Overpaying for Health Coverage that you don’t use?

Health Coverage is designed for you an individual to pay medical claims that typically we wouldn’t be able to afford. Of course, we want it coverage our small claims as well. However, the main purpose of health coverage is to cover catastrophic claims, that’s the real reason why we obtain health coverage. We don’t get auto insurance for oil changes and tire rotations, we get it for the major stuff. However, without receiving a government subsidy to reduce premium costs. Plans on the federal exchange can be well, expensive. With large out-of-pocket exposure. Now for someone who doesn’t use their health coverage very often and is relatively healthy. Why are they going to want to overpay for health coverage they do not use? Fortunately, when relatively healthy there are plans on the private market that are based upon health NOT income like it is on the marketplace exchange. These plans are typically in nationwide PPO networks that do not limit your network like HMO & EPO networks, they typically carry very low out-of-pocket exposure and carry very affordable monthly premiums. You ask how is that possible? Well, Insurance in its self is about risk pooling. When the risk pool is unhealthy and you have guaranteed issued plans like on the marketplace exchange, more claims are going to be submitted. The insurance company has to offset the claim loss they are going to receive. How do they do that? They raise the monthly premiums and out-of-pocket exposure. A healthy risk pool has fewer claims naturally, which in turn the insurance company can reduce monthly premiums and out-of-pocket exposure. Now, this isn’t saying that the marketplace is a bad thing bc, in fact, it’s great for individuals who do make a lower income and can qualify for a subsidy and or have major medical issues, bc they cannot be denied coverage on the marketplace per the ACA. However, if you are healthy and or do not receive a government subsidy for reduced premiums there are more affordable coverage options with less out-of-pocket exposure available. I always advise you to review all your coverage options and to speak with a licensed specialist prior to making any decisions regarding coverage. Reach out today and speak to one of our licensed benefit specialists and review all your avilable coverage options.