There’s never been a time in the United States where health care costs have been higher. According to the Centers for Medicare & Medicaid Services (CMS), in 2015, spending on medical costs accounted for $3.2 trillion – about 17.8 percent – of the country’s economy. And health care industry experts anticipate that this trend will continue. The CMS estimates that by 2025, our country will pay nearly $5.5 trillion for health care expenses – which will be almost 20 percent of the U.S. economy.
With medical costs on the rise, having health insurance to help pay for routine medical expenses and provide financial protection against unexpected emergencies, is a priority item in many household budgets. But as health care costs have increased, so have the prices of medical insurance, and more people are finding it difficult to pay for coverage. A Kaiser Family Foundation study reported that 46 percent of uninsured adults said that they had no coverage because the cost of health insurance was too expensive to afford.
Legislative issues are only exacerbating the health care market’s challenges. In the fall of 2017, after legislators in Washington failed to pass any significant reform to Obamacare, and the Trump administration cut subsidies to health insurance companies that help pay out-of-pocket costs for low-income consumers, more health insurance companies are expected to leave the marketplace exchanges, and premiums for the remaining exchange insurance plans are anticipated to soar.
Thankfully, health insurance alternatives, such as short term medical insurance, can provide you the coverage you need, at a price that accommodates even the most carefully-managed budgets. And there are new rules coming that make these insurance plans even better for consumers.
What Is Short Term Health Insurance?
If you’re in search of affordable health insurance coverage, look no further than short term medical. As the name implies, this type of insurance provides benefits similar to coverage offered by marketplace exchange plans, for a designated period of time.
Short Term Health Insurance Benefits
Pivot Health offers short term health plans which provide the following benefits:
- Up to $1,000,000 in benefits per coverage period
- A range of deductible choices, from $1,000 to $10,000, plus choices for out-of-pocket maximum amounts, to meet your budget
- Affordable 20% coinsurance amount, and flexibility to choose copayment amounts
- Hospitalization, surgery and medical services coverage
- Physical therapy
- Mental health services
- Home health care and extended care facility
- On select plans, separate prescription drug benefits and copays on physician visits
One of the most valuable features of short term health insurance is that it costs significantly less than major medical plans purchased on or off the marketplace exchanges when needing coverage for a temporary amount of time.
Duration of Coverage
Short term medical plans are designed to provide coverage for up to 364-days in many states until you find a permanent health care coverage solution (state-specific rules apply).
Depending on your needs and state’s regulations, you may be able to apply for 90-day, 180-day and 364-days of coverage (plus Pivot Health’s four back-to-back short term health certificates at one time that can offer a more wallet-friendly option). Purchasing back-to-back certificates during your initial application keeps you qualified through the entire duration of your coverage.
You may even be able to extend your short term medical coverage, depending on your state of residence. That’s because after your initial certificates terms expire, many states also allow you to purchase up to two years of additional consecutive certificates.
Choosing when to start and end coverage is simple and convenient. Pick a coverage start date that works for you – anywhere from 24 hours up to 60 days after applying. You also may cancel your coverage at any time, with no penalty. To ensure you’re completely satisfied with your coverage, Pivot Health even offers a 10-day “free look” period. Should you purchase a plan and cancel within the first 10 days – and you haven’t filed any claims – you’ll receive a full refund of your purchase.
No Provider Network Restrictions
The freedom to visit any health care provider you want is a key advantage that short term medical insurance has over marketplace exchange plans. No provider networks mean you’re not limited to visiting providers designated by your insurance company, and you don’t have to be concerned that benefits will be paid differently for “in-network” providers than for “out-of-network” providers.
Pivot Health also offers several lower deductible, PPO network plans that include doctor’s office visit copays and some prescription drug coverage.
Valuable Non-Insurance Benefits
As an added bonus, when you purchase a short term health insurance plan from Pivot Health, you’ll receive valuable discounts on vision care services and products, as well as a prescription drug savings card for use at pharmacies nationwide. You even receive the ability to access 24/7 telemedicine consultations – an increasingly popular option for connecting with a doctor at your convenience.
What Are the True Costs of Going Uninsured?
Your health, your finances, your community…all are important to you. Without health insurance, you’re risking all these aspects of your life. And the risks are important to consider when deciding if you really can’t afford health insurance.
There’s no doubt that being uninsured risks your economic security. Experiencing a medical emergency that you need to pay for without health insurance could be financially devastating. Medical debt has been linked to housing instability, increased credit card debt and a higher risk of bankruptcy. It’s also important to realize that uninsured individuals don’t have the benefit of an insurance company to help negotiate health care costs, and bear disproportionately higher health costs than insured individuals.
In addition to paying for medical expenses, your finances also can be affected if health issues impact your earning potential. Uninsured workers, who may delay seeking medical treatment until their condition worsens, often miss more time from work when they are ill or injured, and due to poor health, may need to retire earlier than planned.
A report by the Institute of Medicine found that adults without health insurance have less access to effective clinical services, including preventive care. Understandably, many people without insurance feel that paying the entire cost out-of-pocket for a routine well-being visit, such as an annual preventive screening and immunizations appointment, is just too expensive.
However, postponing, or skipping these important medical checks can have a serious impact on your health. The report went on to state that when sick or injured, uninsured individuals “are more likely to suffer poorer health outcomes, greater limitations in quality of life, and premature death.” In fact, the statistics for poor health outcomes in uninsured individuals are staggering, for acute and sudden conditions, as well as for chronic diseases.
Uninsured hospital patients with acute conditions, such as heart attacks, strokes and respiratory failure, have a greater risk of dying while they are hospitalized and for two years after being discharged. Further, uninsured adults injured in accidents are not as likely to fully recover, and many more die because of their injury or report that their health declined after their accident, according to a study published in The Commonwealth Fund. For these patients, the cost of attending follow-up surgery or care visits during which issues or complications may be diagnosed, may be too expensive without health insurance to help share the expenses.
Without routine preventive care and screening visits, chronic conditions in uninsured people often remain undiagnosed until they are in the later stages. Uninsured individuals particularly risk suffering from diseases that are asymptomatic or produce only minor symptoms. Even when diagnosed, many people without insurance find they are unable to purchase prescription medications to effectively manage conditions such as diabetes, elevated cholesterol and high blood pressure. As a result, these medical conditions may become more advanced, impacting the individual’s quality of life.
Because many uninsured people delay seeking medical care until their medical situation becomes intolerable, even a serious illness such as cancer, may not be diagnosed until it is in a more advanced stage. One report showed that uninsured people are less likely to receive an early diagnosis or treatment of sexually transmitted diseases, which can lead to serious medical issues and even higher risk of contracting human immunodeficiency virus (HIV) . Without knowledge of their positive-HIV status, these individuals often don’t seek medical treatment until the disease has progressed and they begin to feel the symptoms.
Children who are uninsured also face significant health consequences. A 2017 Kaiser Family Foundation study found that 4 million children in the United States still have no health insurance. These children are less likely than insured children to receive essential immunizations and have access to a regular source of care. They are also at greater risk for hospitalizations due to avoidable medical conditions and miss more days of school because of health-related reasons. Overall, research indicates that health insurance not only provides children access to essential medical care, but also could had broader long-term positive effects on their health, education and financial success as adults.
All these statistics relate to the simple fact: being uninsured reduces your access to the medical care you need, and may have a serious impact on your health.
In addition to the personal risks related to being uninsured, there are even consequences for a community when it has a high population of residents without health insurance coverage. When uninsured individuals delay health care until they experience a medical emergency, it often costs more for the health care provider or facility to provide emergency medical care than it would have cost if the individual had received primary care to prevent or treat the condition or illness at an earlier stage.
Using emergency room services as a primary source of medical care can result in overcrowding and affect waiting times for all patients. The availability of care and service offered by hospitals also may be affected if a community has a high rate of uninsured residents. Over time, some hospitals may limit or eliminate unprofitable departments, such as emergency services, maternity care, substance abuse care and psychiatric emergency care. Losing these types of important services may negatively impact a community’s health overall.
Community health also may be impacted when uninsured children don’t receive all recommended vaccinations. Measles, mumps and whooping cough – diseases which may be prevented with a few routine childhood vaccinations – are once again on the rise in the U.S., as a result of children not being vaccinated.
Health Insurance – Protecting You, Your Family and Your Community
When you purchase health insurance, you receive access to the medical care you need, in turn helping reduce risks to your personal health and finances, as well as supporting your community. With options such as short term medical, you can buy the coverage you want, at a price that fits into your budget.