Health Insurance Costs So Much – Can I Get Anything Cheaper?

I just had a phone call today from an insurance professional in auto/homeowners insurance.  He had a non-ACA insurance health plan through a life insurance company.  It is an indemnity plan (meaning it pays you back money when you go to see a medical provider).  There are no networks and the premium  is very affordable and on the surface it looks great.

Here is the situation that may change your mind about it, however.  His problem was that his wife was pregnant and had to move over to an Affordable Care Act (ACA) compliant plan because their Indemnity Policy does not cover pregnancy / childbirth.  She was able to do so and the family, because of a special election period due to pregnancy or birth can also move over to that plan ( a local Blue Cross Plan).  Their income is too high to get a subsidy so the premium for all of them would be over $1400 per month (definitely why I always complain about affordability in the Affordable Care Act).  It might be a politician’s definition of affordable but it is not mine and is also not many of my client’s ideas either and this is a problem that is never addressed by the media.

If he does not take that option of going to the Affordable Care Act Plan for the entire family, he would either have to forego coverage for his wife on the ACA compliant plan OR he would have to pay both the premium for the Indemnity Plan for the entire family – including his wife – and pay for her separately under the Affordable Care Act compliant plan.  The Indemnity Plan will not allow them to drop  family coverage in the middle of the year.  They either cover everyone ( and this will not affect the ACA compliant plan because an Indemnity Plan is not health insurance) and her pregnancy would not be covered, or they have to pay for the ACA plan for his wife and pay the Indemnity Plan for the entire family, or they have to drop the Indemnity Policy and take the ACA Plan – through a local Blue Cross – for the entire family at $1400 per month. Not amazing choices.

My advice is that they should take the ACA Blue Cross Plan for the entire family.  I know the premium is high but… and this is a big but… health issues, including pregnancy, come up all the time and an indemnity policy just may not be there for you when you really need it.  In my own family I have a son, who, at age 25 was diagnosed with a terminal illness out of the blue.  He had always been perfectly healthy and we never expected a terminal illness at such a young age.  Luckily, he had good, full, health insurance.  He is still alive and fighting for his life 7 years later.

Your health is the most important thing that you have.  You can have all the money, all the cars, all the sports tickets, and on and on but what good are they to you if you can’t walk, or talk, or have to live in constant pain, because you didn’t take care of your health because of the cost?