Medical Insurance 101: As a young adult – is it necessary?

The P-YA Conversation  

We are almost empty-nesters. Almost. The youngest has moved to the West Coast and the second may well be moving to the Upper Midwest or North West soon. Not to promote any political persuasion, but it has been nice keeping both boys on our insurance until the age of 26.

But, at some point, the birds leave the nest and they need to be prepared for the world. In prepping for the world, I have asked each of them about what they plan to do when they are sick in their respective new areas. I received the following reply, “I guess I will go to the ER.”

I try not to gasp and roll the eyes. Deep breath. Think fast. Respond slowly.

As a healthcare professional and a proponent of consumer accountability and cost containment, I was shocked at the response. We had not done our job of educating the kids on the health system – except to ask the question to get an idea of what they do know. Hmm. Not much knowledge. Much to do.

How does a parent translate the complexity of the healthcare system to a young adult who has never had to deal with health benefits? Always had mom and dad help with appointments, pay for co-pays, manage the deductibles and out of pockets, and of course, premiums? Have we been hover-parents and didn’t know it?

I honestly don’t remember my parents talking to me about medical insurance. My first job provided healthcare benefits back in the days before PPOs, EPOs, HMOs, HSAs and goodness, what other acronym can we create to make the learning more difficult but perhaps the care more affordable??

So here’s how the Parent – Young Adult conversation can go:

YA: I never get sick.

P: Yes, you are right. Young adults are relatively healthy. Your greatest risk is an accident.

YA: I drive safely.

P: You are involved with other activities that could involve accidents. Example: bicycle riding or hunting. It may not your fault. It could be the person you are with.

YA: I am careful. My friends are careful. It won’t happen to me.

P: I feel comfortable that you are as careful as you can be. But things happen. If you fall off your bike and injure your leg, just an ER visit to x-ray your leg, have a doctor evaluate you, give you some antibiotics and painkillers could be as high as $5000. Do you have $5000 in your bank account?

YA: No.

P: How would you pay for the bill?

YA: I can’t right now. I guess I could ask you for help.

(Try not to gasp and roll the eyes. Deep breath. Think fast. Respond slowly.)

P: What do you think will happen between you and the ER facility?

YA: I guess I will receive a bill.

P: Yes, and more than likely for the total amount. How will you pay the bill?

YA: I’ll try to pay it. Is it like a credit card?

P: Sort of. But it will take a long time to pay off $5000 on your salary.

YA: I guess I have never thought about.

P: Well, we really haven’t had a need to talk about it but I guess we do now. Insurance is created to provide some protection against the risk of an accident or illness that could financially deplete you. With insurance, although you pay monthly premiums, in most cases you won’t receive a bill for the total. It depends on what product you purchase. Given that with your first job you are making around $25K and it does not offer you healthcare insurance, basic healthcare insurance is an investment in your financial and health future.  We can look at your budget, look at the different insurance options, and choose one that is good fit for your needs and budget. Healthcare insurance should be a line item just like your cell phone bill and groceries. The good news is you are young and healthy and the premiums can be affordable. First, let’s look at some basic insurance language that will help better understand the products.  

Coming Next:

Truisms of Young Adult Healthcare Insurance

Medical insurance dictionary

What medical insurance options are available for young adults?

Woohoo! I have my first job with benefits. What does that mean and now what to I do?

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