Should One Health Plan Fit All?


As healthcare costs continue to rise, we have been using various ways to make our health insurance more affordable. Eliminating the doctor visit copays and/or the prescription drug copays from your major medical plan can definitely save money on your premium. So if you are normally healthy, not accident-prone, and seldom need to take prescription medications, eliminating copay benefits would probably suit you and your wallet.

Another means of cutting cost is with a high-deductible health plan; the rate is usually less expensive than health insurance with a low deductible. This option is based on the risk (hope) that you will not be in a medical situation which will require you to meet that deductible, and it is more practical for healthy individuals. You accept more of the financial responsibility with the high deductible, and therefore pay a reduced premium.

Yet another way to trim your health insurance expenses is to enroll in an HMO health plan, rather than the more traditional PPO type. HMO plans generally cost less in comparison to PPO plans which have the same benefits, deductible, and maximum out-of-pocket responsibility. The main trade-off is network restrictions.  HMO networks tend to be smaller than PPO networks.

If you don’t feel compelled to stay with a particular physician because of a long medical treatment history, you could select a primary care physician (PCP) from an HMO network, who would then refer you to specialists when necessary. However, there are NO out-of-network benefits, so be sure to choose from their network provider directory.

Most couples tend to share the same health insurance plan. They are not obligated to do this; it is merely their choice. If one spouse has excellent health and seldom needs medical treatment, but their partner has a health condition which requires frequent doctor visits, lab work, imaging/x-rays, therapy and prescription drugs, those folks obviously have different health insurance needs!

Why should they both pay a higher premium for a low-deductible copay plan, when only one person uses the full benefits of that insurance? The healthier person could save money by getting their own separate higher-deductible health plan, possibly with no copays as well. In health insurance, one plan does not fit all!

Does your plan suit you?  If not, contact AustinHealthPlans.com at (512) 535-3556 or send an e-mail to: tom@austinhealthplans.com.  We will discuss your situation and make recommendations for several options.  There is no obligation and no fees for our services.  Get a free quote today!

About tcdiehl

I have been an independent insurance agent licensed in Texas since 2003. My focus is providing affordable insurance coverage through multiple reputable insurance providers for individuals, families, and small groups. I can also help with Medicare insurance needs. Allow me to connect you with the appropriate health, life, disability, long term care, and/or dental plan(s) based on your health, personal, and financial needs. Call me at (512) 535-3556, E-mail: tom@austinhealthplans.com.
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