How to Choose an Individual Healthcare Plan
How to Compare Healthcare Plans
When looking to buy a healthcare plan, it is important that you make an Apples-to-Apples comparison. Most insurances today tell you that you can "Save 15% in 15 minutes or less", but they fail to explain exactly how you will make the savings, without losing benefits or coverage.
So knowing that there really only are four types of Healthcare Plans, here's an outline:
- Community Health Plan (CHP) is for all people. CHP plans have a low cost and have the greatest selection of benefits and coverages.
- Federal ACA Plan is for people with major medical issues. ACA plans are very expensive and should only be purchased if you have significant, long term medical costs.
- Medicare is for people 65 and older
- Medicaid is for low income people. Usually under about $30,000 per year.
Choosing Coverages and Benefits
Most people like to have choices. Unfortunately, ACA plans are "One-Size" fits all. ACA plans are required to include certain coverages. Coverages that add cost and are not needed or even wanted by most people.
For example, ACA plans include maternity and drug treatments. If you are a male who doesn't drink alcohol, you must pay the cost for these coverages. You can't decline these coverages. This is a big problem for some Christian organizations that object to contraception coverages.
On the other hand, CHP plans are totally flexible and can be personalized to your meet your individual needs and desires.
CHP Sample Choices not usually included in traditional insurance plans:
- Purchase any time – No "Open-Enrollment"
- Alternative, non-traditional treatments are OK
- Use your own doctor
- Dental & Vision coverage can be included.
- Elective surgery and procedures
- Take the plan with you wherever you live
- Your Personal Concierge and healthcare advocate
- Bills and payment terms are negotiated for you
- Medical Financing to lower your monthly cost
- You Pick! If you don't see it here, it probably can be included. Just Ask!
Always compare the plan's price to the plan's Coverages and Benefits
Really Important to Know
The total cost of your healthcare plan, not just the monthly cost, is what you really need to know about. Therefor, in your comparison, you need to consider all the following costs:
The Monthly Cost: First, you need to be able to afford the monthly cost. The CHP plans are about 50% less expensive than ACA plans. For example, a 25 year old person the starting monthly CHP cost is about $95. For the same person, the ACA cost is about $200.
The Deductible Cost: When you have a medical event you will need to pay the plan's deductible cost before the plan pays any of your medical bills. For ACA plans the deductibles range from about $1,000 to over $6,500. For CHP plans the deductibles range from $250 to $2,000.
The Co-Insurance Cost: After you pay the Deductible, most plans charge you Co-Insurance. Co-insurance is a percentage of the remaining medical costs. Usually you see 80/20 or 70/30. This percentage calculates to a dollar amount. For ACA plans the co-insurance could run between $1,000 and $7,000. For CHP plans there is no co-insurance!
Max Out-of-Pocket Cost (MOOP): The MOOP is the total of your deductible and co-insurance cost. This is the cost that is really important to know. For ACA plans the MOOP is almost always greater than $6,500 for an individual and over $14,000 for a family. For a CHP plan the MOOP is between $250 and $2,000 per person.
As an example, your major medical plan may have a $5,000 deductible and a 80/20 co-insurance. Your medical costs are $20,000. Once you pay the $5,000 deductible the remaining medical cost is $15,000. You will pay 20% of this cost until you reach your Max Out-of-Pocket. If your Max Out-of-Pocket is $6,500, your co-insurance cost is $1,500 ($5,000 plus $1,500 equals $6,500).
All-in Annual Cost: Finally, add your annual monthly cost to the plan's MOOP to really see the plan's cost. If you are paying $250/mo., your annual cost is $3,000. Add a $7,000 MOOP and you All-in cost is $10,000.
Choosing the Right Healthcare Plan
Be careful of Indemnity Plans: Indemnity plans are not healthcare plans. Indemnity plans only pay a specific amount of your medical bill. These plans are financially dangerous.
Group insurance plans: Group plans are really not affordable. They are offered by employers who think group plans are a good employee benefit. They are not! Group plans cost about 5% to 15% more than individual ACA plans.
Which Plan to Purchase? If you are relatively healthy you should choose a CHP plan. If you have significant medical issues or have a lot of money to pay for coverages you don't need, then you should choose an ACA plan.
For overall flexibility, price and value, the CHP is the winner!
Healthcare Plan Cost Examples
Because CHP plan are very flexible and you choose your benefits, prices will vary. Even though ACA plans all include about the same coverages, prices do vary. For example, you could pay as much as $926.47 instead of $705.86 for a family of four whose age is 45.