It’s a new year and that means new resolutions, new life events, new health insurance. Even if you stayed with the same company or are on the same plan as last year, it’s likely that there were some changes to your plan. Maybe it’s more out of your paycheck for your monthly premium, or perhaps now your portion to pay at the doctor’s office is more. Regardless of the change, it wasn’t something that benefited you. It likely just added more complexity to your already hard to understand policy and is costing you more. Why? Health insurance was never designed with you in mind.
Let’s talk about the basics to get a better understanding of how health insurance plan design works.
1. Coverage – “What will I get with my plan?”
This includes and excludes certain services and treatment options to provide adequate coverage and manage cost. (i.e. office visits, hospitalizations, prescriptions)
2. Premiums – “What is the cost to have coverage?”
Every insurance plan design requires someone to pay a premium to hold the policy. An employer might take the entire cost to off-set the employee’s portion, or in most cases, the employee has a bi-weekly premium deducted from their paycheck.
3. Cost-Sharing – “How much do I owe?”
Someone has to pay for the care provided. Is it you the policyholder or is it your insurance/employer? This is determined by the cost-sharing structure in the form of deductibles, coinsurance and copayments.
4. Provider Networks – “Who can I see?”
You can’t just go to any provider you like; you are restricted to the network of the policy. The purpose behind this is to, you guessed it, manage costs and in some (rare) cases, promote higher quality providers who have better health outcomes.
5. Regulatory Compliance – “The Age-old Guideline”
There are requirements that health insurers and employers must follow to administer health insurance benefits. Regardless of new laws and policies, there hasn’t been substantial change in the health insurance space.
As you can see, none of the 5 components of health insurance design have anything to do with YOU, who is paying for and covered by the policy. No matter how many of those new year’s resolutions you keep or abandon by the end of the month, you will still pay the same or more next year on your premium and other health services.
At NuLight, we offer customized plans that meet you where you’re at and incentivize you for your positive health management. We don’t all buy the same car or the same house as our peers, right? So why should our health insurance be any different? You deserve better and we deserve coverage that meets our unique health needs and lowers the cost of care.
Contact us today to talk through our options and see if a partnership with NuLight makes sense.
Email: info@nulight-consulting.com
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