More than Just Lines on a Map: Best Practices for U.S Bike Routes
Lowering Your Healthcare Costs
1. Are your health insurance
premiums too high?
Consider the following:
An intelligent, factual, method for lowering
your monthly major medical premiums
In 2009, the average family’s health insurance premium
was $13.375 (Kaiser Family Foundation)
The average American family spends less than $2,500 per
year in out-of-pocket medical expenses
The average American household with $2,000 major
medical deductible rarely meets their deductible
This results in health insurance premiums that are far too
expensive for the amount of benefits that are actually used
2.
3. Accidents
1. Include an accident plan to compliment
your health insurance plan.
If a medical claim is due to an accident—
Use the “accident plan” to cover your
annual deductibles & co-insurance
…with on a $100 deductible
65% of all healthcare claims are due to
accidents
4. Critical Illness Protection
2. Include critical illness coverage in your health insurance
program
Reality:
*Every 26 seconds…Someone in the U.S. will suffer from a coronary event, and
about every minute, someone will die from one -1
*Every 24 seconds…Someone in the U.S. is diagnosed with cancer -2
*Every 40 seconds…Someone in the U.S. is having a stroke -1
Cancer deaths are declining --about 1% each year since 1999-- due to
increased prevention efforts, earlier detection, and improved therapies -3
Possible uses:
Pay the deductible and co-insurance on your health insurance
Your mortgage, auto loan or credit card payments
Keep your business running
Expenses for your and your family’s travel/lodging while you’re seeking medical
treatment outside of your community
Expenses for child and nursing care
Freedom to choose your health providers
Freedom to have your spouse by your side
Freedom from worry about your bills and your mortgage
Freedom to take extra time off from work while you get back on your feet
68% of each dollar spent on 1. Heart Disease and Stroke Statistics – 2008 Update, American Heart Association
healthcare goes to treatment 2. Cancer Facts and Figures, American Cancer Society, 2006
of a critical illness 3. New York Presbyterian Hospital http://www.nypcancerprevention.com/issue/5/con/features/cancer-surpasses-heart-di.shtml
5. Total Medical Insurance Program
MAJOR MEDICAL - ACCIDENT - CRITICAL ILLNESS
MALE 40 / FEMALE 37 / 2 CHILDREN - $10K ACCIDENT & CRITICAL ILLNESS BENEFIT
EXAMPLE # 1 EXAMPLE # 2 EXAMPLE # 3
MAJOR MEDICAL PLAN ONLY MAJOR MEDICAL PLAN MAJOR MEDICAL PLAN
$25 CO-PAY Accident/Critical Illness Combo With Accident/ Critical Illness
$25 CO-PAY Combo High Deductible
(No Office Visit Co-Pay)
Deductible: $1,000 Deductible: $5,000 Deductible: $5,000
Office Visit (Co-pay): $25.00 Office Visit (Co-pay): $25.00 Office Visit: $0
Medical Premium: $580.00 Medical Premium: $398.00
Accident plan: $59.95 Accident Plan: $59.95
Critical Illness: $48.00 Critical Illness: $48.00
Total Premium: $965.00 Total Premium: $687.95 Total Premium: $505.95
Total Savings for Example # 2: $277.05/mo. = $3,324.60/ yr.
Total Savings for Example # 3: $495.05/mo. = $5,940.60/yr.
Including an Accident and Critical Illness policy with a higher deductible major medical policy
creates a combined benefit plan that will greatly reduce your monthly medical insurance
premium.
In the event of an accident or critical illness, both the Accident and Critical Illness policy’s
benefits can be used to pay the higher deductible on your Major Medical plan. The Critical
Illness plan may also provide funds to cover any additional out-of-pocket expenses or lost
income that may result from a serious illness.
6. “The True Cost of a Co-Pay”
Major Medical Insurance
(MALE 40 / FEMALE 37 / 2 CHILDREN - $10K ACCIDENT & CRITICAL ILLNESS BENEFIT)
MAJOR MEDICAL PLAN MAJOR MEDICAL PLAN
$25 CO-PAY (No Office Visit C-Pay)
Deductible :$5,000 Deductible : $5,000
Office Visit Co-pay: $25.00 Office Visit Co-Pay : $0.00
Monthly Premium: $580.00 Monthly Premium: $398.00
Annually: $6,960 Annually: $4,776
$6,960 - $4,776 = $2,184.00
1. Savings by purchasing $0 co-pay plan: $182.00 /mo. = $2,184.00 /yr.
2. Average “retail price” for doctor’s office visit: $120.00
3. Average PPO discounted price for doctor’s office visit without co-pay:
$80.00
4. Number of family office visits required to justify the additional
premium:
$2,184 ÷ $80.00 = 27.3 Office Visits
5. Number of office visits actually used per year: (Example) – 10
$25.00 x’s 10 visits = $250.00
6. “True Cost” of the co-pay feature: $2,184 + $250.00 = $2,344.00 /yr.
7. Actual “true out of pocket cost” for each office visit = $234.40 ea.
7. provides,
yet maintain low out-of-pocket exposure by including an Accident and Critical
Illness policy to
your “total health insurance program”.
Total Major Medical Plan
Medical with co-pays $ __________
HSA or no co-pays $ __________
Annual Deductible …… $5,000
Personal Accident Plan Critical Illness Policy
$ 10,000 per accident Available Funds:
($100 Deductible) $ 10,000 Lump Sum (ea.)
Premium: $ ________ Premium: $ ________
Total Medical Ins. Program
Total Monthly Premium:
$ __________