Individuals without Health Insurance Have Some Options

By Vicki Pounders

Individuals without employer-based health insurance have other options available

But it's not as simple as just picking one. Experts say that a plan that works best for a single person might not be ideal for a couple with children or a recent college graduate who expects to find a job in a few months.

"Consumers should talk to a local insurance broker, or they could go online to a site like ehealthinsurance.com," said Ellen Laden, director of public relations for Golden Rule Insurance.

While some people are capable of doing the research and choosing a plan online, Laden suggests that people with several dependents talk with a broker in person.

"With a broker, they can talk about what their needs are, what their particular circumstance is and determine what's the best solution for them. You really need to talk to someone or do your homework."

One option is the health savings account. Laden said they're not for everyone but can work well for some.

There are two parts to health savings accounts: a high-deductible health plan and a tax-advantaged savings account. The idea is to take the money you save on premiums and put it into a savings account that can be used for deductibles, vision and dental care, long-term health-care plans and more.

Laden used the example of a self-employed person, age 28 to 30.

"You work for yourself and you have to buy your own insurance," she said. "You get an HSA and you choose the $1,050 deductible. Let's say your insurance is $100 a month. Let's say your bill is $20,000. You have a $1,050 deductible. It's the second week of January and you haven't saved anything in your HSA."

In that case, the HSA-holder would have to pay the $1,050 deductible, which can then be deducted on the income tax return. The rest of the expenses for the year would be covered with no co-pay.

"Let's say you have one of those wonderful co-payment plans and a $500 deductible," Laden said. "You pay $500, but you also have to pay 20 percent of that $20,000. Right then and there, you're out of pocket $4,500."

Laden said almost 40 percent of Golden Rule's Alabama customers are HSA-users. Some 34 percent of those were uninsured when they signed on to the HSA/high-deductible medical plan.

Blue Cross Blue Shield of Alabama spokesman Jim Brown said the company has found that most of those using HSAs are large employers.

"We've got about 50,000 accounts," he said. "Health savings accounts are good for saving, and if you really know what you're doing in terms of managing those dollars. It's still sort of lukewarm on whether they're going to be effective. People really need to manage their affairs to use them."

One option that BCBS is offering is a special open enrollment for those without insurance. BCBS offers a few different plans for those who don't have insurance through an employer. The enrollment continues through November and allows individuals under 65 who aren't covered by other insurance to purchase a group plan.

The company also offers Individual Blue, a plan for individuals and families, and Blue Link, designed for those needing short-term coverage.

"Blue Link is a plan that's really for people who are between jobs or the 22-year-old who just finishes college and is coming off their parents' insurance. They don't have another place to go. This is a bridge policy, typically for six months."

These plans might offer a more affordable option than something like COBRA, a government-based plan that allows certain individuals to keep employer-based insurance. With COBRA, however, the insured has to pay the entire cost of the plan -- the employer may have been footing the bill for as much of 70 percent of that -- plus 2 percent.

"All employers are not in the COBRA-required pool," Brown said.

Laden noted that companies like Golden Rule, of which United HealthCare is an affiliate, offer plans that will cover big medical expenses like hospital stays, testing, etc., but not individual doctor visits or prescription drugs.

"Those kinds of plans, for example, you can get for less than $50 a month," Laden said.

The key, she said, is that one can't afford to be without some type of coverage, even if it's a simple plan to cover the more expensive medical things.

"No one wants to be in an emergency room without health insurance," she said. "Even worse is someone who is sitting at home when they're so ill they need to be in a hospital, but they think they can't afford to go."

Brown said Blue Cross Blue Shield is finding that insurance just isn't a priority for many. "For a variety of reasons, they simply choose not to have it."

Being without it is risky. Laden stressed that most medical expenses aren't planned. An accident or sudden illness can be expensive for those without any coverage.

"There is affordable health insurance," she said. "What you want to do is make sure you are covered for those costly expenses that could put you and your family into bankruptcy."

Vicki Pounders can be reached at 740-5743 or vicki.pounders@timesdaily.com.

sourceL www.timesdaily.com

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