Most consumers think of health insurance as one big package (that somebody else should pay for) that is designed to take care of all of their healthcare needs. In fact, most Americans make this mistake until they get sick and discover just how inadequate their benefits really are.
An insurance policy is simply a type of contract. You, the consumer, agree to pay an insurer a particular amount in exchange for which the insurer agrees to compensate you for particular expenses you incur in connection with certain health problems.
 |
| Long Term Disability Insurance Multiple Sclerosis |
In that sense, health insurance can be thought of as a form of casualty insurance. Like other forms of casualty insurance, you need to pay attention to the types of problems that are covered, under what circumstances, and what exactly the insurer has agreed to pay when the casualty occurs.
The purpose of health insurance is to protect you and your family against the potentially catastrophic costs of medical expenses that can accompany a serious illness. Thus, in the overall scheme of things, health insurance is simply a means of protecting your other assets so that you will not have to drain them to pay for the expenses that can accompany a serious illness. Like other forms of insurance, health insurance is best purchased before a significant health issue arises. Policy-makers understandably discourage equality of coverage for both healthy and unhealthy individuals; if good health coverage were as readily available after an illness as before there would be little incentive for healthy people to shoulder any significant premium costs for good insurance, and the private insurance system would collapse.
Inadequacy of coverage for seriously ill or disabled individuals
Unfortunately, our government has encouraged employer sponsorship of health insurance as the primary source of coverage in the private marketplace. Employers purchase health coverage that they believe will satisfy the needs of their employees. By marketing insurance to employers the coverage has been adapted to the demands of its purchasers. Thus, over time, more benefits have been provided for "working well" people, to the detriment of coverage for individuals who are seriously ill.
Most traditional health plans now have inadequate coverage for seriously ill individuals, and in order to meet the increasing demands of the working well to whom the insurance is marketed, this trend is likely to continue. For example, many policies now include chiropractic and counseling benefits, but few policies still provide reasonable or adequate rehabilitation or therapy benefits, and those benefits that do exist are often prohibited for "maintenance" therapy (such as is required for MS).
Similarly, coverage for durable medical equipment has been constrained over time, home healthcare coverage is becoming a rarity, and prescription formularies (the lists of medications that a company is willing to cover) are continuing to narrow. Most basic employer policies are simply inadequate for the needs of seriously ill individuals, and anyone who wants comprehensive health coverage must have a catastrophic major medical policy in addition to a basic employer plan.
Discontinuity of coverage
Adding to the dilemma of coverage deficits is the problem of discontinuity. Because our health insurance system is mostly based on employer-sponsored benefits, health benefits can only be considered as secure as the prospect of the employee's continued employment. In other words, the provider of employer-sponsored benefits is the employer and a break with the employer could eventually cause a break with the coverage. If your insurance is a benefit of your spouse or parent, the loss of that relationship (through divorce or death, for instance) could also deprive you of your critical health benefits.
Consequently, employer-sponsored health benefits lack the essential element of continuity that we expect from every other insurance policy we own, and a thorough insurance and financial plan should include specific strategies that can be implemented when or if employer-sponsored insurance becomes unavailable. To find out more, you can check out Long Term Disability Insurance Multiple Sclerosis.