The Friedman Blog

Posted on 10/04/2013, by Jeremy Edsall

Affordable Care Act - Time for Greater Understanding of Healthcare Costs

In life sometimes bad things happen to us. Sometimes we think we may immune to getting sick, contracting a disease or suffering with a life threatening illness but these things do occur every day to people like you and me.


That’s why it’s good to know that when something bad does happen you have some protection to keep a bad situation from getting worse. The problem for many is a lack of a basic understanding of the level of protection their health plan provides. Most people are only concerned with what it will cost them to see a doctor when they get sick and what they’ll have to pay for prescriptions. 


We don’t often think about what would happen if suddenly we had to be rushed to the hospital, undergo emergency treatment, be admitted to intensive care, or spend a period of time in the hospital.  Do you know right now what you’d be covered for in any or all of the above situations?


With the nation’s healthcare system changing with the implementation of the Affordable Care Act, medical insurance choices are evolving to meet the needs of all people regardless of income, age or pre-existing medical conditions.


To allow everyone to participate, a variety of new health insurance plans are now available.  Those who previously were without coverage will be able to choose plans that cover from 40% to 90% of basic healthcare costs with premiums based on age, income and smoking habits.


All new Affordable Care Act marketplace plans will provide coverage for 10 essential health benefits including:


1. Ambulatory Patient Services (walk-ins)
2. Prescription Drugs
3. Emergency Care
4. Mental Health Services
5. Hospitalization
6. Rehabilitative & Habilitative Services
7. Preventative & Wellness Services
8. Laboratory Services
9. Pediatric
10. Maternity & Newborn Care

Not all of these services are covered at 100% and most will require a co-payment or be subject to a deductible.  Most people look at the cost of a health plan, but fail to look at the cost of using the plan’s services.  What may look like the cheapest solution, most times will have the highest out of pocket expenses.

 


We suggest you discuss your healthcare choices with your insurance advisor.  Find the plan the best meets your needs, especially in a worst case scenario.  Your advisor can suggest strategies, such as Voluntary Benefits, that will provide added protection for many of the out of pocket expenses a basic medical policy doesn’t cover.


Voluntary Benefits Include:


• Accident – An individual accident product that offers several coverage levels to fit all budgets. An accident policy can provide on/off-job or off-job only coverage.
• Cancer – An individual cancer product that helps pay some of the direct and indirect costs related to cancer diagnosis and treatment.
• Critical Illness - An individual critical illness product that provides lump-sum benefits for specific illnesses and pays for multiple critical illnesses.
• Short Term Disability - An individual short-term disability product that replaces a portion of income. Short Term Disability can provide on/off-job or off-job only accident and sickness coverage.
• Medical Bridge – An individual hospital confinement indemnity plan that complements your core medical coverage. Offering benefits such as hospital confinement, wellness, rehabilitation unit confinement and doctor’s office visits.
• Term Life - An individual term life insurance product that offers three level term options…
• (10, 20 and 30 year)
• Universal Life - A cash value life insurance product with flexible premiums and an adjustable death benefit.
• Whole Life - A permanent whole life insurance plan that provides guaranteed level premiums, guaranteed cash values and a guaranteed death benefit.


These are offered thru payroll deduction by the employer to their employees. Products are available on an individual and group basis depending on the size and needs of each company. All individual products are portable upon departure from the company.


Friedman Associates is an independent insurance agent representing a carefully selected group of reputable, financially strong, insurance companies; therefore, we are able to offer you the best insurance coverage at the most competitive price for your particular commercial insurance, personal insurance or employee benefit need.

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