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How New Health Insurance Plans Could Cost You Your Health and Finances

By Tex Freitag

doctor holding medical chartHave you been concerned lately about your current health-care coverage? If so, you’re not alone. According to The Commonwealth Fund, 71% of uninsured adults felt that they could not afford coverage. And for those who did pay for the coverage, three in 10 didn’t feel like they would be able to keep it.

Sadly, that last sentiment is an unsurprising one. The expenses in American health-care coverage are about double compared to the health-care costs found in most other countries. And there are lots of cons to even Medicare Advantage plans too.

Unfortunately, despite the rising dissatisfaction with American health-care coverage, traditional health plans haven’t been able to lower the increasing costs associated with medical care. As a result, health insurance companies are starting to get a bit more creative with their new health plans. For instance, the North Carolina Blue Cross and Blue Shield company has created the My Choice policies. These policies offer health-care providers reimbursement at 40% more than what Medicare would, making their coverage more likely to be accepted. And a startup called Bind Benefits has removed annual deductibles entirely.

These new health plans sound promising, right? But their appeal comes with a few costly disadvantages.

Both Plans Apply Premiums

While both plans meet the rules for the American Health Care Act, they interpret the rules quite differently compared to more traditional health plans. As Kaiser Health News (KHN) points out, the main difference is how the policies avoid the federal law’s rule for a yearly limit on out-of-pocket costs.

The federal law only calls on this limit for in-networks. So instead of having such systems in place, these health plans avoid having a network at all. And when they want to add charges, they label them “premiums” so they don’t count towards an out-of-pocket maximum.

What does that mean for you?

This issue should be a fairly red flag. Having no limit on the costs that you pay up-front could mean that you end up paying more than what you already do for healthcare. Or, worst-case scenario, you end up not being able to afford a number of services you need to maintain your well-being.

You’ll Need to Negotiate Prices with Health-Care Providers

As previously mentioned, neither health plan has an in-network. This means they have no network of health-care providers that have agreed to their coverage prices. Consequently, the job falls onto you to haggle prices with any health-care provider you end up going to.

Negotiating with institutions and doctors that have more authority than you can be immensely draining. It’s an added stress that may not even work out for you, which is not great for your mental health.

But, maybe the concept of negotiating seems appealing to you. After all, you do get the freedom to choose which health-care provider you want to go to. While that can seem appealing, you lose out on having pre-determined costs or knowing that your health-care provider will even accept your coverage. For instance, if a health-care provider doesn’t like your coverage pricing, they could choose to balance bill you.

All of this work adds up to a lot of stress for a lot of unnecessary risk.

Chances Are, Not Everything Will Be Covered

While health-care coverage sites won’t always broadcast what they cover, KHN did point out that the health coverage from Bind Benefits won’t be able to cover everything. For example, while health insurance typically covers substance abuse rehabilitation. However, the extent to which your insurance covers addiction treatment facilities will depend upon a variety of factors.

To offset this issue, this particular health plan allows you to add in extra coverage through paycheck deductions.

However, this solution has a limit. After all, you can only deduct so much from your paycheck. You have other costs to worry about, such as paying rent and buying groceries. Keeping these costs in mind, it’s likely you’ll have to go without a medical service you need, despite having a health-care coverage plan.

What Can You Do to Avoid Some of These Costs?

Whether or not you choose to go with a new health-care plan, you’ll want to minimize your costs. But how do you go about it?

One of the best things you can do is to change how you purchase prescription drugs. The United States is the most expensive place for many medications. Using an international and Canadian pharmacy referral service can curb that cost. A website like this allows you to connect with licensed pharmacies outside of the States in countries that have lower prescription prices.

You might also want to consider buying generic prescriptions, further lowering the price of your medications, and seeking care from an outpatient center, which is typically cheaper than a hospital.

With these tips at hand, you’ll be able to keep a surprisingly large part of your medical costs in check — even if your health coverage doesn’t.

Photo Credit: stock photo

March 27, 2019

Comments

  1. 1

    James says

    The Orlando Clinics located in Florida are offering surgical services and medication.

  2. 2

    Jhon says

    Is health insurance cover medicine bills?

Trackbacks

  1. Vaccines Have Been Lifesaving, But Are They Money-Saving Too? – Len Penzo dot Com says:
    February 3, 2020 at 1:55 pm

    […] a doubt, vaccines are an integral part of the US healthcare system. Unfortunately, when it comes to day-to-day healthcare expenses, it can be difficult for the average American to have enough to cover certain medical costs. […]

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