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Debunking the six myths about health insurance

Debunking the six myths about health insurance

10.6.2021

The problem isn’t just that buying health insurance is often complicated and even daunting. It’s also that there is a lot of confusing information out there, preventing folks from finding a real health plan that’s the right fit.

If you’re reading this quick guide, odds are you’re currently shopping for health insurance. Maybe it’s your first time and you’re unsure where to start and what to trust. Or maybe you’re thinking about switching your plan and finding a more wallet-friendly option. Regardless, we’re here to help simplify the shopping experience for you by cutting through the noise.

Below we’ve debunked the six major myths about health insurance. We hope this factual rundown can help you find a health plan that saves you money and, ideally, provides just the right amount of healthcare coverage, where and when you need it most. Here goes.

1. A health plan with a lower monthly premium is the most wallet-friendly option

In the short-term, this logic makes sense, but it’s not the smartest way to assess the value and cost-efficiency of a health plan. To make sure you get the most healthcare bang for your buck, evaluate health plans based on how much you’re going to pay over the course of the year when you add up premiums (your monthly payment to have insurance) and the costs you pay for medical services and drugs.

Even if two plans have the same premium, if one requires you to pay a lower cost for doctor visits and prescriptions, it could save you money in the long run. For example, some plans cover generic prescription drugs for free, which can save you hundreds of dollars annually compared with other plans with the same monthly premium.

Consider your healthcare needs for the whole year. This will help you select a plan that covers what you use most and avoid paying for extra plan perks.

2. I’m young and super healthy. Therefore, I don’t need health insurance, right?

So, you haven’t been to the doctor in years and don’t take any prescriptions. That means it’s smarter to just skip insurance altogether, right? Helpful Hint: it’s not smarter. Especially in the age of COVID-19. Moreover, there’s always the possibility of an emergency.

To give you an idea: at the average cost of a 3-day hospital stay is $10,000 and that’s before testing or surgery. You’re leaving yourself open to financial catastrophe without health insurance. A car accident or major unexpected illness can turn into bankruptcy in a matter of weeks.

Plus, there’s also a real psychological aspect to this. Every day you’ll need to worry about avoiding injury or illness—forget carefree skiing, travel, bike rides or commuting with germy passengers. That’s a heavy burden to bear, not to mention the cost of getting treated if you do crash or get sick.

Get a comprehensive ACA-compliant plan, or risk saving a dime to spend a dollar (or a few thousand)

3. All health plans are real health insurance

ACA-compliant coverage refers to health plans that offer benefits for a broad-range of healthcare services that meet the requirements established by the Affordable Care Act.

Major health insurance companies, like Friday Health Plans, offer ACA-compliant coverage. This coverage covers pre-existing conditions and guarantees access to essential health benefits like free annual wellness exams and preventive medications. There are also out-of-pocket maximums, which limits the amount you will spend in one year on medical expenses. Quality health insurance can save you from bankruptcy after a serious accident or illness.

And only ACA-compliant plans are required to cover COVID-19 testing and treatment at no cost to members. So make sure you’re buying the real thing when it comes to health insurance.

Buyer Beware: Health Care-Sharing Ministries (HCSM)

Health Care-Sharing Ministries are organizations in the United States in which health care costs are shared among members who have common ethical or religious beliefs. While HCSMs may offer affordable coverage, they do not offer real health insurance. They are not regulated by the Department of Insurance, and do not guarantee essential health benefits or coverage for pre-existing conditions and may have limitations on what they will cover. Which means they can deny you coverage or drop you off the plan if you get sick or hurt, or deny covering you for anything related to a past medical condition.

They often have fixed annual limits on how much they will pay, leaving you on the hook if you have a big hospital bill. They also do not have partnerships with doctors and hospitals, so you are on your own to negotiate healthcare costs. Many doctors and facilities do not accept these plans for this reason.

4. Health insurance is simply too darn expensive!

Certain health insurance plans can be super expensive, absolutely, but there are many wallet-friendly options out there, like a Bronze or Catastrophic Plan.

Are you under the age of 30 and healthy? Consider buying a Catastrophic Plan. With a lower premium and essential healthcare benefits, a Catastrophic Plan covers what you need most, protecting your wallet in case of an unexpected emergency. The difference between a Catastrophic Plan and, say, a Silver Plan, could amount to thousands of dollars over the course of the year.

But even if you don’t qualify for a Catastrophic Plan, you could score a subsidy to help pay your monthly premium.

See if you qualify for financial assistance

Financial aid for health insurance, otherwise known as a subsidy, is a type of federal financial assistance that can lower your monthly premium or reduce your out-of-pocket medical costs.

5. I’ll have to hit my deductible before my benefits even start

When you’re buying a health plan, it’s crucial to see what services are covered before your deductible kicks in. Often times, services like emergency room costs and in-patient stays won’t be covered until you reach your deductible.

However, with many plans, you can access great benefits and services before your deductible. At Friday Health Plans, for example, we offer plans that cover unlimited free primary care doctor visits, access to thousands of free generic drugs, unlimited $0 Teladoc appointments (including mental health visits), and preventive healthcare services, like dozens of vaccines and free birth control -- all before you even touch your deductible.

6. Buying a plan is way too complicated

It’s more complicated than it should be, for sure, but we’ve worked hard to simplify things. Please review our 2023 Plan Guide to see, at a high level, what plan might be the right fit for you. And if you ever have any questions, please reach out to our Friday Care Crew at questions@fridayhealthplans.com. Health insurance shopping can be tricky, and we’re here to help.