Why Do I Need Health Insurance?
Yes, health insurance can be expensive. It can be tempting to go without coverage especially if you never get sick. After all, you go to the doctors a few times a year, take a med or two and your good. When you're healthy, it's hard to see how fast medical bills can mount or see the benefit of having health insurance. You feel if a medical bills comes, you can pay it off. What's the worse that can happen? So you decide to self-insure and accept 100% the risk of future medical and prescriptions expenses.
Insurance was created for one thing, to share the risk. In sharing the risk, here are two immmediate benefits from enrolling in a health insurance plan. Fee Schedules & Max-Out-of-Pocket.
Without Insurance Medical Emergencies Can Bankrupt You
Maximum Out of Pocket: The MOOP is the combination of what you paid in copays, deductibles and coinsurance in a calandar year. With a "maximum out of pocket", you're guaranteed a capped amount on your spending. Without a "MOOP", you would continue to pay and pay. Example: You get a $40,000 medical bill. You health plan has a MOOP of $7,000. So the most you will pay is $7,000 and now you are covered at 100% for the rest of the year. This is the power of having insurance.
How You Save Money Before You Meet Your Deductible
Fee Schedules: Before you meet your deductible, you will save on your medical costs.
Insurance companies negotiate discounts with health care providers and hospitals called "fee schedules". People without insurance don't have fee schedules so they pay, on average, twice as much for healthcare services. Providers can charge any fee they want when you don't have insurance and you owe it.
For example with insurance:
$0 copay for your 1x per year Preventive visit.
You may pay $0 copay for a flu shot instead of the ~$40.
You may pay $50 for an office visit instead of the ~$130 without insurance.
Savings can be even higher for more expensive services. MRI's can be as high as ~$2,000 without insurance and reduced down to ~$800 just by having insurance
Same with hospital bills. ~$40k hospital bills can be fee scheduled down by tens of thousands of dollars to $18,000 or less. The fee schedules help keep the cost at a reasonable and customary rate.
Christopher S. Kudryk
KBenefits provides insurance solutions for small business owners and individuals in NJ & NY. Contact KBenefits today and see how we can benefit you.
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