Health Insurance: Why Having It Is a Necessity
Jun 1, 2012
June is Cancer Awareness Month. The National Cancer Institute estimates that in 2012, 1,638,910 men and women will be diagnosed with cancer. That number sounds astronomical; however, I would venture to say everyone reading this article has known someone who has been diagnosed with cancer at some point in their lives.
Cancer doesn’t care how old you are, what race you are, if you have children or grandchildren. Cancer can strike anyone at any time, which is why early detection is so crucial. Early detection increases the chances of survival greatly. The survival rate is often tripled in several types of cancers when it is caught in the early stages.
Preventative care is one of the best weapons against cancer. Doctors can look at your family history and take early precautions for certain areas of concern. Furthermore, the doctor will be able to continuously run tests and be sure there is nothing alarming. If there is a result that is concerning, early actions can be taken to ensure your health. Annual physicals are encouraged for everyone regardless of age. Your doctors will advise you of any tests that should be done due to hereditary risk or age.
Aside from the emotional burden that cancer causes, many families face a financial stress when dealing with treatment. According to the Census data there are 49.9 million Americans without health insurance.
The National Cancer Institute estimates medical costs for cancer at $37 billion annually.
Unfortunately, even patients with health insurance face costs that are life changing. Insurance companies do not cover all costs associated with cancer treatments. If you have health insurance, contact them immediately to inquire about the coverage’s that are offered, so that you can prepare to make arrangements to pay uncovered expenses.
Patients typically calculate expenses such as doctor visits and lab tests, but underestimate other costs. Medicine is a huge expense. The average cost of a 30-day supply of cancer drugs exceeds $1,700. Whether you have an insurance policy or not, you want to do your best to lessen the financial costs while still maintaining the best life-saving treatments available to you.
Many patients are embarrassed to bring up the financial challenges associated with battling cancer. Cost is a valid concern while preparing for treatment. Prepare yourself by speaking with your medical professional about your treatment, as well as the costs that you will be facing.
Patients are under the assumption that if they have health insurance there is no other help available, and many times this is simply not the case. Your doctor or specialist will validate your concern and should be able to guide you in the right direction to alleviate some of the costs. Cancer will challenge you in many ways, so try to take the challenge of finances out of the equation as much as possible.
A vast majority of Americans would agree that it is imperative to carry health insurance. The reason many would agree with that statement is because having a health crisis may end up costing you tremendously. A simple procedure can run an individual thousands of dollars. Many patients who have stayed in a hospital will be happy to share the outrageous costs they incurred. For instance, I personally can tell you the last time I was in the hospital, one Advil cost me $28 with insurance!
With those statements taken into consideration the results of the Census are startling. The Census stated that 49.9 million Americans do not carry health insurance. Why is this number so high? I pondered this question and realized the answer is quite simple. Health insurance, in many cases, is unaffordable. A study by the benefits consultant group Milliman states that the average annual health care cost for a family of four is $20,728, which is a 7% increase from last year. Since the average salary in the United States is $47,000, health insurance will prove unaffordable for many families.
Since it is so important to have health insurance in case the unexpected happens, let’s discuss some ways to obtain insurance without breaking the bank. First, there is Medicaid, which is a government-funded program that is available to those who qualify. Each state has different eligibility requirements; to find out if you meet the guidelines contact your state Medicaid office.
In cases where Medicaid is not an option, you may turn to your employer. Many employers offer insurance in group plans. Group plans are ideal because often you will get good coverage at a fraction of the cost compared with individual plans. The reason group plans can offer the low premiums is because of the large number of people enrolling. In addition to getting a reduced rate on your premium, inquire as to whether your employer is deducting the premiums from your pay on a pre-tax basis. The benefit to doing this is that you will be taxed on the amount after insurance is taken out; therefore it will lower your overall gross income, so you will pay lower federal income taxes.
Insurance premiums drastically increase or decrease depending on the deductible you select. A deductible is the cost you will pay before the insurance covers the remaining expenses. Consider some factors when choosing deductibles. It would be ideal to have a low premium every month, however if the out-of-pocket expenses are so high that you won’t be able to cover it, then the benefit of insurance would be greatly reduced. Furthermore, if you are someone who visits doctors frequently, then it may benefit you to pick a plan with low co-pays and low deductibles; whereas if you are on the other side of spectrum and rarely visit doctors, then a high co-pay every now and then won’t break the bank. When it comes to choosing policies, analyze your situation to make the best choice.
Prescriptions are an expense that you must consider. Almost half of all Americans take at least one prescription daily. United States prescription prices are the highest in the world. There are several ways to reduce the cost of medications. Almost 80% of prescriptions offer a generic version. Generic drugs are FDA approved and will reduce your cost sometimes by more than half. Speak to your healthcare provider about the option of a generic. Another way to alleviate costs is to shop around. Medications are priced differently at various locations. A little research could prove priceless. Finally, look into the pharmaceutical company that provides the drugs. They often offer steep discounts to people.
Purchasing health insurance is a project in itself. It can be confusing and time consuming. There are different plans to choose from. The two most common plans offered are Health Maintenance Organizations, and Participating Provider Options. These two policies vary greatly.
The Health Maintenance Organizations (HMO) and Participating Provider Options (PPO) are the two most common health insurance plans. One of the biggest differences between HMOs and PPOs is the requirement to choose a primary care physician (PCP).
HMOs will require their insurers to elect a PCP as soon as they enroll. You will be required to get all your care through your PCP. If at any point you need to see a specialist, such as a dermatologist, you would need to first see the PCP to get a referral. If you go directly to the specialist without the referral, the HMO plan will not cover any charges.
On the other hand, with a PPO the insurer doesn’t pick a PCP. If a specialist is needed you can go directly to the medical professional in the preferred network without a referral. The PPOs have a network of medical doctors to choose from, however if you choose to go outside the network, the insurance company may not cover all costs and the premiums are usually higher.
Types of Plans
· Lower up-front costs and premiums.
· Lower or no deductible.
· Medical records are easily accessible by all providers in the network.
· The medical provider will file the insurance claim on your behalf.
· Require referrals to see a specialist.
· If you go out of network you may not be covered at all.
· Must choose a primary care physician.
· You do not have to choose a primary care physician.
· Can see doctors in and out of network without any referrals.
· Up- front costs are more expensive than HMO.
· PPOs usually have a deductible.
· If you go out of network you must pay upfront and then submit a claim to the insurance company for reimbursement.
· Medical records are not accessible it is more difficult transferring records from one provider to another.
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