Details

Whether we like it or not, in the United States you can’t have a conversation about health care without also talking about health insurance. Let’s cover the most important points.

Healthcare Quality

Journalistic investigations as well as broader studies have consistently shown that whether in emergencies or planned care situations – those without health insurance receive poorer health care. Not only that, but having health insurance may make us more likely to get the preventative care we need to keep us healthy in the first place.

The reasons for this are myriad. But because health insurance and the healthcare system are so entrenched, the best intentions of individual healthcare providers working with an uninsured patient, are likely to be overwhelmed by a complex and overburdened system that isn’t designed to work without insurance in the mix. Arguably, this setup isn’t always good for those with insurance but it’s never good for those without it. 

Simply put, in the current system, the best chance you have for high-quality health care is to have health insurance. 

Healthcare Costs

Medical debt is one of the major contributors for consumer debt and a reason for huge financial stress for Americans. And because health care and insurance are so intertwined, what is charged for health care often assumes an insurer will bear part of the cost. But when an insurer is taken out of the equation, it’s often the patient who is forced to pay the difference. And the costs can be crippling. 

What do “crippling” health care costs look like? It’s an ambulance ride of mere minutes costing several thousand dollars (whether it’s a life threatening emergency or not). It’s an X-ray to check for a broken bone costing thousands of dollars. It’s an overnight hospital stay costing many tens of thousands of dollars. It’s ongoing treatment for a rare – or often not-so-rare – condition that costs hundreds of thousands of dollars or even more.

When you have health insurance, costs become much more manageable. Not only do insurers get special rates that they’ve negotiated with various providers, but depending on your policy the insurer will be obligated to pay for a predetermined percentage of those negotiated rates, sometimes as much as 90 – 100%. 

Key Points

In addition to getting better care and paying less when you have health insurance, here are a few details that are essential to consider.

• Out of Pocket Maximum: When you have health insurance, there’s something called an annual out of pocket maximum for covered services. This means that no matter what, for things your insurer covers, even if you have costs in the millions of dollars, you will never have to pay more than a certain maximum amount in a given year. Typically this number is in the single digit thousands.
  

• Preventative Care: Depending on the specifics of your plan, there’s a good chance your insurer will cover preventive services at very low or no cost. They’re not doing this because they’re nice. They’re doing this because with preventative care they believe you’ll be healthier which can actually save them money in the long run.
  

• You Will Need Care: Whether you’re young and healthy or old and frail, at some point you will need care.
  

  Even if you’re young and healthy, you will need health insurance.

  Whether it’s a broken ankle you get while playing basketball, mental health services, medicine for a condition you didn’t even know you had, or a surprise surgery, something will happen that causes the need for care. Don’t fall into the trap of believing that you are invincible. You’re not. And when you find yourself in a situation where you need care, the last thing you want to be worrying about is whether or not you can pay for it.
  

• It’s Not Just For You: If you needed medical care and you couldn’t pay for it yourself, the lengths your friends and family would be willing to go to help you might surprise you. But it may be through incredible sacrifice. They may raid their retirement fund, sell their house, or quit their job to care for you if that’s what the situation called for. How terrible would it be if you knew these hardships could have been avoided if you had health insurance and your costs were more manageable? Hopefully, you’ll never need to find out.

Conclusion

Now that you’ve given some thought to the need for health insurance, move on to the next task (for logged in users) to understand how to evaluate your health insurance needs and where to buy health insurance.