Health Insurance companies are able to decline an applicant for individual under 65 policies based on the individual having too many pre existing medical conditions. Such concerns could include high blood pressure, high cholesterol, Type II diabetes, any form of cancer, depression, sexually transmitted diseases and so on. If you are one of the millions Americans that has a pre existing condition stopping you from obtaining an affordable health insurance policy, you have some alternatives available.
Medicare and Medicaid
One alternative is looking into your state’s Medicaid program. This is the Federal Governments sponsored assistance program to the States. To qualify for Medicaid, you need to prove you are at or below your states poverty level, set by Federal Government guidelines. The current income level to be considered for Medicaid is $18,310 for a family of 3. If you are at this income level, this is probably the best and only option available to you and your family.
Self Insuring
A second option to consider is “self insuring” your family. You are basically willing to take on the risk of your families medical needs with no other assistance. You have agreed to yourself that when a family member needs any type of medical attention, you are willing and capable of negotiating and paying the bill. That includes all routine doctor office visits, scheduled lab procedures, specialized tests (MRI, CT Scans, EEG, ECG,), all hospitalization. An advantage to this method is most medical and dental providers are more than willing to accept cash at time of service rather than submitting claims forms to insurance companies and waiting up to 90 days for payment.
Discount Medical and Dental Plans
A third option would be joining a discount plan. These plans are not insurance. These plans are exactly what they sound like. You agree to pay a monthly membership fee to have access to the discount plans pre approved provider list. Some provider lists are regional and some offer nationwide access. When your family member needs medical attention, you select a provider from the plans available list. Call to schedule an appointment. After services are rendered, the provider has agreed upon discount percent off the regular “cash price” (the price normally charged to a patient not using insurance). Once you pay the agreed upon discounted price, your service transaction is completed. There is no need to complete any claims forms, submit for approval, have service denied, or request a pre authorization for service.
Several of the discount plans available in America offer additional discount options you may select such as vision care, chiropractic care, prescription drug, identity theft protection, and others.
A prudent healthcare consumer who does not meet their states poverty limit but wants an option to insurance can shop and save enough money to self insure with the assistance of a discount plan.
Let’s look at the following example (based on average rates in Arizona for a traditional PPO policy, deductible $2,500 ind./$5,000 family, 80/20% co-insurance, max. out-of-pocket $2,500) with an adult male, adult female and teenage child. Average monthly premiums are $200 for adult male, $300 for adult female and $100 for teenage child totally $600 per month, $7,200 per year. If one family member is hospitalized for a covered medical claim equaling $25,000, the following monies are required to be paid by the family: deductible $5,000 plus the max. o-o-p $2,500 for a total of $7,500. By adding in the annual premium of $7,200, this family will have paid $14,700 in that calendar year not including any other medical expenses.
Compare to a discount plan with an average monthly membership of $40, $480 per year and 50% discount of doctor/hospital bills. The hospital bill would be reduced to $12,500 plus the annual membership fee of $480 bringing the annual total to $12,980 saving $1,720. Also, the discount plan does not restrict the member from any special treatments, special tests, or any other necessary medical treatment.
A prudent consumer understands the time value of money. Someone who fits the above example may want to weigh the traditional insurance option versus a discount medical and dental plan he or she feels meets their family’s needs. If we estimate an annual savings of premium, compared to a discount membership, the prudent family would be able to save $6,720 in an account appropriate for their circumstances. If one considers the national average doctor visit is $125 with an average discount of 40% is $75 per doctor visit. If we then take the monthly savings of $520 and divide by $75 discounted doctor visit, a family could make 7 visits per month and only break even.
Americans with preexisting conditions unable to attain health insurance do have options to consider. One only needs to employ their computer and the search engine of their choice to find the best solution for their family.
For assistance with the largest discount plan in America, please follow the link below.
Pre Existing Condition Healthcare