When you have insurance, and still acquire medical debt?

Once a year we are reminded of the importance of having health coverage during the open enrollment season. It is during this time that we are reminded that having some coverage is better than having no coverage. This past open enrollment was the most successful open enrollment of all time, breaking records with millions signing up on the marketplace, yet why is it that one quarter of Americans owe $10,000 or more of medical debt, even though half of them have medical coverage that is intended to minimize excessive health-care costs.

Medical debt is so common in our country that we have become almost numb to receiving the constant bombardment of calls from bill collectors, and mailbox letters, reminding us of the dreaded debt that looms in the back of our minds. Recently a survey reported that the 3 most common reasons for medical debt in order are: emergency room visits, Covid-19 treatment, and mental health. The top of this dreaded list is emergency room visits, which has affected a whooping 46% of respondents. It is also one debt we have all either had to deal with ourselves, or know someone that has dealt with. Let us not forget that all three are the cause of serious debt for a majority of Americans, which in turn become avoided and cause serious hardship down the road. 

To put into perspective the impact of medical debt, and how it affects the consumer, more than half of the total people surveyed say that medical debt has prevented them from reaching financial goals of buying a house, or saving for retirement.

Even with health insurance, why is it that so many Americans are taking on medical debt? The answer is having health insurance does not make much difference on the consumer taking on medical debt, but it does cap how much debt you will owe. The reason for such medical debt can be attributed to the most widely used word in the insurance industry, the deductible. The survey finds that people with health insurance are susceptible to taking on debt, and the cause is what you have to pay out of pocket unexpectedly . 

The deductible, which in most cases is set high with a low premium, is a set dollar amount the consumer will pay out of pocket before the insurance will pay any benefits. The most common reason why consumers choose high deductible plans has all to do with low premium cost. This does come at a cost for the consumer, because high deductible low premium plan policy holders are less likely to seek out primary or preventative care due to high out of pocket cost upfront. This means when accidents do happen, and the consumer is expected to pay the full yearly deductible amount, they quickly find themselves in the doomed world of medical debt, so what is the solution? The answer is ADVOCACY! 

Benefits Management Team (BMT) has been speaking to clients about advocacy for 3 years now. We can admit that the concept is hard to wrap your head around at first, mostly because we have been trained to deal with our healthcare in a process which has only led to inflated prices, and overcharging. What if there was a better way you ask? Well the solution to these common problems with healthcare is having your own healthcare advocate. 

The main goal of advocacy is educating the consumer about how their policy actually works, but this is just one layer, because what's important is getting quality healthcare too. The benefits of advocacy can help you deal with:

• Shopping for the lowest costing provider for a needed service or procedure (eliminate "gauge pricing" and "surprise medical bills")
• Bill negotiation for medical bills that were unexpected or unavoidable 
• Claims submission and follow up with your health insurer to ensure you're receiving all the benefits you're entitled to. 
• Rx discount on "everyday" prescriptions, and the lowest cost on Brand Name drugs (typically an 80-90% savings) that don't have a generic available. 
• Review of your current health insurance benefits and ensure that you're covered with the best option available. 
• Offer expert general advice on how to have your healthcare delivered to you at the highest quality and best, and fairest, price!
• And so much more…

Now don't get us wrong having insurance, and capping medical debt is a good thing, but let's face it if you don't know how to use your insurance, chances are you are gonna hate it. Having an advocate is just putting another piece to the puzzle that is our healthcare system, but a piece that works for you, has your interest in mind, and not that of the insurance company. Having an expert help you navigate the complicated world of healthcare is a step most consumers are not accustomed to having, but one that MediShield can offer you. Let us show you how to shop smarter for healthcare, and teach you how to become a consumer of healthcare, and not a victim.

Contact us to learn how!