This is the question I got this week from a 22-year-old woman who just started her first job after college: like most young adults, she doesn’t go to the doctor very often, but recently went to the dermatologist who prescribed some medications for her acne. The prescriptions weren’t paid for by her insurance and were very expensive. She wondered why she should continue to pay for her employer’s health insurance if nothing was going to be covered.
We talked about her policy, and, of course, there was a deductible. Since she hadn’t gotten any healthcare services this year, she had not yet met her deductible. The medication was “covered” by insurance, but the cost of the medication went toward her deductible. So, she had to pay for the prescriptions out of her own pocket.
When she chose her health insurance plan, she picked the cheapest policy. She didn’t realize that one of the reasons why it was cheaper was because it was a “high deductible” insurance plan. It’s likely that most of her healthcare services this year won’t be paid for by the insurance company because of the high deductible. For our 22 year old, this might be a wise choice. She pays less per month and she is unlikely to need many healthcare services since she is young and healthy.
Even if you did not select a “high deductible” plan, many people are frustrated at the start of the year by the fact that a lot of healthcare services are not paid for by insurance due to the deductible.
What can you do? First, when you select an insurance plan, know what your deductible is. If your employer has a Health Savings Account (HSA) which allows you to put pre-tax dollars away to pay for healthcare services, it’s wise to put in at least enough to cover the deductible.
You might also want to consider choosing a lower deductible plan the next time you can change your plan. You need to consider the increase cost of the insurance vs. the lower deductible.
Planning ahead is the best solution so you do not have surprises like our 22 year old. At least now, she understands her insurance plan and knows what to expect.
Tell us how you choose your deductible? We’d love to hear from you!
For more information about your health insurance, see HealthSpin’s Easy Healthcare: Choosing Your Health Insurance.
We hope we’re helping you “Spin Your Healthcare Your Way!
You never answered the question!!
Why would anyone pay for coverage that doesn’t cover anything??
Hi Matthew,
thank you for your question, I apologize for the late response, your questions did not previously show up. Saying her insurance doesn’t cover anything is more a figure of speech. It is referring to the fact that she has a very high deductible so she has to pay for services upfront before her insurance kicks in. This is the case with a lot of plans which is why it is important to know what your deductible is.
I hope this helped answer your question.
Have a great day,
Lori-Ann Rickard at MyHealthSpin
Been there, done that. My Wife is a teacher. If she goes in for an office visit, it’s a $20 copay. Urgent care? $20 copay. Seemingly anything she does, she only pays a $20 copay.
For me? Absolutely nothing is covered by my insurance. It’s a $2000 deductible, but until that number is hit NOTHING is covered. Office visit? Full price. Urgent care? Full price. Any sort of medication to treat an illness? Full price.
The part that annoys me to no end, is I searched endlessly on the open market for a plan that ACTUALLY COVERS SOMETHING. There’s no easy way to check it, you have to click umpteen different buttons until you see what a plan actually covers. I don’t really care that it covers everything after the deductible is reached, which they’re all so proud to display. That’s a given!! What does it cover BEFORE the deductible? Answer? Nothing. In 99% of the plans I researched, absolutely nothing.
Makes zero sense, why even call it health insurance? It should be called catastrophic health insurance, because that’s all it covers.
Scott,
I couldn’t agree with you more. In cases with high deductibles you almost hope that you don’t meet your deductible because that usually means you had a major health event. I agree it should be called catastrophic insurance. It is important to have insurance in the event of an emergency but it is difficult when you have to pay so much out of pocket. Is there a possibility for you to get on your wife’s insurance? Or to have it as a secondary?
I hope you can get something figured out,
Lori-Ann Rickard
I just found out I was pregnant and my health insurance from work does not cover maternity. what do I do now? can I get on obamacare somehow?….which I was on and couldn’t afford it then…..but it will certainly be cheaper than the maternity costs.
Congratulations on this exciting time in your life! That’s unfortunate about your policy through work not offering maternity care. I would double check that with your HR department if you haven’t already. With the Affordable Care Act (ACA) most, if not all, plans are supposed to cover pregnancy, maternity and newborn care.
It may be difficult to get ObamaCare as it seems as though insurance is offered through your employer, but maybe since it does not cover maternity care you will be able to. But keep in mind that open enrollment ends on January 31st. So you only have a week to get it all straightened out. If you need help in choosing the best plan for you check out my book Easy Healthcare: ObamaCare (www.myhealthspin.com/ebooks). It will answer all of your questions!
Good luck with this issue and congrats on your pregnancy!
Lori-Ann