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High healthcare costs and what you can do to combat them

by Kristy Naylor RN And Marcy Kleinjan RN
| October 26, 2022 12:00 AM

We finished up September discussing the rising cost of caring for our elderly population and some alternatives for keeping them at home longer with better outcomes. This month our focus will be traditional health insurance plans, hidden out of pocket costs and the benefits of continued self advocacy and exploration of a few options that can save you some of your well earned cash.

I’ve personally spent more than $121,000 over last 15 years in health insurance premiums for me and my family-not including the two times (only) that we actually met the deductible of over $6000. Then add in max out of pocket or co-insurance of $10,000 plus what you spend on prescriptions, co-pays, and non-covered items. The cost is staggering. And it starts over every year! Personally, I don’t want to pay for someone else’s heart surgery or some CEO’s Maserati or vacation home in the French Riviera. It makes me angry, especially if myself or my loved ones need the care. Here’s the thing, a lot of folks that have traditional health care plans probably don’t know what their deductible is or what their max out of pocket is, or even what those terms mean.

“Healthcare-related costs cause a bankruptcy every 30 seconds. Around 530,000 families file for bankruptcy per year due to medical expenses. 41% of working-age Americans have issues paying medical bills. 39% of those who have issues with medical bill payments already have employer insurance. Here are some of the most common actions taken by Americans with medical debt: 70% of those with medical debt say they had to cut spending on basic necessities. 59% say they had to dig into their savings, using most, or all of it. 41% say they took a second job. 37% say they had to borrow money.” (divinitygroupllc.com) The “Big 4” causing the most financial impact are accidents, cancer, heart attack/strokes, and intensive care.

The national average cost of a knee replacement in 2018 was $35,000. A heart valve replacement $170,000. A recent local appendectomy with no overnight hospitalization and less than 4 hours in hospital from start to finish nearly $22,000. Out of work for a minimum of 2-4 weeks or more depending on the related diagnosis/illness with 2-3 weeks of paid time off if you’re lucky. Discharged home with minimal teaching or follow up to see if you actually retained any of that teaching. Plus the cost of lost wages, time, child care, and bills happen and need paid while you are recovering. The system is broken and consumers are suffering. We’re nurses & we don’t like suffering.

So what to do about it: Alternatives

Direct Primary Care - $70-$140/month. What does that include? Depends on your needs, shop around, there’s plenty to choose from and great providers here in the valley.

Accident/Cancer Plans - Divinity Group LLC, Jon Devine, call him! 406-381-3328. Very affordable plans to get the“Big 4” as mentioned above covered for around $50/month per policy and a return of premium savings feature. Super cool!

Cost Sharing and Catastrophic plans - $115+/month, for ER and unexpected hospitalizations. Some company names being Zion, One Share, MPB Health, and NetWell just to name a few.

For around $385/month you can get better care/coverage and be more financially secure as well. Over that 15 year timeframe that we started with, that’s nearly $52,000 saved. Pretty impressive.