Every year, millions of Americans learn the hard way that they do not have adequate health insurance coverage. Sadly, it’s often a situation of too little information too late.
More than 20,000 Americans die each year because they cannot afford basic medical care, medications or surgery. Surprisingly, it’s not just the uninsured who are at risk. Consumer reports indicate that four out of 10 people do not have adequate coverage levels.
The following information will help you determine if you have enough coverage:
1. What Is the Lifetime Cap on the Policy?
When shopping for health insurance most people simply look at annual premium rates and deductibles, but that can be a big mistake. Most health insurance policies have lifetime limits or cap rates that limit the total payout on the policy. Once that level is reached, coverage stops. Many low-cost, state-sponsored policies have a cap rate of only $50,000 annually. Experts suggest at least $1 million to $5 million per policy. Given the rapidly rising cost of medical coverage, the difference can literally mean life or death for someone facing a catastrophic accident or serious illness.
2. Are the Doctors, Laboratories, and Imaging and Other Providers In Network?
Most people realize the need to verify the hospital is in network but don’t realize the individual providers may not be. Even for the same surgical procedure it’s not uncommon to find that a surgeon, anesthesiologist, lab and even imaging studies are covered by different plans. It’s important to verify that all providers are covered by the plan in order to avoid costly surprises later.
3. What’s the Worst-Case Scenario?
Take time to add up the total cost required to use the policy in a bad year. If premiums, deductibles, co-payments, medications and all other out-of-pocket expenses exceed your savings, then chances are you are underinsured. Remember, health insurance is one of the most important policies available, but it works only if you can actually afford to use it.