Of course, a lot of health insurance coverage sounds good, but what if you pay $50 more every month for coverage you never seem to use? With new coverage requirements coming out this year, and probably higher premiums, I thought this would be a good time for a reality check. Let’s see how coverage and costs work in real life. That’s always a good place to start when you’re trying to decide whether to keep or change your health insurance policy.
What can average premium prices tell us?
First, keep in mind that health insurance premiums vary depending on your age, your medical history, and the health care prices where you live. So, let’s just focus on averages and look at a large sampling from across the country.
This spring, a major company in the industry reviewed some 30,000 policies purchased by people in the majority of states. Based on those policies, we can get an idea of what adding coverage meant for premiums.
It turned out that the average premium was 47 percent more on both individual and family plans that covered eight benefits: annual exams for adults, baby developmental check-ups, chiropractic services, emergency services, imaging and lab work, maternity services, OB/GYN services and prescriptions.
Plans with fewer benefits were available for an average cost of $190 per month, while premiums for plans with all eight categories of benefits averaged $279. The difference is even more than $50 a month. It’s $89 monthly or $1,068 per year.
How much coverage will you need in 2014?
This October 1, you’ll be able to compare new options to your existing coverage. If your plan existed March 23, 2010, you have what’s known as a grandfathered plan. That just means it’s allowed to continue after health care reform became law and is exempt from some, but not all, new requirements.
Like newer plans, your policy cannot limit the dollar amount of coverage available over your lifetime. It cannot be cancelled due to an unintentional misrepresentation on the application. Grandfathered plans remain exempt from some things that are required of the newer plans.
The most popular new requirement is probably coverage for recommended preventive health care without having to meet an annual deductible or being subject to co-insurance or co-pays.
Remember that you don’t have to become an expert on health insurance this fall. We can help you compare policies offered through your state’s exchange, plans insurance companies don’t make available at the exchange and your existing grandfathered plan.