How do you use your health insurance?

BURR At one time or another everyone deals with the question of health insurance or the lack thereof. Much discussion regarding the affordability of health insurance and the

availability of coverage for those with pre-existing medical conditions has been thrust to the media forefront. Whatever the number of uninsured people you believe, the basis of the discussion comes down to this: "How does one spend their healthcare dollar?"

With new directives from Washington seeking to change the fundamentals of health insurance coverage, whether by a single payer health insurance system ("socialized medicine") or taxing employer health benefits, everyone will face additional difficulties when making financial decisions regarding healthcare. For employees with group benefits, health insurance coverage is available but often at a significant financial premium for both the employer and employee. Others who need health insurance but are self employed, or do not have access to a group policy, may find it more difficult to even find health insurance coverage let alone be able to afford it.

For those persons seeking health insurance coverage, there are individuals who either cannot afford a health insurance policy or have not been able to obtain an insurance policy for a variety of reasons.

I want to focus on those who can obtain health insurance or already have access to health insurance to discuss how those individuals use their healthcare dollars. Given the current state of the economy and that a mandate for individual health insurance has not been instituted, options for the use of our healthcare dollar need to be evaluated. Health insurance policies offered by an employer, or those that are available to individuals, need to address the current economic times. These policies need to allow the individual to maximize potential of their healthcare dollar.

Health savings accounts are a great way to essentially save money for use towards planned healthcare costs. Money saved in an HSA is a tax benefit and, for those who have a good idea of their annual health related costs, is a way for them to maximize their benefits by accounting for planned spending. These types of accounts commonly utilize higher deductibles, thereby reducing monthly premiums in most cases. Essentially, this puts control of the healthcare dollar where it needs to be — with the individual. The funds in these accounts can typically be spent on any health related expenditure, not just on seeing the doctor. Who better to determine how healthcare dollars are to be spent than the person using the benefits? The pitfall to some, but not all, of these plans is that if you do not spend the money in the account you may lose the funds.

For those with existing health insurance plans, you need to take a look at your plan benefits. There may be money savings in increasing your deductible (money that you pay for healthcare costs before the insurance plan would pay benefits), thereby decreasing your monthly premium. Deductibles can vary, but typically range from $250 to $5000. Depending on your overall health and utilization of your health insurance, you may even want to consider a catastrophic coverage plan that would pay in the event of a major medical condition or hospitalization. These types of plans are significantly more affordable and would give you the security of having health insurance in place in the event of major illness.

Another way to ensure your medical care is via private contracts with a physician or physician groups. It's a relatively new concept, but it follows what our parents and grandparents did when they were ill and needed a doctor, and this also works well with HSA's. Instead of paying for each visit, a contract for service is paid directly to the physician by the patient to cover most, if not all, of the doctor's care. This is typically paid in either monthly installments or annually and can cover the very basic care for a minimal fee, to full service Concierge Medicine. The latter of these guarantees immediate access to your physician. Concierge practices usually include lab tests and other diagnostic testing such as EKG's, with some including annual vaccinations and other services not typically covered by insurance. Although an incremental cost above typical health insurance, Concierge Medical clients gladly pay this extra cost for the knowledge that they have immediate access to their physician.

With careful planning and attention to the details of available plans, one may find that there are health insurance plans that both meet their needs and are affordable. Reviewing your current health insurance plan along with an analysis of your annual healthcare expenditures may allow you to reduce your monthly premium without sacrificing the coverage that you need.

— Dr. Burr is a Board Certified Internal Medicine Physician practicing Concierge Internal Medicine in Southwest Florida