Friday, June 29, 2018

Back To The Future - Consumer Driven Health Plans

By: Coleen Elkins, Managing General Agent

24-7 Health Insurance 

RV Insurance Benefits

As we prepare for the Affordable Care Act tax penalty to be reduced to zero on January 1, 2019 we can anticipate changes once again as to how we insure our health.

I have a question for you to consider. Would you ever walk into a big box electronics store and give the clerk your Visa card and ask them to pick out a big screen TV for you?  I hope not! You compare brands, you look at brand ratings, you watch for the best sale price right?

Why then do we walk into our doctors office and blindly hand them our insurance card which provides us zero financial assistance until WE have spent over $5,000 on our deductible? Ponder this for a moment, if your health insurance premium is $900.00 a month you have spent $10,800 in a year for the privilege of carrying that health insurance card. If you utilized your insurance card and finally meet your $5k deductible and your $7,350.00 out of pocket maximum you now have spent $18,150.00 on your health that year.

Why are not savvy consumers when it comes to our health? Have we somehow we have been conditioned not to ask?

Twenty five years ago when we opened our first health insurance agency consumers were more proactive. Then along came health insurance copays provided by our friendly health insurance company, and for a very low monthly premium we now had unlimited office visits for a very low copay. The consumer lost the drive to be price conscious. Each year health insurance premium rose for over a decade.

In 2004 our government decided we needed to once again be proactive so they introduced Health Savings Account plans aka HSA's. We had a high deductible health plan, a low premium and a tax benefit. People once again began to become aware of cost and were saving money in a special savings account in the event they had to use their health plan.

Then in 2010 our Federal Government decided to get involved again and help consumers reduce the cost of their healthcare with the Affordable Care Act. They reduced the tax benefits of the HSA plans and in some cases they were not longer available to enroll in. Since 2010 insurance premium increased and networks narrowed from PPO plans to HMO plans to regional HMO plans causing many Americans to give up the doctor they had for years.

What will 2019 bring? Are the insurance companies standing by with solutions?

Actually a select few are and our agency already has solutions available in some areas of the country.

Consumer driven health plans are coming back. Referenced based pricing is on the rise to drive cost down and create competition.

We certainly are ready to help our clients find plans that fit their budget, give them their doctors back and provide options for cost savings by choosing where to receive care.

The state of Texas is a head of the curve. The Texas Department of Insurance recently created a website to the public called After entering their zip code a consumer can learn the cost of inpatient procedures, outpatient procedures, office visits, ER visits and more.

Here is an example of what you will learn when searching for cost of an office visit.

As a consumer driven health insurance agency we hope that the department of insurance in all states will introduce tools to drive down cost and raise consumer awareness.

Our focus is to be the advocate and a solution for our current clients we have had the privilege of serving for over 24 years, and to our new clients that seek our services which by the way are provided at no cost to you.

We look forward to being of service!