Eight Tips For Considering Health Care Plans

Accessing quality and affordable health insurance today is forcing many individuals and small business groups to re-evaluate their coverage and costs annually.  The numerous options available can make selecting the right plan for you, your family and possibly your business a daunting task.  In addition to keeping costs down, there are other considerations you may not be aware of when purchasing health care insurance.      

The following are things to think about that can give you greater value and benefits for your health care dollars when evaluating a health care plan:

1.    Using a broker may not have the most cost effective plan for your needs.

Most people generally assume that they are getting the widest selection and lowest price by getting health insurance through a broker.  However, brokers earn a commission from their transactions, just as individual health care companies do.  The very nature of using a broker for anything includes additional fees.

 2.    Multi-year premium rate locks are available to protect against annual premium increases.  

Health insurance premiums have been rising annually for years and are forecasted to continue.  There are plans on the market that offer two to three-year rate locks which can be extremely cost effective into year two and certainly year three.

 3.    A comprehensive plan structure can include gap coverage to offset out-of-pocket expenses.

High deductible plans can deter people from seeking preventative care or other procedures because of the out-of-pocket expense to satisfy the deductible. There are gap insurance products that will pay down your deductible and co-insurance exposure reducing your out-of pocket costs.

 4.    Individuals and small businesses can access large group coverage plans vs. individual or small group plans. 

Strength in numbers is a key to buying power and eliminating the claims spotlight for an individual or small group.  Look for a provider who offers large group plans, which are able to offer lower premiums based on a larger risk pool.  Some large group plans are even able to offer guaranteed issue health coverage year after year, regardless of claims.

 5.    Small business owners should consider the Fringe Benefit Bonus structure IRS 15B vs. the traditional small group plan.

This is a small business option that President Reagan introduced to help small businesses. The Fringe Benefit Bonus structure eliminates participation requirements, COBRA administration and minimum employer contributions.

6.    Dental discount plans can be a cost effective alternative to traditional insurance. 

The prevailing belief of many is that access to good, affordable dental coverage is not available to individuals. However, there are discount plans available to individuals and families that can perform better than traditional insurance. 

 7. Plans that are portable.

There are health care plans that are portable in coverage if you move or change jobs. Many health care plans will terminate if you move to another State or change jobs. The flexibility of having portable coverage is beneficial for avoiding the initiation of a new policy.

 8. Inquire about the health care insurance provider’s patient care     resources available online and by phone.

Health care insurance providers offer resources that can save time and money when accessing patient care.  For example, there are online tools to look up prescription medications to see if there is a generic option vs. a brand name that can save lots of money.  There are also options to access a doctor over the phone to describe a common condition to get a prescription ordered rather than making an office appointment to achieve the same result. 

There are many ways people can influence their access and cost to affordable health care as well:

• Depending on your age, smoking can increase your monthly premium up to 50 percent.
• Taking prescription medications as directed is very important to underwriters of health insurance.
• Keeping relatively fit through exercise and diet affects potential rate increases due to obesity.
• Having accurate record keeping of medical procedures over the years can eliminate a pre-existing condition concern for an underwriter if it has passed established timelines.

Premiums and out-of pocket expenses are steadily rising year over year, becoming a cost that is unaffordable for many to continue, or even consider, coverage.  This can lead many to go without insurance, a major risk since if an unforeseen medical event should occur, gaining access to health insurance afterward can become cost prohibitive or not available based on a pre-existing condition.  Rising health insurance costs can be controlled and reduced if you choose to take the time to investigate and identify a plan that is comprehensive and cost effective for you.  

 Michael Ritsch is a Health Benefits Advocate in Herndon, Virginia. He is a licensed agent in the Commonwealth of Virginia for Health and Life Insurance. Michael specializes in health care benefit plans for individuals, families and small businesses. For more information Michael can be contacted at Michael.Ritsch@ushadvisors.com or WWW.ushagent.com/michaelritsch