I have received quite a few calls this year from single men complaining about the large increases in premiums they have received from their health insurance companies. Some have said the cost has jumped from the mid $100’s to over $200!
This is due to new federal and state requirements that insurance companies must include in their coverage. Here in Colorado the main reason is that starting January 1, 2011, all new policies have to cover maternity. All in-place plans (policies purchased previous to 2011) have to cover it after their anniversary date. AND, men and women have to be charged the same amount for a policy.
Previous to this, maternity was always an expensive “rider,” added to an individual plan. Additionally women were always charged a little more than men because of their more frequent use of wellness and the fact that insurance plans did cover “complications” to pregnancy, just not “normal” births.
The net result guys, is that you have received a double whammy. You are now paying the same premium prices as are your girlfriends and for maternity as well.
Take heart however, when you turn 50, she’ll be helping cover the cost of your Prostate exam.
If you’d like to know more about this development, check out this article
or give me a call at 303-541-9533 to see about some lower cost alternatives.
It doesn’t make sense, does it? Logic tells us that buying
in bulk is more cost-effective. So when you take the purchasing power of a
group of people, you would expect to negotiate a better premium price per
person for health insurance than that of an individual trying to purchase
coverage. But health insurance doesn’t work that way.
Group insurance is required to cover a wide range of
pre-existing conditions. The insurer of a group understands that,
statistically, a number of members will already suffer from ailments such as
heart disease, diabetes, and cancer, so they charge a premium that will cover
the treatment of these potential illnesses.
However, health insurance companies that cover individuals
can pick (and reject) whom they choose to cover.* Because individual health
insurance companies offer their plans to only the relatively healthy, premiums
can be substantially lower than group premiums.
It always comes down to the bottom line: health insurance
companies are just that—companies. Prices are set to not just cover costs, but
to ensure profits at the end of the year. But the silver lining is that every
health insurance company in the state of Colorado
is regulated by the Colorado Dept. of Regulatory Agencies, Dept. of Insurance.
For more information, you can visit their website or give me a call at 303-541-9533.
I’ll cut through all the jargon and get your questions answered quickly.
*With some exceptions: for example, during certain times of
the year, a child under the age of 19 cannot be denied coverage.
Unfortunately, premiums for individuals go up every year due to the fact you are a year older and thus more expensive to cover. Additionally, it increases for something called “medical inflation.” This is higher than the general inflation trends because medical inflation covers all the expensive new procedures and prescriptions that come on line each year. Your policy will cover most of these, but there is a cost associated with it.
In 2011 however, we are seeing some additional charges that have had to be added to your policy due to the passage last year of the federal Patient Protection and Affordable Care Act. Major changes are:
- No child under 19 may be denied for health coverage due to a pre-existing condition.
- There are no longer any annual or life-time limits on individual health insurance services.
- Children may remain on their parent’s plan until they are 26.
- There is no longer any “co-payments” associated with required wellness visits; they are covered at 100%.
- There are a whole list of additional tests and immunizations required to be covered at 100%, many of them age related.
The Department of Health and Humana Services will not allow health insurance companies to tell you that these new additions are increasing your premium, but simple logic will tell you this must be the case.
The big kicker here in Colorado is that all new policies now have to cover maternity. Since normal births cost $15,000 to $18,000, this has to have an additional big upward impact on premiums.
Insurance companies have had to figure how much these new requirements will affect their outlay for services. I believe some companies have overestimated how much these costs will be and have increased their premiums too much.
If you’d like to find out if your company’s latest increase is in line with the market, give me a call at 303-541-9533.