Health insurance can be a wonderful thing for someone who is not ill, working and is financially stable. However, when people become chronically ill or disabled due to a disease or illness, having health insurance can work against them. As a result, there are many different pros and cons to consider when reviewing health insurance plans.
Many people that work for an employer have the main cost of their health insurance paid by the employer. If you become ill and are temporarily or permanently disabled you may be offered COBRA insurance, which allows you to pay the main cost of your insurance. However, you also has a loss of income at this time and are less likely to be able to afford this cost on a long-term basis. In addition, if you own a business you might not have access to health insurance at all because you cannot afford it. According to the Health Insurance Info website, these policies can cost significantly more than group policies and can be more difficult to obtain because they frequently depend on you undergoing a health evaluation.
Co pays for medications, physician visits and testing are affordable for many people. It is a wonderful feeling to be able to go to the local pharmacy and pick up an expensive medication for a fraction of the cost. It is equally wonderful to be able to go to a physician and afford to pay for your treatment through a co-pay. However, if you are low-income or unemployed, co-pays can be a nightmare. Imagine having a low income and trying to afford medications that are $15 to $40 a piece. If you need several different prescriptions each month, this can quickly add up. Although having health insurance is helpful, it may be somewhat useless if you are in this situation.
When you get health insurance it is assumed that you will have coverage for most everything that you may need. Most of the time, services are readily covered by health insurance companies and you are able to recover from your illness or injury. However, today many insurance companies have moved into the field of case management of their clients. With this case management, less and less coverage of medical procedures and services are being allowed. For example, some insurance companies have put a cap on how many therapy treatments you can have. According to the website for Cigna insurance, speech therapy has a maximum allowable benefit for speech therapy in any kind of setting. This means that if you have a stroke and need rehabilitation--whether it be in a rehab facility, home care or outpatient care--the number of visits are taken out of the same pot. In the end, this can drastically reduce the amount of therapy you receive.
- Health Insurance Info; Pros and Cons of Group Health Insurance; 2009;
- Medicaid.gov. "Eligibility." Accessed Dec. 10, 2019.
- U.S. Office of Personnel Management (OPM). "Fast Facts: High Deductible Health Plans." Accessed Dec. 10, 2019.
- U.S. Department of Labor (DOL). "FAQs on COBRA Continuation Health Coverage." Accessed Dec. 10, 2019.
- U.S. Department of Labor (DOL). "Workers' Compensation." Accessed Dec. 10, 2019.
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- U.S. Department of Health and Human Services. "Pre-Existing Conditions," Accessed Dec. 6, 2019.
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- U.S. Department of Health and Human Services. "Short-term Health Insurance Plans are an Affordable Option." Accessed Dec. 10, 2019.
- Cigna. "What Is Short Term Health Insurance?" Accessed Dec. 10, 2019.
- U.S. Department of Labor (DOL). "About Association Health Plans." Accessed Dec. 10, 2019.
- National Association of Insurance Commissioners. "Consumer Alert: Not All Health Plans Are the Same, Know What You're Signing Up For." Accessed Dec. 10, 2019.
- The Commonwealth Fund. "Health Care Sharing Ministries: What Are the Risks to Consumers and Insurance Markets?" Accessed Dec. 10, 2019.
- National Association of Insurance Commissioners. "Consumer Alert From the NAIC: Be Careful When Purchasing a Discount Health Card." Accessed Dec. 10, 2019.
Kristie Jernigan is a health writer with over 17 years of experience as a medical social worker. She has worked mainly with the elderly population and with children. She holds a Bachelor of Science in psychology and early childhood from East Tennessee State University and a Master of Science in health care administration and gerontology from the University of Phoenix.