I’ve written a number of times about my experiences with individuals, families, and small businesses, but the most difficult experiences are those in which the out-of-pocket costs have escalated well beyond what only few families can afford. There are many that say this can’t happen, not in America. But, I’m here to share that I see it all too often these days.
What I now see is that a household must have a new set of resources – nothing like those of the past. Having an insurance company, an agent, and a great employer just doesn’t cut it today.
Below are a few steps for any single person, business owner, or family. I’ve included many of these resources on the Indigo Partners website to assist you in your journey. Ultimately, I hope that Indigo becomes your dashboard for alternative benefits administration.
Step 1. Get an independent Insurance Evaluation.
The reality is that we have traditionally accepted insurance recommendations from our independent agent or HR manager hired by our employer, and that used to be good enough. But today, the market has fractured in a serious way. There are the “have’s” with generous (and expensive) benefit plans, the “have a little” that try to reach into the best plan the budget can afford, and the “have not’s” that are accepting some kind of safety net plan or no coverage at all. Each person and family circumstance is very different, and the qualifications are becoming more complex.
You may be over-insured and paying more than you need to for premiums, or you may be under-insured and paying more than you need to for prescriptions or healthcare costs. It’s a difficult equation that really changes as you progress in life. Many people purchase plans with low deductibles for “just in case” but are giving money to the insurance company each year. Other people unknowingly purchase plans with limited networks and are unable to find providers in their area.
Step 2. Get your Apps on!
Every family needs its trusted Apps. Telehealth is here to stay, and it’s a VERY GOOD OPTION for many health conditions. But, when you most need it, you or a family member become very stressed. Using telehealth is like riding a bike: you never forget how to ride a bike, but only if you have learned to ride it in the first place!
So, take the time to study your Telehealth options. You will find there are a surprising number of options available, but you have to look at Telehealth like you once looked at urgent care and primary care physicians and specialists. When you walk into an urgent care clinic, it’s a roll of the dice for who you get. If you schedule with your physician, you are often sent to a specialist you don’t know. Telehealth is no different. You must get to know the service and be able to find ways to communicate your needs effectively.
Step 3. Hire a Health Advocate.
Regardless of your health situation or knowledge level, the healthcare system is a confusing place. There are more and more stories of people being billed for services they never received. The fact is that most of us are intimidated by challenging an invoice.
Let’s face it: we inherently know that we need these people, and most of them have no idea what their billing office is doing. Still, having an adversarial feeling about the care you receive will not be healthy. In the past, your agent would have played this role for you, and when commissions were more generous from the insurance companies, agents felt as if it was their responsibility. Technology and the internet have displaced this service.
You need an advocate! Just like Telehealth, advocates come with various skills. Take the time to get to know a few and understand what they can offer. Be willing to engage them to do a few ‘small jobs’ for you, and experience the effectiveness of their service. Believe me, you will be glad you did if/when a crisis hits in your life. Whether it’s you or a loved one, it all becomes incredibly overwhelming.
If you’re interested, Indigo Partners can guide you through your options.
Posted in Add-On Benefits
