Sunday, April 5, 2009

Health Insurance vs Health Discount Programs: Compared and Contrasted by John S. Houston

Many people feel traditional health insurance is the only way to deal with the cost of doctors, hospitals, pharmacies and all that goes into providing our families with good health care. In the last few decades there has emerged a couple of good Health Discount Programs which for many is a viable, and much more affordable, alternative. In mid-March 2009 CNN reported that 18% of Americans under age 65 were without health coverage. We know from previous news reporting -and campaign stump speeches- this amounts to approximately 47 million US citizens out of a total population of just over 300 million. 25% say cost is the most urgent health care issue after cancer.
Traditional health insurance is typically provided through an employer and covers the employee's family. What's good about these plans is that they automatically accept anyone who is a dependent or family member of the employee without regard for pre-existing conditions, previous medical history or any other condition that might prove expensive to the insurance company. That is to say, those covered do not have to undergo underwriting....the process by which the insurance company assesses your risk. Another benefit is that the employer usually pays a hefty portion of the cost. The average American worker pays $1,946/yr for his/her coverage. These plans enable the employee's family to contain medical costs as they are typically liable only for co-pays and deductibles. Many of the more expensive procedures such as MRIs and CatScans need to be pre-approved, unless performed under emergency circumstances e.g you're wheeled into the ER as a result of an auto accident. If you're fortunate enough to have this coverage, great. Unemployment in the US is now at 8.5% nationally. More and more people are losing their jobs in this recession. Health coverage is just one of the casualties. Yes, you normally have the option of COBRA, but that is enormously expensive.
One alternative worth looking at is health discount programs (HDPs). These programs are not insurance. Depending on what you choose to purchase they can provide reduced costs for doctors, hospitals, prescriptions - even dental, vision and chiropractic care. These are also available with no underwriting - no exclusions for pre-existing conditions. Also included are ancillary services such as diagnostic tests, laboratory procedures, physical therapy, imaging (MRIs, etc) hearing and mental health services and diabetic supplies...a pretty comprehensive range. You could see discounts of 40% on doctors visits and 60% or more on laboratory tests. Prescription savings can range up to 85% on both generic and brand medications. Many HDPs include a hospital advocacy program where an advocate is assigned to negotiate with the hospital to give you the best possible fees. In some cases these have been reduced to zero. Yes, you have to use a network of providers - that is to say doctors, dentists, hospitals, etc who have agreed to charge members these lower fees. You might be surprised how many providers participate in these programs. Every HDP has a website that makes it easy to find providers. And you don't have to live in or near a major metropolitan area to find participating providers. The best part is these health discount programs can provide benefits to an entire household for about $40 a month. Try finding a COBRA premium like that! If you are at risk of losing your traditional health coverage, if you are under-insured, or without insurance altogether - you ought to consider a health discount plan.

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