Health Insurance- Success Stories
Marty, his wife and two teenage kids “make too much” to receive a pretax credit for an ACA policy. If they had bought an entry ACA Marketplace plan, it would have a high deductible which made the policy low value in their view.
Marty has his own small business and group health was not an affordable option. They wanted an affordable policy they could use without having to pay down a huge deductible.
They chose a fixed benefit plan that had both in network and out of network benefits. Restrictive networks are a challenge for many marketplace plans. This policy included preventative care, visits with doctors and specialists as well as outpatient care without a deductible. Hospitalization was included but there was a deductible for in-patient care.
Fixed benefit plans provide a specified dollar benefit for care such as doctor or specialists visit. Marty and his family would pay the doctor directly and be reimbursed a specific amount by the insurance company. Because the doctor’s office is being paid at the time of visit, they often provide a “cash price” for care which is attractive to doctor’s office and Marty’s family.
Also, because the plan has limits in benefits, they added optional coverage for accident and critical illness. This helped protect them financially from the high cost of serious illness and kept the premiums low.
Marty and his wife considered themselves to be smart shoppers and appreciated they can have a positive impact on their healthcare cost by shopping procedures such as an MRI or colonoscopy. They also took advantage of the plan’s relatively high cash benefit when they used urgent care facilities. Emergency room care is something they would use only in a life-threatening emergency.
Because they family was healthy and not managing any chronic conditions, this plan was a great value for them. If there were serious pre-existing conditions, we would have looked closer at other options.
Taking this approach, they saved themselves over 1,000 per month in premium compared with a marketplace plan.
Angela is a soon to be single mom with a teenage son. She believed in having health insurance.
Angela needed a low-cost plan and wanted a plan with a strong network of doctors and hospitals. Marketplace plans were not the answer.
She decided on a health sharing policy. She appreciated the community aspect of the plan and their values. The plan included full hospitalization and medical treatment.
The plan had exclusions for items she was not concerned with such as expenses related to non-Biblical lifestyle choices because they would have conflicted with her personal values. For example, excluding payment for health care needs related to abortion and illegal drug or alcohol related abuse expenses was acceptable to her.
Angela also appreciated the plan’s low premium and wide range of deductibles she had to choose from. Instead of having individual deductibles per insured, the plan has a single deductible for the whole family. That feature makes this plan even better for larger families.
Another reason the plan had lower premiums is because routine and preventative care are not covered. Angela was satisfied making the trade-off of lower monthly premiums and absorbing the cost of an annual doctor’s visit. Her view was they are like automobile oil changes. Low-cost necessary items she could plan for and absorb. She would have been more concerned with transmission repair and serious engine repairs. She also appreciated the included zero-dollar unlimited telemedicine benefit because it fit so many occasions and was very convenient.
Another medical cost reducing feature of the plan is that tobacco users are eligible. As a non-smoker this also became a good fit.
Angela was very happy with how this plan fits her budget and lifestyle.
We are all different, we are in different situations and have different priorities and different resources. These examples are here to provide a general picture of the ways we help others protect their family and provide for their family over the long term. Insurance is forward looking and when applied properly, a very valuable tool.
We look forward to hearing your story and providing you with options that help you protect and prosper.