offers you. The trick is, you have to find them. Which leads us to your next step.

Figure Out Your Freebies.

Insurance companies have figured out that keeping people healthy is much cheaper than making sick people healthy again. Many of them are willing to pay for all or part of preventive services, like:

• Cancer screenings (Mammograms, ladies? Prostate cancer screenings, guys?)

• Vaccines

• Well woman and well child exams

• Pediatric visits and school immunizations

• Contraceptives

• Annual checkups

This is just a small sample of services your insurance might cover or subsidize because they want you to stay healthy. You want to stay healthy, too. It’s a win-win!

Don’t Fear the Deductible.

It’s a scary truth: before your deductible is met, your insurance doesn’t have to pay for any of your medical expenses. That could be anywhere from $250 to $15,000 dollars.

BUT…there are silver linings in that high-cost storm cloud. Remember those preventive services? There are plenty of insurance plans, even high-deductible plans, that will subsidize preventive care even before your deductible is met. You may only owe a copay at the time of visit.

Need a prescription? Your plan probably covers or subsidizes generic drugs, too. Some common antibiotics or contraceptives are FREE in many health plan designs.

But what if my plan doesn’t subsidize anything before my deductible is met?

We can help with that. Believe it or not, paying out-of-pocket can save you money. When doctors have to submit insurance claims, it costs them time and money just to try to get paid. Many doctors are willing to offer self-pay discounts simply because they can avoid the administrative cost and burden of hunting down payment.

Normally, finding out the cost of a healthcare procedure is, in medical terms, a giant pain. We think it should be as easy as shopping online, which is why we set up our healthcare marketplace with upfront prices so you can compare costs in your area.

A Parable of Prevention

Let’s say you come down with a respiratory infection. You go in for a checkup, pay a $25 copay because your insurance subsidizes preventive care. Your doctor prescribes a common antibiotic called amoxicillin, which only costs about $4 a bottle because it’s a generic. You take it easy for a few days, and feel better. Total cost: about $30. 

Now, let’s say you skip going to the doctor. If your respiratory infection turns into pneumonia, you might have to be hospitalized. A 2015 report in Becker’s Hospital Review cited the average cost of an inpatient stay at a non-profit hospital as $2,289 a day. If you have an unmet deductible, you’ll be paying out-of-pocket. If you have coinsurance, you’ll be paying a percentage of your total charge (average 20%). Total cost: out-of-pocket $2,289/day, coinsurance about $460/day.   

The moral of the story:

It will always cost less to prevent major medical episodes than to avoid care until your condition becomes urgent.

Live healthily ever after.

Sources:

http://www.beckershospitalreview.com/finance/average-cost-per-inpatient-day-across-50-states.html

https://www.healthcare.gov/blog/3-steps-to-use-health-insurance-to-stay-healthy/