consider the following: an intelligent, factual, method for lowering your monthly major medical...
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Consider the following: An intelligent, factual, method for
lowering your monthly major medical premiums
Consider the following: An intelligent, factual, method for
lowering your monthly major medical premiums
• In 2009, the average family’s health insurance premium was $13,375. (Kaiser Family Foundation)
• The average American family spends less than $2,500 per year in out of pocket medical expenses. • The average American household with a $2,000 major medical
deductible rarely meets their deductible.• This results in health insurance premiums that are far too expensive
for the amount of benefits that are actually used.
• In 2009, the average family’s health insurance premium was $13,375. (Kaiser Family Foundation)
• The average American family spends less than $2,500 per year in out of pocket medical expenses. • The average American household with a $2,000 major medical
deductible rarely meets their deductible.• This results in health insurance premiums that are far too expensive
for the amount of benefits that are actually used.
Are your Health insurance premiums too high?
Are your Health insurance premiums too high?
Accidents
If a medical claim is due to an accident –
Use the “accident plan” to cover your
annual deductibles & co-insurance ... with only a $100 deductible.
65% of all healthcare claims are due to accidents
1. Include an accident plan to compliment your health insurance plan.
Critical Illness Protection
Reality:• *Every 26 seconds…Someone in the U.S. will suffer from a coronary
event, and about every minute, someone will die from one -1• *Every 24 seconds…Someone in the U.S. is diagnosed with cancer -2• *Every 40 seconds…Someone in the U.S. is having a stroke -1• Cancer deaths are declining --about 1% each year since 1999-- due to
increased prevention efforts, earlier detection, and improved therapies -3
Possible uses:
Pay the deductible and co-insurance on your health insurance• Your mortgage, auto loan or credit card payments • Keep your business running• Expenses for your and your family’s travel/lodging while you’re seeking
medical treatment outside of your community• Expenses for child and nursing care• Freedom to choose your health providers • Freedom to have your spouse by your side• Freedom from worry about your bills and your mortgage• Freedom to take extra time off from work while you get back on your feet
1. Heart Disease and Stroke Statistics – 2008 Update, American Heart Association2. Cancer Facts and Figures, American Cancer Society, 20063. New York Presbyterian Hospital http://www.nypcancerprevention.com/issue/5/con/features/cancer-surpasses-heart-di.shtml68% of each dollar spent on healthcare
goes to treatment of a critical illness
2. Include critical illness coverage in your health insurance program.
Total Medical Insurance ProgramMAJOR MEDICAL - ACCIDENT - CRITICAL ILLNESS
MALE 40 / FEMALE 37 / 2 CHILDREN - $10K ACCIDENT & CRITICAL ILLNESS BENEFIT
EXAMPLE # 1MAJOR MEDICAL PLAN ONLY
$25 CO-PAY
Deductible ………….. $1,000Office Visit (Co-pay) $25.00
Total Premium: $965.00
EXAMPLE # 2MAJOR MEDICAL PLAN
Accident/Critical Illness Combo$25 CO-PAY
Deductible ………….. $5,000Office Visit (Co-pay) $25.00
Medical Prem. $580.00Accident plan $59.95Critical Illness $48.00
Total Premium: $687.95
EXAMPLE # 3MAJOR MEDICAL PLAN
With Accident/ Critical Illness ComboHigh Deductible
(No Office Visit Co-Pay)Deductible $5,000Office Visit $0
Medical Prem. $398.00Accident Plan $59.95Critical Illness $48.00
Total Premium: $505.95
TOTAL$821
Total Savings for Example # 2: $277.05/mo. = $3,324.60/ yr.
Total Savings for Example # 3: $495.05/mo. = $5,940.60/yr.
Including an Accident and Critical Illness policy with a higher deductible major medical policy creates a combined benefit plan that will greatly reduce your
monthly medical insurance premium. In the event of an accident or critical illness, both the
Accident and Critical Illness policy’s benefits can be used to pay the higher deductible on your Major Medical plan. The Critical Illness plan may also provide funds to cover any additional out-of-pocket
expenses or lost income that may result from a serious illness.
“The True Cost of a Co-Pay”Major Medical Insurance
(MALE 40 / FEMALE 37 / 2 CHILDREN - $10K ACCIDENT & CRITICAL ILLNESS BENEFIT)
MAJOR MEDICAL PLAN $25 CO-PAY
Deductible ………….. $5,000Office Visit Co-pay …. $25.00
Monthly Premium: $580.00
Annually: $6,960
MAJOR MEDICAL PLAN (No Office Visit C-Pay)
Deductible …………... $5,000Office Visit Co-Pay …. $0.00
Monthly Premium: $398.00
Annually: $4,776
$6,960 - $4,776 = $2,184.00
1. Savings by purchasing $0 co-pay plan: $182.00 /mo. = $2,184.00 /yr.
2. Average “retail price” for doctor’s office visit: $120.00
3. Average PPO discounted price for doctor’s office visit without co-pay: $80.00
4. Number of family office visits required to justify the additional premium:$2,184 ÷ $80.00 = 27.3 Office Visits
5. Number of office visits actually used per year: (Example) – 10$25.00 x’s 10 visits = $250.00
6. “True Cost” of the co-pay feature: $2,184 + $250.00 = $2,344.00 /yr.
7. Actual “true out of pocket cost” for each office visit = $234.40 ea.
“ Complete Your Healthcare Program”
Enjoy the lower premiums that choosing a higher Major Medical Deductible provides, yet maintain low out-of-pocket exposure by including an Accident and Critical Illness policy to
your “total health insurance program”.
“ Complete Your Healthcare Program”
Enjoy the lower premiums that choosing a higher Major Medical Deductible provides, yet maintain low out-of-pocket exposure by including an Accident and Critical Illness policy to
your “total health insurance program”.
Total Major Medical Plan
Medical with co-pays $ __________HSA or no co-pays $ __________
Annual Deductible …… $5,000
Personal Accident Plan$ 10,000 per accident
($100 Deductible)
Premium: $ ________
Personal Accident Plan$ 10,000 per accident
($100 Deductible)
Premium: $ ________
Critical Illness PolicyAvailable Funds:
$ 10,000 Lump Sum (ea.)
Premium: $ ________
Critical Illness PolicyAvailable Funds:
$ 10,000 Lump Sum (ea.)
Premium: $ ________
Total Medical Ins. Program
Total Monthly Premium:
$ __________