Paying More, Getting Less

Years ago, when cigarettes were advertised on TV there was a commercial for a certain brand that asked the question.

“Are you smoking more and enjoying it less?”

That phrase can be re-worked and applied to health insurance as well.

Are you paying MORE for health insurance and getting less?

If you are like most people, the answer is yes.

Family of 4, mid 30’s in greater Atlanta. They want a plan with all the bells & whistles with low copays & low deductible.

OK, so how about $25 copays and a $500 deductible?

Outstanding! Just what they want.

Premium is $751 per month.

So what are they getting for their $751?

Unlimited doc visits at $25 each. Generic drugs covered with a $15 copay. Rx deductible of $100 for brand name only, then $30 or $60 copay. Other charges subject to a $500 deductible then 80% of the next $10,000. Out of pocket on a major claim is $2500 + copays.

All this for only $751 per month.

What happens when you eliminate the copays and discount the professional services? You raise the deductible to $2500 but pay 100% after the deductible. Your out of pocket on a major claim is now $2500. That’s it. Not $2500 PLUS copays, just $2500.

And the new premium is . . . $290 per month.

That is a savings of $461 per month. Over $5500 per year.

In most households that will pay for a lot of doctor visits & meds.

Nothing wrong with the copay plan as long as you understand you are paying more but getting less for your dollar.