SOMETHING I WISH SOMEONE HAD TOLD ME

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WHAT PEOPLE DON’T TELL YOU

ABOUT HEALTH INSURANCE…

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Buying health insurance is one of those daunting experiences. Like you never really know what you’re buying until you have to go to the hospital or the doctor and then you’re hit with a pleasant surprise. If Medicaid is an option for you OR if you luckily fall eligible for insurance under a family member’s or spouse’ s coverage…you’re in good hands but you still might want to learn more about what people don’t tell you.

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If you pay out of pocket for health insurance- it’s nice to know how to shop for it, and what you’re actually getting for your money. For starters, when researching health insurance companies and plans, after reviewing your options you want to compile a short list of words that have “*” or words that appear in fine print. These are the words that will haunt you in the event you are ever confronted with a situation that will force you to WANT to know what those words really mean. 

Once you begin shopping for health insurance words get interesting and life ultimately becomes confusing. Out of the blue, the word “deductible” rears its ugly relevance. Like what is a

deductible and why does it exists?

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Allow us to help you…

A deductible is a specified amount of money that the insured must pay before an insurance company will pay ANYTHING for your health services. When you pay for health insurance out of pocket and you have a less costly plan which means a more costly deductible you want to make be clear that any health services that you are paying for out of pocket- are in fact going toward your deductible. With most health insurance plans, once you meet your deductible –everything is pretty much covered under your insurance plan. But the key is thoroughly reviewing your health insurance options so that you can make the best decisions for your health services.

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With health insurance, you always want to have full coverage. But full coverage is expensive and there are no flash sales or special discount savings to help you cut costs. According to the NCSL, most full coverage premium plans start at $341 for an individual and $951 per family- a month. That’s a lot of money for something you may or may not use. But it’s for your health and your health should be your most important priority. Right? It totally sucks that, even hardcore priorities must be legit prioritized. Because let’s face it- if we didn’t get sick for an entire month after praying a hefty premium- there is no doubt that we’d like our money back! Unfortunately, insurance does not work that way. You cannot pay for it- only when you need it- unless you have a high deductible. Depending on your health insurance carrier- full coverage may include Emergency Room Visits, Regular Doctors Visits , Prescriptions , Dental, and Optical visits- all covered where you may not have to pay a co-pay.

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A co-pay is the amount you’re responsible for when seeking health services. In this case, if you visited the Dentist you may have a $5 co-pay OR if you picked up a prescription- your

insurance plan may cover generic drugs and for brand drugs there may be a co-pay in this case, you would be responsible for the prescription co-pay.

PRESCRIPTIONS

Sometimes prescriptions are tricky…where only generic prescriptions are covered. Generic prescriptions are no-frills- let’s just call them knock-offs; a fake. A generic drug is a chemically equivalent, lower-cost version of a brand-name drug, costing 30-80% less!

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A brand-name drug and its generic version must have the same active ingredient, dosage, safety, strength, usage directions, quality, performance and intended use. – Health Smart

Although, generic pills have the same effects as brand prescriptions- it just happens to be that it takes generic pills 7 years to hit the market once a brand drug has been introduced to the market. Ordinarily, we would never subscribe to knock-offs but when it comes down to medicine- it’s totally acceptable. Brand drugs can cost up to 80% more than the generic, and may or may not be covered. When brand drugs are not covered by your insurance- they may be covered with a minimal co-pay; or simply not at all- whatever the case…it will be in the fine print, and that’s what most people miss when selecting health insurance plans.

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