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How Does My Insurance Work?



 

How does my insurance work?  How is it changing?  What can I do to make the best choices, both for my family’s health, and for my financial health?  Here are some facts and tips, courtesy of the Unified Virginia Chiropractic Association and ChiroHealthUSA.

 

HISTORY:

  • In the 1940’s, about 10% of Americans had some form of modern health insurance that paid for doctor visits.  By 1955, that figure was nearing 70%.  In the 1960’s, public health insurance programs (Medicare and Medicaid) were born.  Later came HMOs, PPOs, and POS plans as insurance companies leveraged stronger business models to direct health-care dollars their way. 1, 2  Then came HIPAA in 1996, a law laying out complex privacy rules;  and around that time, “catastrophic” (high-deductible) plans and corresponding healthcare savings accounts (FSA, HSA) rose in popularity. 2
  • Enter 2010, when the Affordable Care Act was signed into law.  As implementation began to roll out in 2014, patients began to see small and not-so-small changes in coverage, out-of-pocket expenses, and complexity.  A very wide variety of interested parties (patients, doctors, hospitals, drug companies, insurance companies) find themselves stressed in different ways.  What the future holds is anyone’s guess – not even Congress is certain.

KEY TERMS:

 

For a list of definitions of key terms, [click here].

KEY TIPS & FACTS:

  • FACT:  Does health insurance guarantee good health?  Not exactly.  The U.S. Census reports that 85.0% of people in self-reported “excellent health” had health insurance in 2010, but 85.1% of people in “poor health” reported the same. 3  Indeed, too often “health” insurance companies cover costs related to accidents, injuries, and illnesses;  and rarely invest in or cover procedures and practices focused on “health.
  • FACT:  Though health insurance is debatable for “health,” it’s essential for catastrophes.  A major illness or surgery can easily cost $50,000, $100,000, or far more.  The leading cause of bankruptcy (62%) is health-related bills. 4
  • FACT:  Medicare coverage varies based on provider type.  While you may pay zero at the M.D.’s office, you’ll have to pay 100% of your care at the dentist unless you have supplementary coverage.  Similarly, only a portion of chiropractic services are covered by Medicare.
  • TIP:  Cheaper isn’t always better.  A cheaper health insurance plan, or less costly care, is NOT always the best value.  Restricted choices, poor coverage, and even poor outcomes are risks of “cheap.” 5
  • TIP:  Read your insurance policy; and ask questions.  Modern health insurance plans shift more responsibility for your health costs to you, the patient.
  • TIP:  If you lack coverage for a particular doctor or provider type (chiropractor, dentist, surgeon, etc.), there are good options for shouldering the financial burden.  Some doctors and offices will offer extended payment plans, with or without interest.  Ask.
  • TIP:  If you have no coverage, or are uninsured or underinsured:  state and federal regulations prevent providers from reducing fees or giving away services;  but that doesn’t mean we can’t help.  Speak with your provider’s billing office if you have any questions or concerns about your health care costs, so that we can help you get the care you and your family need and deserve, while respecting your financial needs.

Health care is a partnership.  Learn all you can about taking a strong role in your own health.  Please take advantage of the opportunity to live… well… with chiropractic care.  Your doctor of chiropractic’s role is to help you feel and FUNCTION at your best—whether you are in pain, feeling better, or feeling great.  Good health can save you, big!    For more information on ways to help your entire family live better, ask your chiropractor for guidance or visit http://www.virginiachiropractic.org to find a highly qualified DC near you.

 

[References]

 

Provided as a public service by the Virginia Chiropractic Association.  Production and content courtesy of Trusted Voice.  All rights reserved.



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