“Truisms” of Young Adult Healthcare

As I worked with my stepson on obtaining insurance quotes, I thought it would be a bit easier.  As a healthcare professional with many years of experience, I intuitively knew what he needed but I found myself grasping for words and analogies to interpret the concept of “out of pocket”, “co-insurance” and other necessary insurance terms to understand pricing and select the right product. I found all the sites we reviewed for quotes had excellent descriptions but could still be overwhelming without an initial conversation or dare I say, learning session, hopefully with a parent or guardian. I did my best, still stumbled, but we got through it and purchased a good product that met his needs at the time.

The “Truisms” of Young Adult Individual Healthcare Insurance (as of 2012)

Some geographical areas offer short-term medical coverage (less than six months) and ongoing medical coverage (greater than six months.)

Similar to auto insurance, you will pay a monthly premium. The premium amount may be based on your gender, age, height, weight, smoker status and at this point, pre-existing serious conditions.

Healthy, young adults generally pay less than older adults.

Costs may vary based on how much you want to pay out of pocket beyond the monthly premium throughout the year.

Costs may vary based on if you want:

1)      Basic coverage to cover you for inpatient hospitalizations and outpatient surgery in case of a major accident or serious illness

or

2)      Comprehensive coverage to cover you for doctor visits, prescriptions and preventative care.

There are many plans to choose from with variations on coverage, deductibles and out of pocket.

Generally, high deductible plans have lower monthly premiums. You are basically betting you will not need to use the insurance but you have it if you need it.

Low deductible plans have higher monthly premiums because you are basically paying more up front for the coverage. These plans are available if you have a greater need to go to a specialist or frequent a primary care physician, need preventative care, tend to have more frequent prescription needs, etc.

As you work through the plans, you will need to consider how and where you can get the extra money for out of pocket and deductibles should you become ill and use the insurance.

As a young adult working through this process, think about your medical history:

  • Over the last year, do you feel you have been relatively healthy as compared to your peers?
  • How frequently have you gone to the doctor in the past two years?
  • Have you parted with your tonsils and appendix?
  • Do you stay current with annual immunizations through other resources such as pharmacies and convenient care clinics?
  • Do you have frequent upper respiratory or stomach infections or skin conditions requiring treatment?
  • Do you participate in higher-risk recreational activities such as skiing?
  • Do you plan to travel outside the country?
  • Are you frequently around people who may be sick or are contagious with illnesses that generally need formal medical treatment?

Next! Medical Insurance Dictionary

2 thoughts on ““Truisms” of Young Adult Healthcare

  1. When you are finishing up with college and headed out into the world, there several things you feel like you know already. #1 You know you are flat broke and more than likely that first job isn’t going to be the cash cow you thought it would be with a college degree. #2 To make sure you’re able to continue to have all the fun times (if not more frequent fun times than) you had in college, you decide to attempt to cut out all expenses that seem unnecessary. You know gas gets you back and forth to work so you make room in your budget for that. You know you have to eat at some point, allot some of the budget for groceries and probably an equal amount for going out. Cable TV is nice but not necessary. All you need is a cell phone to communicate and the internet to watch television, communicate, and do grown up stuff. After those budgeted items, the rest is just tossed into the cash to burn pile. When people ask you about health insurance, (from the perspective of a young adult male age 24) we say we don’t need it. We feel like we stay away from seriously life threatening diseases and that everything else will usually heal or go away on it’s own. We also say that we don’t want an extra $100+ per month coming out of our paycheck going to some company as a “just in case I get sick”. We say we’d rather take the money ourselves and put it away for one of those rainy days, but in reality, it enters the same cash to burn process and goes out the window (for most of us). You are incredibly lucky to have had the years of healthcare experience to be able to explain it. And you are a great parent for passing on what you knew to your son. I think the young people of the US would benefit tremendously from a class before we graduate called “The True Costs of Healthcare” to look at the different types of coverage, their costs, and what it actually costs with or without insurance to visit an ER versus your Primary Care Physician on a routine visit. I know that when I graduated, preventitive care seemed pointless to me. Only sick people needed something to prevent them from getting sicker, I thought. One adenotonsilectomy later and I understand what waiting till the last second or an emergency when you are uninsured can cost.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s