Overwhelmed by high deductibles? Worried about your out-of-pocket exposure? Fear not! Jeff Hess, the individual health expert, has the solution to your problems. Check out the video below to learn the best way to spend your healthcare dollars and get an affordable plan this ACA season!
How to Fight High Deductibles and Avoid Out-of-Pocket Exposure
With the Affordable Care Act, in order to make plans affordable to everybody, deductibles are typically $5,000 and up. For 2017, the maximum out-of-pocket is $7,150 for an individual and $14,300 for a family. While it’s affordable month-to-month, it’s not affordable to actually use the insurance plan. You have the health coverage, but you really can’t use it.
For those who are shopping for insurance on their own, they may not know that there are gap plans available that will take care of your deductible and out-of-pocket exposure for certain conditions. Essentially, a gap plan works to minimize your maximum out-of-pocket exposure that you have on your health plan. To help mitigate the high deductibles, there are several gap plan options available in the marketplace. With so many options, you really need to talk to an agent to see which one best fits you and your family.
Gap Plans Offer Accident, Sickness, and Critical Illness Coverage
Within gap plans, there are actually varying components. First, there’s the accident plan. So if you have a $5,000 deductible, you can get a $5,000 accident plan. Then, if you have an accident and you end up in the hospital, needing to have surgery, your deductible is covered. Ultimately, you don’t have to worry about that exposure.
Secondly, gap plans have hospitalization or sickness coverage options. While it doesn’t cover accidents, it does protect you if you’re admitted into a hospital. This sickness plan will pay you $5,000 or more thereby covering your deductibles. If you prefer, you can have the payment assigned to the hospital. So if you end up in the hospital for an illness like pneumonia, your deductible goes from $5,000 to $0.
For the most part, gap plans have what’s known as a critical illness component to it as well. Critical illnesses include invasive cancer, heart attack, or stroke. Sometimes those three major illnesses are all that’s covered under this type of gap plan. However, some plans have up to thirteen critical illnesses listed under their umbrella of coverage. So if you’re diagnosed with a critical illness, it will pay you anywhere from $5,000 and up.
Qualified Plan + Gap Plan = Affordable Healthcare
It’s for you to decide what’s best for you and your family. Typically, these plans are very affordable, especially when you look at the cost to benefit ratio. If an individual gets a gap plan that has all three components, it’s $30/month. If you’re in an accident and have to pay $5,000, just think how long it’d take you to reach $5,000 paying $30/month. It’d take you about 15 years to reach $5,000. Therefore, gap plans are the best way to make your health insurance affordable.
Ultimately, you have two options. You can choose a plan with a lower deductible so it’s affordable to use. However, this option means higher premiums. For instance, you may end up with an $80/month premium. On the other hand, you can go with a higher deductible. Rather than paying an $80 premium, you can spend $30 on a gap plan, which will help combat your high out-of-pocket exposure. Then if you’re in an accident or have a severe illness, you’re financially covered.