Mamas on Bedrest: What to Look For When Shopping For Health Care Insurance

March 13th, 2013

Hello Mamas,

I am newly single and find myself in the precarious position of needing health insurance. (Or will need it shortly!) To be honest, I had no idea where to begin! As a health care provider, I am keenly aware of the importance of adequate health care coverage. As I type this I have a family member who is without coverage and newly diagnosed with a rare form of cancer. Strange stuff pops up and it is imperative that you be prepared.

Health care coverage in the United States is a hotbed issue. With the passage of the Affordable Care Act in 2011, health care coverage is available to many more Americans, yet there are still many people who do not have adequate health care coverage. Additionally, far too many people play what I like to call “Health Care Roulette”. I see this primarily in younger, healthy people who feel that shelling out a couple of hundred dollars each month is a ludicrous expense, but also in families where they struggle to keep a roof over their heads. The young figure they  aren’t on medication, have no illnesses and they mistakenly believe that they are at very low risk. This is a sad, risky line of thought. Young folks are often the ones who jet away on ski vacations, take exotic adventure vacations, hike, bike and engage in other vigorous activities in which unexpected accidents can occur. A broken bone requiring surgical reduction and setting can run thousands of dollars. If you are uninsured, you are responsible for that medical bill. And let’s not forget ourselves, Mamas on Bedrest, in this category. How many of you really anticipated going on bed rest? Yet as many of you are well aware, without health insurance, a hospital bed rest stay or even a complicated labor and delivery can put a family thousands of dollars in debt or worse-bankruptcy. So with all of that in mind, I set about finding reasonable, affordable health care or myself.

I consider myself very lucky. I happened to mention my plight to my accountant and she had some ready resources for me. As I am self employed, I will be able to deduct all of my health care expenses off of my taxes, including the cost of  the policy. But even better than that, she referred me to a very reputable, knowledgeable insurance broker who has set me up with an incredible health care plan. She herself is single and self employed. We are only a couple of years apart in age, so she pretty much set me up with a plan that she would use for herself. I am quite happy with what she has offered me. Here are the highlights.

Co-Payments- I opted for a plan without co-payments. First and foremost, I rarely go to the doctor. I go annually for my gynecological exam and otherwise only go perhaps for a physical examination or an urgent illness/injury. By using providers within the network, I will be assured of a fixed cost for the visit (covered by the insurance). If I go “out of network” I will have a fixed payment for the office visit and will be responsible for any additional charges. But in general, I can apply what I pay to my deductible and later recoup some costs. Also, opting for no co-payment keeps my premium.

Deductibles-I got a pretty good deal here as well. As a single person in relatively good health (got dinged a bit for my age!) I have a reasonable deductible and it will integrate prescriptions into that deductible. My deductible is also my maximum out of pocket expense. Deductibles can be tricky and I highly advise getting some help here. My broker really gave me good information on this and I am quite pleased with her advice.

HSA Account – Being self employed and a Health and Wellness professional, having a health savings account is a must for me. Along providing me with a way to save up funds in the event of a catastrophe or even if I choose to do some alternative treatments, there are tax advantages or business owners. HSA’s are also available if you have a high deductible health insurance plan, so ask your insurance agent if you are eligible for an HSA. While this may not help you now, it would be a great way to pay for a midwife or birthing center or treatments (such as a birthing tub) in the future, which are often not covered by conventional insurance plans.

Supplemental Accident Coverage-This coverage provides added benefits in the event of an accident; you know the type-you break your leg while skiing in Switzerland? This additional coverage will enable you to be flown home and pay for some medical expenses and not be hit with a gastronomical bill. It won’t cover everything, but it will make a dent and provide much needed cash immediately.

Life, Dental, Vision Insurance-I also have the option of adding these coverages to my policy. Yes, they come at additional expenses, but their monthly payments are far less than paying for expenses out of pocket. Again, check with your insurance broker/agent for more details.

I realize that this topic may seem out of line with Mamas on Bedrest, but in actuality it is very pertinent. I can’t tell you the number of mamas who call me when they find out that Maternity care is not a covered benefit of their insurance policy and they need to purchase an additional rider. (Like that’s going to happen if they are already prescribed bed rest!). It’s really important that you look at your insurance policies from time to time, I recommend yearly at the enrollment period, and make sure that you have all the coverage that you and your family need. Many people view health care insurance as an expensive luxury. But if you get without adequate health insurance coverage, it can mean the difference between exemplary care with the best treatments possible and just getting by.



2 responses to “Mamas on Bedrest: What to Look For When Shopping For Health Care Insurance”

  1. Jane J says:

    I had never heard of supplemental accident coverage. I have taken out trip insurance before, but I’ll have to check into this as well.

    Thanks 🙂

  2. Darline says:

    Hi Jane,
    I only became aware of this type of insurance when my husband’s company offered it to us many years ago. What Supplemental accident insurance does is in the event of an accident or catastrophic event, it gives you money to live on. I think the initial intent is that it provides you with the funds to meet your deductible, but as my insurance broker told me, if you are ill and/or injured and unable to work, if you receive a large check, you’re likely going to use it to live. Makes good sense actually. The most widely known company for this (and I’m not saying necessarily the best, just the one with name recognition) is AFLAC. Do take a look. These days there are all sorts of supplemental insurance policies and one can easily tailor insurance to fit individual needs.

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