Perhaps one of the most confusing aspects of a health insurance plan is the deductible.
Perhaps one of the most confusing aspects of a health insurance plan is the deductible. As comprehensive as your insurance plan, your carrier will probably not pick up the tab until you meet a certain threshold. Lower-tier plans that are less expensive on the employer side (if indeed your employer offers one) typically carry riders and caveats such as this. Paying out of pocket can be a tough pill to swallow. Just keep in mind that lower deductibles also tend to come with higher premiums. What can you pay, and more importantly, what do you want to pay?
The Way Deductibles Work in Practice
As we indicated above, the deductible is what you are obligated to pay before your health insurance provider pays for the rest. Sometimes, copays will be relatively small, but other times, they could be astronomical. The primary difference between health insurance deductibles and their counterparts elsewhere is that they are applicable for an entire year. The Affordable Care Act set a ceiling for maximum payments in principle, and the Department of Health and Human Services is responsible for administering the Act in practice. For 2021, individual policies are capped at $7,200, while family policies are capped at $14,400.
Picking the Right One for You
Finding the right policy for you can be a minor headache. The appropriate levels are calculated based on how much risk you can absorb and how much you know you must budget towards healthcare in general. For recurring expenses, like medication refills, selecting a lower deductible is the way to go. By contrast, higher-deductible plans are offset with lower premiums. Take your coverage needs into account, both for you or your spouse and any potential dependents. Otherwise, you might not be taking full advantage of any cost-sharing benefits that are available to you. Your carrier should, in theory, be willing to meet you in the middle.
Individual vs. Family Policies
Deductibles for family-related policies are typically doubled relative to the amount a single payor can expect. Insurance companies monitor the transactions that each client household completes. If one individual hits the minimum amount, they are covered for the rest of that year. Conversely, the payouts will only cover the entire family once everyone in said family fulfills their obligations.
Medical and Prescription Scenarios
Medical expenses and prescription expenses are not always lumped together. This arrangement leads to separate paths that could complicate the process. Separate plans for medication-related deductibles and copays for preventative care can make a world of difference.
A Customer Testimonial
Our next testimonial comes from Nisha Rastogi, owner of Primrose Schools of Gambrills. “Our company was first introduced to Drew Skibitsky and the MWE Partnership during the spring of 2017. Many of our employees at the Primrose School of Gambrills had requested different benefit options, and we wanted to be able to provide something. Drew showed us options for health insurance, life insurance, and supplemental health that could be offered in any combination. We decided to move forward with several of the plans, and [our] employees were very excited to participate.” Thanks, Nisha, and wonderfully done, Drew!
Get Your Voluntary, Supplemental, and Health Insurance Policies with the MWE Partnership!
Are you a business looking to provide your employees with essential voluntary benefits? If so, look no further than The MWE Partnership. When you choose The MWE Partnership, you get experienced service and comprehensive voluntary benefit options that will meet all your employees’ needs. With over 17 years of experience, The MWE Partnership is your go-to provider for all your supplemental benefit needs. If you are interested in finding out how The MWE Partnership can help your business, contact us today! We encourage you to like our Facebook page and follow us on Twitter and LinkedIn for the latest voluntary benefit news!