Category: ACA and Policy, Cost of Healthcare, Government Programs, Health Insurance

Get Going! You’re Almost Out of Time!

Jan. 15, 2016, is an important date if you are buying health insurance coverage on healthcare.gov. It means, as of this posting (Monday, Jan. 11, 2016), you have four days to make a decision to get a plan for February 1, 2016. If you don’t hit buy and select a plan by Jan. 15, the EARLIEST you can have health insurance coverage is March 1, 2016.

You might wonder why the start dates are so long after the purchase dates.  To put it simply, because federal guidelines require those timelines and we here at Blue Cross have to honor them.

As the third open enrollment for health insurance draws to a close on Jan. 31, it’s a good time to review a few simple facts. Like the fact that no matter how much you have to pay for health insurance, that spending is DWARFED by what an illness can cost you. Want some concrete examples of what life without insurance can cost?*

The average diabetic requires at least $8,000 per year in medications, and that’s without the diabetes causing other health issues. The average cardiac event, even a small blockage, costs $22,000 over the first five days of treatments. Having a baby? That will run you $12,000 in Louisiana if nothing goes wrong. Tragically, babies born early can run up seven-figure hospital bills (that’s $1 million+).

The pricing for some relatively simple events boggles my mind. Tear your ACL, something that happens to young and active people? By the time you get that fixed and have some rehab you would easily spend $20,000 without insurance. Gall bladder surgery? Averages about $22,000 when you are paying cash.

Need a knee replacement? This is where things get tricky. You can get one in Louisiana for as little as $35,000, rehab and all. But at a different facility, with a different doctor, you can pay as much as $80,000 for the exact same treatment. Without a health insurance company to negotiate the prices and set standards for you, it can get pretty expensive.

And once Blue Cross signs a doctor or hospital into our network, they can’t charge any more than our agreed-upon rates for the procedure, and they can’t bill you for anything above that rate. You don’t get anything like that protection when you are paying for it yourself — the medical providers can charge you whatever they want. Cost leveling and predictability is a nice benefit of having health insurance.

So far, we haven’t talked about what happens when someone really gets sick. A simple course of treatment to cure Hepatitis C, for example, runs from $80,000 to $150,000 in a single year. Cancer treatments can exceed $25,000 per month. Medical care is by far the most expensive thing the average person will ever purchase, and it’s often not optional.

So the real question we should probably ask when we shop for health insurance today is not “Can I afford this insurance?”, but more likely “Can I afford to be sick without it?”

That final answer is almost always “no.”

If you’re still on the fence, think about your family and how worried they would be about you while you are sick. Would you want to add the worry of paying for your treatments, plus missing work and possibly pay while getting treatment, to that situation?

I was diagnosed with an often-deadly cancer when I was 22 years old. I remember clearly all the conversations my parents and I had with doctors about treatments and outcomes. I don’t remember a single conversation about money, ever. My dad had good health insurance, and, as a college student, I was still covered by it, so we could focus our energies on getting me well and my illness didn’t derail the family finances. Good news since dad had four other kids to put through college after me.

As I sit here, 32 blessed years later, I would want nothing for any of you but the same ability to focus on the really important things. So, between now and Jan. 31, think really hard about investing in some health insurance, even if you can only afford catastrophic coverage, to protect you and your family. It might mean the difference between financial stability and ruin.

Hopefully, you will never have to use it!

*Prices in this article where gathered from a variety of sources, including American Heart Association data, reports from the American Diabetes Association, Kaiser State Health Facts, and local, internal and proprietary sources.

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