It costs $11,480 a year for an employer to provide family health-care coverage, on average, to an employee, a jump of nearly 8 percent in the past year, and there’s no end in sight.
Even though the average employee now pays nearly $3,000 of the coverage bill, according to a survey by the Kaiser Family Foundation, you have little control over your employer going from one health plan to another, usually with resulting higher deductibles or increased co-pays.
Best health advice
The bottom line, says an industry observer, is that employees need to take care of both their health and health insurance needs. Staying away from alcohol, tobacco, and drugs while watching their weight and getting regular exercise is important, he says. They also have to be sure to take advantage of preventive care that’s offered them.
“Regardless of age or level of wealth, no one is immune from the devastating effects of spiraling health-care costs,” says Thomas Hines, senior vice president of the Northern Trust Financial Planning Group, which conducted a survey of 1,312 million-aire investors. It was surprising to learn that “affluent individuals and families are feeling the pinch along with everyone else,” Hines says.
There is some relief. Employees can contribute more to their health-savings accounts this year, up to $2,850 for self-only coverage or $5,650 for family coverage in pre-tax dollars. Employers can contribute, too, in varying amounts to the HSA that grows tax-deferred until it is used to pay deductibles and other medical costs not covered under a high-deductible health-insurance policy.
But the best “policy” may be to avoid having health issues.
Rhonda Clark, coordinator of the cardiac rehabilitation clinic at the Carroll County Hospital in Carrollton, offers a tidy 1-2-3 regimen for a healthier heart and longer lifespan.
“Quit smoking, watch your weight, and walk, walk, walk,” says the 40-something mother of three who has been involved in various aspects of cardiac care for 15 years. She follows her own advice, working with her two horses and cultivating roses at the Eminence property she shares with husband Stanley.
Comparing health plans
While most people strive to stay well, it’s risky to be without some type of insurance as universal health coverage remains a political football. Most employers offer at least limited coverage, so it behooves the self-employed and others to seek private health plans.
To compare the true costs of health plans, Money magazine says to add together total premiums for the year, estimated co-payments based on how often you went to the doctor last year, cost of services that are partially covered, cost of services that aren’t covered, plus cost of co-pays for prescriptions you take regularly.
Don’t shop for price alone, though. At least once a year, it’s a good idea to check on your carrier’s financial strength since that can change quickly; several companies that had financial problems in recent years often quoted “aggressive” (a euphemism for “super low”) rates.
In comparing plans, Money suggests you call and ask how sick you’d have to be to get a visit to the Mayo Clinic. If advisable, you may wish to purchase a major medical policy, which will help cover medical expenses over and above your regular plan. Because the coverage of your basic plan is, in effect, the “deductible” on any claim, major medical insurance is quite reasonably priced.
The National Committee for Quality Assurance, a nonprofit agency, issues report cards on insurers, based on access to care, quality of service, preventive programs, and more. A.M. Best and Weiss rate an insurer’s financial strength, while the Insurance Information Institute has helpful details on how to choose an
insurer. In addition, the Kentucky Insurance Department has information on a company’s financial health and its compliance with state laws. See below for more information on these groups.
HEALTH INSURANCE RESOURCES
There’s plenty of help available in getting health insurance or analyzing health insurers:
Kentucky Department of Insurance, Frankfort:
or phone (800) 595-6053
National Committee for Quality Assurance: www.ncqa.org
Insurance Information Institute: