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home : columnists : columnists February 5, 2016


12/12/2012 4:31:00 AM
Expensive, But Necessary - Keeping Health Insurance Costs Down

Rebecca Gordon
Vice President, Gordon Marketing


I hate health insurance!! It's too expensive!

Yes, it is expensive, but health insurance is something we all need. Remember, $300 per month in premium is cheaper than a $100,000 claim. However, what can you do to keep your price as low as possible?



Don't take a doctor copay. If you have the option to eliminate this, do so. The insurance is assuming that if you pick this benefit that you might be considered an "over-utilizer," or someone who goes to the doctor for everything. For example, you are feeling a bit run down. Instead of staying home one day, you run to the doctor demanding a Z-Pak. An over-utilizer is an insurance company's worst enemy. They are looking for folks who will make decisions on their own without involving the doctor (of course, I am speaking about very mundane issues...nothing major).



Did you know that if you eliminate the doctor copay you will still get a discount? If your plan is part of a network or Preferred Provider Organization (PPO), you get all the discounts that have been negotiated by the insurance company. Here is an example: the average price in Indiana to go to a primary doctor is $78.00. However, if you go to a doctor that is in your network (Noblesville has great networks with deep discounts), your price could actually be around $50. In this example, you would pay the $50 and let it apply towards your deductible. If you go to the doctor three times per year (the national average is 2.3 times per person), you would be on the hook for $150.



Now, let's assume you have a plan with a doctor copay of $35 per visit. You go to the doctor and you only pay $35 at time of visit, right? Actually, you might be paying an extra $105 a month in premium for the benefit of the copay. Now, let's go back to the original example of three visits. Your total cost with the doctor copay could be $105 for copays and $1,800 for extra premium or $1,905. The kicker in this example is that your $105 (three doctor visits at $35) does NOT count toward your deductible.



Keep in mind, the recent health reform law does have its perks. For one, all well baby visits are included with every policy at no additional charge. In other words, your kid's immunizations are covered so you don't need to worry about a doctor visit copay. Adult preventive physicals are covered, such as mammograms and pap smears. If you are having a routine annual exam or a routine mammogram, there will be no extra charge. Again, no need for a doctor copay. There are several ways to keep health premium affordable.

Got a question, let me know. Email me directly at Rebecca@gordonmarketing.com. Stay Healthy!







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