Healthcare costs can be tremendous. By being an informed consumer, you can take control of what you spend on healthcare costs to keep more of your hard-earned dollars in your pocket. It is important to consider options like GAP insurance, indemnity plans, and supplemental coverage, as well as strategies to save on prescriptions and outpatient services so you can ensure your health and finances are in good shape.

  1. GAP Insurance

Think of GAP insurance as if you were purchasing a bucket of money at a fraction of the cost to help offset the expenses associated with your medical deductible and co-insurance. For people who are apt to spend more on their premiums to have better coverage, using a GAP plan with the lowest priced coverage can create a more affordable option.

Consider this example of a 45-year-old male purchasing his insurance through the Healthcare.gov Marketplace with no subsidy qualification.

Should he enroll in a Gold level plan (option 1) or the most affordable plan – a Bronze HSA with GAP insurance (option 2)?

      Option 1       Option 2
Deductible        $1,500        $6,700
Max out of pocket        $8,700        $8,050
Level         Gold         Bronze
HSA Compliant           No           Yes
Premium          $504          $339
Premium – GAP – $8000              77
TOTAL COST          $504          $416
Out-of-pocket exposure        $8,700            $50

 

 

 

 

 

 

 

 

Option 2 wins! Not only would he be saving over $1,000 per year in premiums, but his financial exposure to out-of-pocket costs would be eliminated with the GAP plan, and he would be able to contribute to a Health Savings Account to save on his taxes!

  1. Indemnity Insurance

Indemnity plans provide a fixed cash benefit for covered medical services. Indemnity plans are a great way to provide financial protection against out-of-pocket costs and can potentially provide a policyholder income protection in the event of a catastrophic health situation. They also provide people with the freedom and flexibility to see any provider they choose – regardless of network limitations. Indemnity plans tend to be more expensive than GAP plans, but for self-employed people, this may provide a high level of peace of mind if they worry about a health situation requiring ongoing medical services that may impede their ability to work.

  1. Supplemental Insurance

Supplemental insurance plans provide additional coverage for specific health situations. The more common supplementals available provide additional funds in the event of an accident, hospitalization or the diagnosis of a major health condition. These plans can be used for both covering medical costs, as well as living costs, however they are very targeted to their area – unlike a GAP or indemnity plan.

  1. Price Shopping for Medical Services

People don’t realize that using their insurance may not always be the best option. We have been trained to provide our insurance card whenever we need any type of medical services. There are resources available that can help to reduce our costs on certain medical needs.

Prescription costs can add up quickly. According to the CDC, approximately 60% of people 18-64 reported taking at least one prescription medication in 2021 and 36% reported taking three or more, contributing to over $63 billion being paid out-of-pocket. These costs can be reduced at times by using some of these savings’ tools.

  • Discount Plans such as pharmacy discount cards and membership programs are usually offered for free and provide significant discounted prices on many medications, at times much lower than insurance copays.
  • Manufacturer’s Coupons and patient assistance programs are key for people who take specialty medications. These prescriptions can have limited or no coverage through insurance companies and very high costs. Usage of manufacturer’s coupons and patient assistance programs may be contingent on income and/or insurance coverage.
  • Online Resources as GoodRx and RxSaver aggregate manufacturer coupons and discounts, making it easy to find savings on specific prescriptions. Consumers can price shop medication prices prior to fulfilling their prescriptions as prices may vary by pharmacy.
  • International Drug Markets are becoming increasingly common to help save on prescription costs. Many countries have regulated prices on prescriptions. Vendors are keen to pass this benefit onto American consumers resulting in huge savings. It is important to do your research, as not all international vendors are safe options.

Labs and diagnostic tests can be applied to your deductible, depending on your coverage. This is a common way for people to incur significant out-of-pocket costs. If either of these services are needed for a small health issue, consider not using your health insurance. Self-pay options or using discounted programs such as Laboratory Assist and Radiology Assist can significantly keep your costs down and protect you from unexpected medical bills.

By being proactive and informed, you can safeguard your health and financial well-being without breaking the bank.

For more information, contact Cindy Gordon – Cindy@GordonHG.com, or schedule a time to talk – www.calendly.com/cgordon