The High Deductible Health Plan Nightmare.
According to a recent Gallop Poll, the percentage of uninsured Americans is now the lowest it has been since the 1980’s. The people without health insurance is currently estimated at about 12.9%. Sounds like good news and that The Affordable Care Act is working, right?
Don’t be so sure. The poll also went on to say, high deductibles and out of pocket costs are creating financial havoc for Americans. The majority of consumers have no clue how their health plans really work.
Just Close Your Eyes and Pick a Health Plan
A recent online Health Exchange exit poll revealed that health insurance shoppers spend less than 5 minutes deciding which health plan to choose. Most people who shop for a health plan are not paying any attention to the deductibles or out-of-pocket costs they could eventually be responsible for paying.
Consumers are comparing health plans based only on price and the cheapest price wins most of the time. Health plans such as the Silver and Bronze plans have deductibles starting at $3,000 to $6,000 per individual with total out of pocket expenses of $5,500 and $12,600 per individual.
How Your High Deductible Health Plan Really Works
Let’s break this down in plain English for a minute instead of insurance lingo. Deductible is the amount you will pay out of pocket for medical expenses/procedures before the insurance company picks up any of your costs. This does not pertain to well visits and most ordinary visits to the doctor for which many people, will be responsible for just a co-pay.
But for medical care over and above well-care, any hospital stay, out-patient procedure, or surgery you will have to pay your expenses until you have met your deductible. With The Silver Plan for instance, you will have to come up with $2,000 from your savings account for any medical procedures.
But wait, we’re not done. After your deductible is met, then your co-insurance kicks in. So any additional medical expenses are now “cost-shared” with the insurance company. If your co-insurance is 40%, you pay the 40 and the insurance company pays 60% until you reach your total out-of pocket expenses which in the case of the Silver Plan, is $6,300.
Let’s use a real-life example and assume you were in a minor car accident but you broke your arm in several places due to faulty airbag deployment. Not too far-fetched right?
With the emergency room visit, x-rays and minor surgery to reset your arm, the hospital bill comes to $10,000. If you owned the Silver Plan, you would have to pay $6,300 of your $10,000 medical bill, more than half. If you owned the Bronze Plan, you would be responsible for the entire amount since your total out of pocket expenses are $12,600.
The Affordable Care Act will force every American to purchase health insurance to protect the insurance companies and the Government from having to pay medical care for millions of uninsured Americans, but The Affordable Care Act could very well drive many Americans into bankruptcy.