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low cost health insurance quote
low cost health care insurance
Low Cost Health Plan

Careful Comparison

The best value in health insurance can be found only by doing a proper comparison between the alternatives that are available to you. The way health care itself is so expensive today, there is no such thing as low cost health insurance any more. What you can do is look for the most cost-effective plan design for you and choose from those plans.

The first factor to consider is the maximum out-of-pocket that you could handle in a year for medical expenses. The greater the expenditure that you could undertake, the lower the premium charge will be from the insurance company. Some plans in some areas have copays only, so in that case you have to add up the possible copays that you could have in a year and select the highest copay combination that you could live with. Do not be distracted by the stated out-of-pocket because if it is set too high, it is a figure that is unreachable with copays only and is not a suitable figure to use when making comparisons with other plans.

If the plan has an annual deductible, add that amount to the total possible coinsurance, i.e., the total you could have to pay as a percentage of expenses after you have paid the deductible. It could be 0%, 10%, 20%, 30%, 40%, up to 50%, but never above 50%, unless there is a very unusual plan out there that is that way. If the plan also has copays for physician office visits, or prescriptions, or emergency room, add a feasible amount for the copay possibilities to the total of the deductible and coinsurance.

This total can then be used for comparing plan to plan in regards to financial exposure. You can decide if it is better to have a lower deductible and higher coinsurance or vice versa. For the same total, is it worth paying the extra to have a lower percentage of coinsurance or would a higher percentage like 50% be okay? If there are plans with similar totals with and without copays, you can compare them to see how much extra the copay feature is costing and then decide if it is worth having the copay feature.

Other means to reduce the premium are to select plans that leave out some coverage that you are not concerned about. For example, some plans do not cover brand name prescriptions, or any outpatient prescriptions. Some limit the number of office copays per year. After reaching the maximum number of visits per year, you have to pay the office visits in full and that goes towards the deductible and coinsurance. Many plans pay either nothing or very little for mental health care and/or substance abuse treatment.

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Cutting out what you consider to be of less importance may help reduce the cost. However, limitations on such things as surgeons' fees, hospital room and board charges, and annual outpatient medical expenses, is cutting into the mainstream of medical insurance coverage and should probably be avoided.

Reliable Coverage

What looks like low cost insurance is possible if it is reliable coverage that will be there and pay the claims when you need it to. If it is not sound financially and not regulated so to remain sound, it's not low cost health insurance, it's wishful thinking.

Except for some coverage such as MEWA employer plans operating under federal law, all genuine health insurance is licensed by the state in which it is sold. If any health expense reimbursement operation is not registered with and regulated by the state, it should not be dignified by calling it "health insurance". Only with oversight by a state agency, can the consumer have any confidence that the operation is likely to be collecting enough money to pay claims and not siphoning off income for purposes other than paying health insurance claims and legitimate operating expenses.

Individual Coverage Issues

In most states, for an individual not covered by an employer or government program, the statutory protection for getting reliable coverage has some assurances but has its limits. Once individual health insurance is obtained it can usually be kept, no matter how one's health status may change, but there is no absolute guarantee of that.

The health insurance company may go out of business. It may stay in business, but quit the health insurance business. It may stay in the health insurance business, but withdraw from a particular state. Either way, you could lose coverage after your health changes, developing what would then be a pre-existing condition, limiting what health insurance you may then obtain.

The health insurance renewal premiums may increase so much that it becomes unaffordable. This is especially true if the practices of a health insurance company result in there being blocks of business that are closed off from new entries. For example, if new plans are repeatedly introduced so that prior plans are no longer sold, and the premiums for everyone on the prior plan is based on the claims of only those on that prior plan, then that creates an isolated block of health insurance business.

Isolated blocks can also be created if the health insurance company closes off all coverage issued in a given period of time from new entries and bases the premium for that block on the claims of that block.

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People who still have good health tend to shop and change whenever their premium increases. Those who have developed a serious health problem while covered, cannot change to another individual health insurance, unless a law mandates otherwise. That increases the claim cost on the average for the isolated block of health insurance business. That increases the premiums for that health insurance block. That increases the impetus for the healthy to quit that health insurance plan. That increases the average claims cost of that health insurance even more. The price death spiral now causes the health insurance plan to be unaffordable. So much for reliable health insurance.

If you want to get individual coverage that you can keep for many years, buy one from a company whose practices result in the most price stability. Don't expect the issue to be expounded on in the health insurance brochure or plan description. If you contact us, we can help you with your health insurance decision. We can't predict the future, but we can provide health insurance information that will help you make a good decision based on what can be known today.

State Mandates

Many state and federal laws have been enacted to help those with pre-existing conditions maintain and hold onto health insurance, and to change plans. However, for individual health insurance, these mandates may have significant limitations due to the way insurance operates. Individual insurance companies cannot voluntarily operate like a national health insurance plan would. All the generous health insurance companies went out of business a long time ago.

In a few states, all individual residents must be accepted when applying for health insurance, i.e., guaranteed issue. However, in most states, individuals can be declined when applying for health insurance, but there may be a state program that accepts all uninsurable individuals, known as a high risk pool. It is to be expected that all guaranteed issue health insurance will cost more than health insurance for which applicants must qualify.

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