Jill R. Hyland

Solutions for Health Insurance Coverage

When it comes to health care, there is no "one size fits all."

Ideally, working for an employer who offers non-contributory health insurance is what most of us would aspire to. However, that is not a realistic scenario.

Finding affordable, adequate health care coverage is a huge problem in our country right now. If you are in a situation where you require certain medications and have no access to reduced rates on prescriptions you can almost bet the farm that you will be paying top dollar for the medications you need.

When considering a change in employment, scrutinizing the potential employers health care plan is a given. Sadly, many people look at everything about a new job except the health care plan. Contracting a debilitating illness or becoming an unwilling participant in an accident is not something that anyone can foresee.

Life situations change and a health care plan that was adequate for a single person may not apply should he/she marry and even have children while employed. If their policy has no provisions for the addition of dependents in the future you can find your health care woefully inadequate. Take the time to project what your future situation might be and plan accordingly.

One of the most overlooked segments of our society are the self-employed. Depending on age and dependent requirements, the cost for individual coverage can be astronomical.

If you are self-employed or a very small business owner, consider joining a local association like a chamber of commerce, better business bureau or some other type of business organization. Many of these organizations offer access to health care that might otherwise be prohibitive on an individual basis.

Unless you are in a category considered as "low income" that would afford you access to social health care, you can plan on paying hefty premiums. If you have a pre-existing condition, your chances of obtaining affordable rates are statistically very low. But, there are some things you can do.

Some tips to bear in mind are:

- Make certain you are looking at insurance that is appropriate and adequate for your needs.
- Read the fine print so you understand what is included and what is excluded.
- Never buy a policy that covers a single disease.
- Are there deductibles and if so, how much?
- Does the coverage include major medical?
- What is the maximum out of pocket expense you can expect to incur?
- When does coverage begin?
- Does the coverage include prescriptions?
- Are lab fees and x-rays included?
- Can you choose your own physician or select from a list of providers?
- What is most important to you?
- Does the coverage include dental, vision, maternity, well-baby care, etc.

If you are in that "no mans land" where you do not yet qualify for Medicare, Medicaid or any of the other social programs yet are too old for individual coverage you might take a look at AARP. It can provide a stop gap for that period of time while you are waiting to qualify for assistance.

If you are a young single parent, investigate any subsidized programs that might be available in your state. Many states have programs that will provide care for your children if not for yourself. These social programs are generally based on a sliding scale based on your income level and in many cases visits and prescriptions for your children might be free of charge.

Investigate non-insurance type programs. If you find yourself not able to pay the hefty monthly insurance premiums, can't get the coverage you need, or fall into areas that are not covered by traditional health insurance means, this type of program can literally save you thousands of dollars. This non-insurance solution gives members negotiated reduced fee schedules or discounts for medical, dental, prescriptions, hospitals, vision care, and more.

With the skyrocketing costs of health care, no one should ever feel embarrassed or sacrifice the health of themselves or their loved ones by applying for any type of assistance that might be available to meet their needs. Until something happens to curb this upward spiral we must all take special steps to see that the most vulnerable members of our society receive the health care they need... namely, our children and our elderly.

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