Getting the Most Out of Your Health Care Premiums
Ever since I started helping others obtain health care subsidies, my family has been footing the full bill for our health care costs. While I take pride in helping others, paying $100,000 in health insurance premiums over five years without a single doctor’s visit made me question if I was truly getting my money’s worth. This spurred me to try and use more health services than what I paid monthly, but despite my efforts, I couldn’t match the costs, leading me to downgrade from a Platinum to a Gold plan.
In 2018 alone, our family’s monthly premium for our non-subsidized Platinum plan was $1,760, totaling $21,120 for the year. As one of three in my family, my portion was $587 a month. In five years, I hadn’t visited a doctor, so I set out to get a physical, have a chest x-ray, see my primary care physician for a cold, consult an orthopedic surgeon, and get an MRI for my knees and shoulder.
In the first month, I scheduled a physical—the first since 2013. Although it’s recommended to get a physical annually after turning 40, and a colonoscopy at 50, I learned that annual physicals are covered as preventative care and don’t cost extra. Unfortunately, this meant I had been missing out on a free $2,100 benefit over five years.
The following month, a cold prompted me to see my doctor, costing me $100 plus a $20 co-pay. Concerned about a recurrence of childhood asthma, I got a chest x-ray, which showed nothing alarming, costing me an additional $80 after insurance.
My third month involved a visit to an orthopedic surgeon, who recommended cortisone shots for my shoulder and knee. Although initially agreeing, I backed out after seeing the size of the needles and some questionable online reviews. Instead, I opted for an MRI to assess any damage before deciding on any treatment.
The cost of MRIs shocked me—$3,500 each. With a 20% co-insurance, I would have been on the hook for $700 each. Deciding the potential costs outweighed my current discomfort, I canceled the appointment, concluding that perhaps getting one’s “money’s worth” in healthcare isn’t as straightforward as it seems.
Frustrated with rising costs under the Affordable Care Act, our family’s Platinum plan’s premium would have soared to $2,532 a month for four of us in 2020. Instead, we switched to a Gold plan at $2,212 a month, focusing on utilizing “free” preventive services and ordering 3-month supplies of prescriptions to save money.
Investing in your health insurance provider’s stock might seem like an odd way to offset costs, but given the profits they’re making—at your expense—it could be a wise financial move. After all, if you can’t beat them, join them. Despite my significant investment in UnitedHealth Group, it wasn’t enough to counterbalance the high premiums.
While I’ve paid far more in premiums than I’ve received in care, that’s probably for the best. It’s better to be healthy and underutilize your insurance than to need it constantly. Still, it’s hard not to be irked by the system, especially knowing that wealthier, healthier individuals like myself subsidize those who are less fortunate.
If you find yourself paying hefty premiums and rarely visiting the doctor, you might feel like you’re not getting your money’s worth. However, in times of genuine health crises, insurance can be a lifesaver—figuratively and literally. So, if you’re in need, don’t hesitate to use the services for which you’ve been paying.
When it comes to insurance—whether for health, life, or otherwise—it’s best to have it and not need it, than need it and not have it.
