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Even though I have Health Insurance – I can’t afford to be sick

Although we have made strides in making sure everyone has access to affordable health care – the Affordable Care Act (ACA) – people are still not getting the care they need because they can’t afford the costs.

If you weren’t paying attention – like I wasn’t – all of a sudden gone was the day that my employer offered an HMO plan where I only had to pay $5.00 to see a doctor.  Suddenly I was paying a higher premium for the coverage and I had to meet high deductibles before my insurance started paying.

My employer, like many, thought that offering a Health Savings Plan (HSA) would be the answer to helping the employees with these high deductible plans.

Yes, they are a great tool to help plan for the high deductible, but you need time to accumulate money – and there are limits on how much you could save a year – which resulted in having to pay a portion out-of-pocket after taxes.

Suddenly I found myself having to budget an additional $500.00 a month in order to save up for my $6,000 out-of-pocket family limit.

Because our plan changed so fast, (and I wasn’t prepared in advance like I probably should have been) I was caught needing money at the beginning of the year to cover medial and prescription costs,  but I hadn’t had time to accumulate money in my HSA.

Result – in addition to saving an additional $500 a month, I had added monthly expenses of paying Doctor’s bills and prescriptions.  Eventually I could submit the receipts to get my money refunded from the HSA, but I needed the cash up front.

So naturally we start to defer going to the doctor until we have money set aside to pay.  We struggled with do I really need that medication? Do we really need to have labs done now or can it wait?

What can you do if you unexpectedly find yourself under a high deductible plan and you haven’t prepared?

  • Get more involved with your health care.  Often preventative care is fully covered, so get your annual physical.  However, proceed with caution if your doctor starts pushing to do other things not covered under the annual physical.  If they want labs just as a precaution – ask if they are necessary right now or can they wait.
  • Depending on the hospital or physician facility, you can often set-up an interest free payment plan for expenses incurred.  This can buy you time to accumulate money in your HSA.  Once you have the money in your HSA, you can submit your receipts for a refund.  This allows you to keep what money you have accumulated to pay for prescriptions since you have to pay for them when you get them.
  • Clean house – that’s right look under the couch cushions.  What I’m really suggesting is look around your house and see what you can sell.  I bet you have some valuable stuff that you don’t use anymore.  Sell it and put the money toward helping cover your deductible costs.
  • Use credit.  No one wants to but you may have to.  Don’t automatically go to the credit card.  Check with your bank or credit union to see if they will do a personal loan.  Although I don’t recommend using your retirement money, but if you need access to cash, consider taking a 401(k) loan if you have that option – at least you are paying yourself back.
  • One final option is to let your employer know you are struggling with this change in health plans.  Often employers have employee assistance plans and they may be able to help you.

How to make sure you have the money you need when you need it in future years.

  • Regularly save in a HSA account if you have the option.
  • If you come into a sum of money – maybe your tax return – put it aside to cover out-of-pocket expenses before you have accumulated money in your HSA.  Then once you have accumulated money in your HSA submit your expenses and get a refund. 
  • Look at your other insurance policies.  Maybe you can save money by increasing the deductible on them and redirect the savings toward your medical deductible.  If you have a permanent life insurance policy you may already have cash value accumulated that could be tapped into if you need to get access to cash.

Unfortunately this problem isn’t going to go away – we can only hope it doesn’t get worse.  However, with the rising cost of health insurance, one can only expect it will.

Stay Healthy.

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