| Introduction | | | | discount plans provide legitimate discounts that |
| More folks including both individual adults and families | | | | benefit their members, many take consumers' money |
| are on their own to provide funding for healthcare. | | | | and offer very little in return." - Federal Trade |
| There is a growing trend of being your own | | | | Commission |
| freelance business owner, being a contract employee | | | | Advantages: |
| or being employed by a business that does not offer | | | | |
| a health insurance benefit. Many people make the | | | | 1. Low Monthly Fee |
| mistake of buying price instead of value in a | | | | 2. Discounted care from some healthcare providers |
| healthcare funding plan. This article provides an | | | | 3. Normally available to all applicants |
| overview of options for funding healthcare with both | | | | Disadvantages: |
| advantages and disadvantages of each strategy. | | | | |
| How Much does Healthcare Cost? | | | | 1. No financial protection from the risk of a major |
| Understanding what healthcare costs is important to | | | | illness or injury |
| deciding the best strategy for funding your own | | | | 2. Difficulty in accessing care without insurance; Some |
| healthcare needs. Buying based only on price and not | | | | healthcare providers may require advance payment |
| value (price vs. benefits) is a common and very | | | | 3. After any offered discount, you still pay the whole |
| grave mistake. Some examples of what healthcare | | | | bill for medical treatment |
| can cost will help illuminate the importance of value | | | | Limited Benefit Plan - Pay a monthly premium for a |
| and risk transfer (insurance) in funding your own | | | | defined-benefit insurance policy. Also often marketed |
| healthcare. | | | | as "Affordable Healthcare," these mini-med health |
| Routine Care: Having an ongoing relationship with a | | | | insurance plans typically offer a set payment amount |
| medical doctor is important value and can help you | | | | for a specific healthcare treatment and a maximum |
| avoid much more costly illness and improve your | | | | benefit limit under $100,000. These plans don't meet |
| overall health outcome. I am an example of the | | | | the "my brother test" - would this type of plan |
| benefits of routine medical care with the goals of | | | | coped with the healthcare costs of my brother's |
| avoiding cardiovascular disease, diabetes and | | | | lymphoma? - No, so I won't sell them. The healthcare |
| managing my sinus allergies. My recent doctor visit | | | | discount cards and limited benefit plans are |
| including blood test = $248 Well Baby Check (price | | | | aggressively marketed on the internet. Just google |
| from local pediatrician) = $160 Annual Physical = | | | | "affordable healthcare" or "low-cost health insurance" |
| $500? Cost depends on how elaborate a physical you | | | | and you will see bunches. There just is no free lunch |
| get. | | | | in health insurance. If the plan is cheap, then the |
| Rx Drug: Prescription drugs are approximately 10% of | | | | benefits are limited. |
| total healthcare spending [1]. Prescription drugs can be | | | | Advantages: |
| a large component of treating a major or chronic | | | | |
| illness. These are drugs that I take with the list prices | | | | 1. Less expensive monthly premium |
| from my local drug store. OTC Claratin (equivalent | | | | 2. Discounted care from some healthcare providers |
| house brand) = $10 / month Crestor = $137.99 / | | | | 3. Limited insured benefit payments for medical |
| month Astelin = $115.99 / month An example of a | | | | procedures |
| more expensive medicine that my wife takes | | | | 4. Improves access to care |
| regularly for her chronic migraines: Topamax (generic | | | | 5. Few enrollment restrictions |
| equivalent) = $566.99 / month | | | | Disadvantages: |
| Diagnostic Tests: Diagnostic tests are an important | | | | |
| part of most disease identification, management and | | | | 1. Incomplete financial protection from the risk of a |
| treatment and are a large component of healthcare | | | | major illness or injury |
| costs. My recent blood test (three panels) = $152 | | | | 2. Due to benefit limitations, some healthcare |
| X-Rays = $100+ Mammogram = $150+ MRI = | | | | providers may require advance payment |
| $1000+; a complex MRI can cost several thousand | | | | 3. After any offered discount and benefit payment, |
| dollars | | | | you pay the remaining balance of the bill for medical |
| Emergency Care: ER Visit = $1000+; this is based on | | | | treatment |
| my experience - I have never had an ER visit that | | | | Major Medical Policy - This is your "Traditional Medical |
| was less than a $1000 in billed costs | | | | Insurance" policy for individuals and families. You pay |
| Hospital Admission About 30% of healthcare costs | | | | a monthly premium for an insurance policy covering a |
| are for in-patient hospitalization. The average length | | | | wide range of healthcare risks with a substantial |
| of a hospital stay is five days [2] with costs highly | | | | benefit limit, often $1 million or more. Most Major |
| dependent on treatment. Heart Arrhythmia (irregular | | | | Medical Insurance policies now sold use a network |
| heartbeat) - Example from one of my clients = | | | | concept called a "PPO" or Preferred Provider Option. |
| $45,000 including an ER admission and then three | | | | Most plans feature co-pays for doctor visits and |
| days in the hospital | | | | prescription drug purchases which reduce the |
| Major Illness: Cancer (Lymphoma) - My brother over | | | | out-of-pocket cost of these routine healthcare |
| two years of treatment = $500,000+; It is hard to | | | | expenses. |
| tell the actual total but when I called to see if my | | | | Advantages: |
| brother was close to exceeding his $1 million lifetime | | | | |
| limit the expectation was at least $500,000 in paid | | | | 1. Protection from the financial risks of a major illness |
| benefits to complete his cancer treatment. | | | | or injury |
| Chronic Illness: A chronic illness is defined by a medical | | | | 2. Provider discounts if "in network" |
| condition lasting a year or more that requires ongoing | | | | 3. Improves access to healthcare providers and |
| treatment. Examples are Diabetes, Asthma, | | | | treatments |
| hypertension and Depression. Approximately half of all | | | | 4. Encourages preventive health treatments |
| Americans have some kind of chronic aliment [2]. | | | | 5. Reduced out-of-pocket costs for routine |
| Type 2 Diabetes - Average Annual Cost = $5949 [3] | | | | healthcare |
| Asthma - Average Annual Cost = $3192 [4] | | | | Disadvantages: |
| Put all of this in a gigantic pile and the average cost | | | | |
| of healthcare in Texas according to the Texas | | | | 1. High monthly premium costs |
| Department of Insurance in 2006 was $7110 per | | | | 2. Applicants must qualify based on health screenings |
| person. That is $593 per month per person. | | | | 3. Generally, no maternity coverage |
| Admittedly that includes a lot of unhealthy and high | | | | 4. Must use "in network" providers for lowest |
| healthcare uses but it provides some perspective on | | | | out-of-pocket costs |
| what healthcare costs. If you have not had a close | | | | High Deductible Health Plan (with optional Health |
| relative, family or friend with a serious illness or injury, | | | | Savings Account) - This is a "Major Medical Policy" to |
| it is hard to imagine the high cost of healthcare. Value | | | | grapple with a major illness but only after an annual |
| in funding healthcare is more than helping with the | | | | deductible is exceeded. An optional tax-advantage |
| cost of routine care. Value to me means grappling | | | | savings account (H.S.A., "Health Saving Account") is |
| with the risk of a major illness or injury. | | | | available to set money aside for healthcare costs |
| Choices for Funding Healthcare | | | | prior to reaching the deductible. A family insurance |
| Cash - Just buy it when you need it and pay what it | | | | plan that qualifies as a prerequisite for a Health |
| costs out-of-pocket. The big disadvantage of the | | | | Savings Account in 2009 can have a deductible of no |
| "Cash" or what I call the "If we are Lucky Plan..." is | | | | less than $2400 and no more than $11,900. |
| that you have no protection of the risk for a major | | | | Advantages: |
| illness or injury. We have over 24% of Texans | | | | |
| uninsured for healthcare with a fourth of the | | | | 1. Protection from the financial risks of a major illness |
| uninsured on the "Cash" plan by choice --- about 6% | | | | or injury |
| of the entire population. | | | | 2. Provider discounts if "in network" |
| Advantages: | | | | 3. Improves access to healthcare providers and |
| | | | treatments |
| 1. No Monthly Premium / Fees | | | | 4. Access to optional Health Savings Account to save |
| 2. Ask for Cash discount from healthcare providers | | | | toward future medical bills with a tax advantage |
| 3. Available to all | | | | Disadvantages: |
| Disadvantages: | | | | |
| | | | 1. Monthly premium costs (lower than Major Medical |
| 1. No financial protection from the risk of a major | | | | Plans but still substantial) |
| illness or injury | | | | 2. Applicants must qualify based on health screenings |
| 2. Difficulty in accessing cares without insurance; | | | | 3. Generally, no maternity coverage |
| some healthcare providers may require advance | | | | 4. Requires making more choices on healthcare |
| payment | | | | 5. Larger deductible and no expensive reducing |
| 3. You pay the whole bill for medical treatment | | | | co-pays |
| Discount Health Card - Buy it when you need it and | | | | Additional Advantage of Optional Health Savings |
| pay less with an "Affordable Healthcare" discount | | | | Account: |
| card. Essentially, you access contracted network | | | | |
| rates without a Health Insurance policy for an annual | | | | 1. Reduced taxable income by amount saved in H.S.A. |
| or monthly fee. I look at this plan as a variation of | | | | account |
| the "Cash" plan since you have no protection of the | | | | 2. Use it or keep it --- any funds not used are |
| risk for a major illness or injury. "The FTC and many | | | | retained for future medical expenses |
| states have found that although some medical | | | | 3. |