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High Cost of No Health Insurance

High Cost of No Health Insurance

Health insurance has experienced a revolution in the last few years. Medical coverage used to be employer-provided and was rarely purchased privately by individuals. The Affordable Care Act (ACA) has made coverage easier to obtain for several reasons:

  1. Individuals may purchase coverage on their own.
  2. Small businesses may purchase coverage for their employees.
  3. Pre-existing conditions are now covered.

Failure to procure health insurance coverage can result in financial losses ranging from inconvenient to catastrophic. With coverage available to millions more Americans, uninsured losses should become a thing of the past.

Chronic/Terminal Illness Can Cost You

For the average healthy person, health care and medical costs per year may be minimal. But what if you are diagnosed with a chronic illness such as lupus, or an illness like cancer that is usually terminal? Your health care costs will skyrocket.

According to the Lupus Foundation of America, the average annual cost for lupus treatment was over $12,000 per year in 2008. The rising cost of doctor visits and prescription drugs will have inflated that figure in the last 8 years since the study was conducted.

Cancer costs are dependent on many factors: the age and gender of the patient, the location of the patient and the treatment center, the type of cancer, and the life expectancy. It is estimated that 8 weeks of chemotherapy can cost up to $30,000 and sometimes more, depending on the diagnosis. And that is just for the drugs! Costs of doctor visits, facility charges (hospital or clinic), and personnel (doctors, nurses, other staff) can greatly inflate this figure.

Accidental Costs Can Be Painful

Accidents happen. Whether you fall in the bathtub, get rear-ended on the way to work, or injure yourself at the gym, a trip to the emergency room will cost you. Uninsured patients pay anywhere from $200-$3,000 in facility fees. Lab costs, doctor fees, and medications can ratchet up the expense of treating an accidental injury.

Should you need further treatment or emergency surgery the cost can escalate quickly: $20,000 or more depending on the type of injury and complexity of the surgery. Emergency room bills add up quickly and may contribute to much of the estimated 62% of bankruptcies in the United States attributed to medical expenses.

Penalties: Money For Nothing

One of the hallmarks of the Affordable Care Act is the penalty for failing to insure yourself or your family. Here is how that works out monetarily:

  • In 2014, the penalty was $95 per adult and $47.50 per child in your household, subject to a maximum of $285 per family or 1% of your gross adjusted income, whichever is greater.
  • In 2015, the penalty increased to $325 per adult and $162.50 per child in your household, subject to a maximum of $975 per household or 2% of your adjusted gross income, whichever is greater.
  • 2016 penalties show the largest increase yet: $695 per adult and $347.50 per child in your household, subject to a maximum of $2,085 or 2.5% of your adjusted gross income, whichever is greater.
  • 2017 and beyond, penalties are expected to stay the same: $695 per adult, $347.50 per child, subject to a maximum of $2,085 or a percentage of your adjusted gross income, whichever is greater. The percentage will be adjusted for inflation in the years beyond 2016, so you can expect the maximum to increase over time.

The interesting thing about this penalty is that it comes out of your pocket, but you receive no insurance coverage for your money. It just makes financial sense to purchase health insurance coverage so that you receive value for the money you are already required to pay into the system.

Where Can You Get Coverage?

Should you get an HMO or a PPO? What does coinsurance mean? Which deductible is the right one for you family?

While the ACA website allows consumers to quote and purchase health care coverage on their own, an insurance broker with specialized knowledge of insurance coverage and terminology is the best way to secure this coverage. The ACA exchanges may not offer the most cost-effective solutions to your health insurance needs.

Hayes Brokers offers a wide range of health insurance, dental and vision plans from many different insurance companies, as well as access to the ACA exchanges. Contact our office today to discuss your needs and find the plan that is right for you and your family.


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