Funding Your Care: Current, Future and Unexpected Needs
Large medical bills may be staring you in the face right now. Or perhaps you know you're going to need an expensive procedure
down the road. All of us want to be prepared for expenses that could come from serious illness or accident, or just from the process
of getting old. We've tried to build a list of resources to help individuals finance their current and future care.
Private Health Insurance
For cash payers, catastrophic insurance is preferred to a plan that pays for "routine" health problems like sprained ankles and the flu. The premium
for non-catastrophic plans is just too high, and it is generally cheaper to pay 100% out-of-pocket for all but the most expensive (and typically rare) services.
Self-funded employers are rapidly moving toward just such a system, using cash pay (termed 'direct contracting' in the employer world)
for more and more of their employees' procedures. Unfortunately this option is unavailable for individuals today due to the Affordable Care Act.
Health care sharing ministries
are a lower cost alternative to health insurance, though the organizations cannot absolutely guarantee coverage
for members. Ministry members help pay each others' medical costs with monthly "shares". Most ministries are Christian-based,
but in all cases members are required to live a healthy lifestyle, governed by a code of conduct. Several health care sharing ministries
were written into the Affordable Care Act, allowing their membership to satisy the ACA's individual mandate.
Those looking at paying cash for healthcare, whether uninsured or insured under a high deductible plan, will want to start saving immediately for future expenses.
Savings can be in any type of earmarked account at a bank or other financial institution. For those with an eligible high-deductible health plan,
funds may be contributed to a qualified health savings account (HSA). These funds are not subject to federal income tax.
When an HSA is owned by one's employer, it is termed a Health Reimbursement Arrangement (HRA). HSA's and HRA's have maximum annual contribution limits,
but in many cases unused funds can roll over and accumulate year to year. Additional resources in this segment coming soon!
Those needing cash or credit to pay for healthcare bills have many financing options available to pay over time. Hospitals and other facilities
are increasingly offering ways for patients to finance their bills directly with the facility. A number of private companies are also offering
medical loans, and sometimes other forms of help for needy Americans to pay their bills. Additional resources in this segment coming soon!
There are dozens of companies, often called patient advocates,
with years of experience negotiating with healthcare providers to lower patient medical bills. Negotiation can happen both before
and after services are performed. Many websites also give patients tips on how to do this themselves without the aid of a patient advocate.
Negotiation techniques include talking down charge rates, finding errors in a bill, questioning coding, and securing discounts for paying off a balance sooner.
Pricing Healthcare recommends a comprehensive suite of services
from The Karis Group that includes bill negotiation, both before and after health services are provided, which can save patients up to 85% off
their bills. Karis works directly with a member’s healthcare providers (doctor’s office, hospital, etc.) to help reduce the
out-of-pocket portion of medical bills, for both insured and uninsured patients.
Medicare is public health insurance, provided by the federal government, primarily for people age 65 and older.
Inpatient hospital care, nursing care, rehabilitation, and some home health are covered under what is called Part A of Medicare. Outpatient and ambulatory care,
medical equipment, screenings, and physical therapy are covered at 80%, which means a patient is responsible to pay 20% of what the government deems
an acceptable fee for the procedure.
Some people get Part A without paying a monthly premium, but most Americans must pay a premium for both part A and Part B. Part C is the part
of Medicare that allows private health insurers to provide Medicare benefits. Private supplemental insurance is also available to pay the remaining 20%
of Part B services. Part D covers prescription drugs.
Medicaid is public health insurance for low income individuals and families without sufficient resources to pay for health care. As a result of the Affordable
Care Act, or Obamacare, many states have expanded the rolls of those who qualify for Medicaid by raising the cap on income.
There are other healthcare options for low income Americans, such as the Children’s Health Insurance Program (CHIP).
Many dentists offer their lowest rates to those with dental insurance.
But dental insurers have been raising deductibles and lowering maximum payouts for years, while more and more dentists are offering discounted cash rates.
There may be cases where you can cut costs by having dental insurance, but price things out over time and call around to find out what kind of deals you can get
by paying directly.
The Karis Group is not insurance and does not provide funds to pay for bills. This is a best-efforts service. Results cannot be guaranteed.