Every year we release a blog about the open enrollment season and things folks should think about when purchasing health insurance. Most of the information is consistent this year, though I’ve updated things a bit below:
Whether you purchase your insurance through the state, government, employer or directly from the vendors, this can be a daunting process. There are often many choices, with slight differences that are difficult to decipher. Beyond that, because price transparency is such an issue in healthcare, it is often hard to plan or budget for future costs when there is no way to find out how much these services actually cost! Below, I’ve tried to outline a couple tips while going through this process.
Nothing is free!!: Many patients get a large portion of their health insurance paid for by a third party (employer, government, etc). This creates the notion that health care is cheap or free in certain situations. Please remember that although you may not pay much in monthly premiums or out of pocket costs for your insurance, your employer is likely paying an exorbitant amount for health care services you may not even use. This cost has gone up considerably in the last few years.
Know your family: Unfortunately, because this can be so complicated, many patients simply select the most inclusive insurance options, which are also the most expensive. Sit down and review what medical services you and your family have used over the past few years. What medications do you require monthly, if any? Do you see specialists, and why? Do you know of any bigger health expenses that may come up next year (like planning for a child or an elective surgery)? Or do you just really need a good primary care physician who has time to address all of your medical needs? (Hint: the answer for almost everyone is yes!)
Understand premiums and deductibles: Just to review, a premium is the amount that you (or a third party) pay monthly for the privilege of being insured. The deductible is the total amount of out of pocket costs you and your family can incur during the year on top of the monthly premium you already pay. The lower your monthly premiums, the higher your out of pocket costs may be… though you still might save money this way! For instance, for a young family of 4 buying insurance from BCBS, the monthly premium for a $1,500 deductible plan is about $975 more a month than the $12,000 deductible plan… that’s $11,700 extra in monthly premiums over the course of the year!!! So this family would essentially pay just as much as the highest deductible in premiums alone. Why would anyone pay that much extra when good primary care can cover 85-90% of issues that will ever come up? Even the $1,500 deductible plan listed above leaves a family paying out of pocket for much of their costs in a year. Those costs are often inflated because of insurance and the amount is completely unknown to the patient prior to utilizing the service (try to think of another purchase you make where you do not know the cost prior to buying?!?).
So, if you have a relatively healthy family, ask yourself why you (or your employer) pay so much more in premiums for, what should be, cheap and comprehensive primary care services. And wouldn’t you want an affordable, budgetable, transparent monthly fee that will cover most everything that will come up during a given year including keeping you out of the urgent care and emergency room (both costly services)? See how a typical family (patients at Direct Doctors) have saved by comparing these options.
If you do have some chronic medical concerns, think about the specialists you are seeing and the medications you are on. Are your current doctors taking your finances into consideration or prescribing and ordering expensive medications/tests without thinking about it? Do they use technology to help track health outcomes in real time, expedite changes in treatment plans and save you trips to the office? If not, it’s probably worth making an appointment here at Direct Doctors so we can discuss how our practice may work with your medical and insurance needs. The best part is, the consultation is free! (Schedule your visit here when it works for YOU!
Lauren Hedde, DO and Mark Turshen, MD are Family Physicians and Founders of Direct Doctors, Inc. a Direct Primary Care Practice.