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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
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
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
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.
“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.
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:
                             $ __________

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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: $ __________