Can you afford to NOT have health coverage?
For the uninsured and mostly healthy individuals who feel the added monthly cost of health insurance is not worth it. We understand how you may feel that way. Paying for something you don’t use or rarely use doesn't make sense to most people, and it's hard to justify the cost.
There is a vast misconception regarding the purpose of health insurance. Of course, we want it to cover our day-to-day needs. Doctor visits, yearly wellness check-ups, and prescriptions, especially if I’m paying a monthly premium. Many plans do, but not all. So the frustration people have when they do not use their insurance often, then the one time they do, they have a copay, a deductible, or something not covered can, of course, lead to frustration. This is more a lack of understanding, not just about the purpose of health insurance but an overall understanding of your current insurance plan and how to use it.
Having a licensed advisor to help you navigate to pick a plan that not only covers the day-to-day but covers the large claims is the best way to go. Let's say for a moment you didnt use a licensed advisor, and you went to the marketplace and picked the cheapest plan. In that situation, more than likely, you'll be paying out of pocket for most medical claims other than annual wellness. So we understand the frustration and apprehension to even having health coverage.
This leads to the primary purpose of this topic. Health coverage is intended to cover major things. There are deductibles, Co-insurance, and Max out of pocket, which are the insured's responsibility. But let's look at the avg cost of some medical services.
Surgical treatment of a broken arm $16,000.00 +
Surgical treatment of a broken leg $ $17,000 to $35,000
Non-Surgical Broke Nose realignment $2,000 to $5,000
These services, of course, are not including the cost of:
X-Rays provide a two-dimensional picture of the broken bone
Bone scans are used when fractures don't show on an X-Ray
CT Scans use computers to show detailed slides of broken bones
MRIs create a very clear image using a magnetic field
These services can cost thousands in themselves. Also, they aren't considered major medical or catastrophic claims. However, let's examine the cost of some unexpected catastrophic claims.
The average cost of a less severe heart attack is $760,000. And if you spread those figures out over 20 years of payments, that's $38,000 per year for a less severe heart attack.
Managing heart disease can cost upwards of $20,000 a year.
Now ask yourself, would you rather have $38,000 in medical bills annually over the next 20 years? Or would you prefer a minor monthly premium to cover most of this cost?
Let's take a look at some other conditions:
People who have cancer can quickly amass six-figure medical bills. In 2018, AARP reported average cancer treatment costs of around $150,000.
Now ask yourself, would you rather have this medical bill or a small monthly premium to cover most of this cost?
Heart Valve Replacement: $170,000
Heart Bypass: $123,000
Kidney Transplantation: $87,538 and $124,271
Disc Replacement Surgery: $16,700 – $45,800
Spinal Fusion Cost Average: $15,700 – $94,300
Gallbladder surgery: $54,041
Now ask yourself, would you rather have this medical bill or a small monthly premium to cover most of this cost?
These are just some of the many conditions & treatments Americans face daily. Insurance is not going to cover all of this at 100%. It is NOT a credit card. There is a portion you would be responsible for. Mostly, that is to help offset claim loss & to keep rates reasonability affordable. We understand that word affordable can be subjective.
Let's say you have an insurance plan; you pay 300.00/ month for the last year. You have a $5,000 deductible with a max out-of-pocket of $7,000. You then have a heart attack. The claims start to pile in, and the above figure of $760,000 is the final bill.
The current example plan will pay 753,000 of the cost in that instance. Leaving you with your responsibility of the max out-of-pocket of $7,000. If you want to calculate the cost of the 12-month premium, that still would only be $10,600 compared to $760,000. It seems like a pretty fair deal, right? Even the scaling across 20 years of $38,000. This is a much better alternative than being uninsured.
This is precisely the primary purpose of health insurance—to cover major claims.
Coincidentally, why 2/3 of all bankruptcies are medically related, so it’s very important to have a full coverage insurance plan that makes sure you’re in the best position in the event the worst happens.
Hopefully, we have put some things in perspective for you as to why it's essential to have health coverage. Not just why it's important to have but also to understand your current health plan. With the upcoming open-enrollment season, it's a perfect time to speak to a licensed health advisor to review your current plan, check newly released plans, make sure you know how it works, or receive quotes for a new plan if you do not have one. We look forward to hearing from you!
