You may not think about insurance protection before you go skiing or participate in a team sport. But, what if you break a leg and have to go to the hospital? Are you protected against those health care costs?
If you get sick, what do you do? Where do you go? What kind of help can you find?
When you break a leg, sprain an ankle, or come down with the flu, you probably don’t think, “Can I afford to see a doctor?” That’s the question, however, that many Americans have to ask themselves. The reality is: Good health care costs money.
You may not have to pay now, but sooner or later, paying doctor bills will become your responsibility.
How much does health care really cost? Do you know? Let’s look at some facts.
Americans today like to think our health is protected. We want to believe we have the best health care system in the world. And we spend plenty of money on health care for ourselves — about $670 billion in 1990 — that’s $2,600 for every man, woman, and child.
We’re spending so much money that we should have terrific health care. Do we?
Take a look at these facts:
* 34 million Americans have no health insurance, according to 1990 census figures.
* Health care costs have been rising at about twice the rate of inflation.
* One estimate shows the per-person cost of health care will more than double by the year 2000 — about the time many of you will be having to deal with health care on your own.
Are You Covered?
When you see a doctor or go to an emergency room, one of the first questions you may be asked is, “Do you have insurance?” Or, “What type of insurance do you have?”
According to Webster’s Dictionary, insurance is “a means of guaranteeing protection or safety.” You buy health insurance today in order to pay for health care in the future. There are several ways to do this.
Managed health care plans such as HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations) handle a large part of insurance coverage. (See “Health Help: Learning the Language” of plans on page 8.)
There is usually a waiting period — a time set by the insurance program — before your coverage begins. That means a time of 30 to 90 days may have to pass before you can begin to use the insurance plan — sometimes even longer.
When you get sick or are injured after the waiting period has passed, the insurance plan helps pay for your medical care.
If you have medical insurance when you go to a doctor or hospital, your insurance acts as protection by paying all or a portion of your medical bills. Keep in mind, however, that some medical insurance may pay only some (not all) of the costs, depending on the plan.
Paying the Premium
Monthly payments for insurance coverage are called premiums. Perhaps your parents have insurance through an employer. This may mean that the employer pays all or part of the premium. With the rising cost of health care, fewer employers are able to cover all of the costs for their employees’ health care. While your parents may be able to qualify for company health care, they may have to contribute a portion of the premium. Sometimes this is done by the employer deducting part of every paycheck. Keep in mind, however, that insurance coverage through an employer ends when the job ends — unless you arrange with your employer for coverage under COBRA provisions. (See page 8.)
You may want to find out how to apply for insurance. Your parents are probably taking care of this for you know, but eventually you will be doing it for yourself. It’s never too early to learn.
All plans require you to fill out an application form. The insurance plan forms will ask for a medical history (a listing of accidents, illnesses, allergies, etc.). This medical history may determine whether or not your parents, or you, qualify for insurance. Once qualified for coverage, a monthly premium will be required.
Know Your Options
If an employer does not offer health insurance as a benefit, many people find they can’t afford a policy on their own. It’s wise to know other options available for persons who can’t afford insurance. Government programs, such as the following, can help:
Federal Programs: Medicaid; Medicare; Indian Health Service; Women, Infants, and Children program; and Veterans Administration. (See page 8 for explanations.)
State Programs: Each state has its own program for those residents who are uninsurable through other means, though this is not necessarily for those who can’t afford regular insurance.
Community Clinics: Community health centers provide services based on ability to pay. Try to locate one nearby.
Stay Alert to Potential Problems
It’s important to know what your policy covers and what it doesn’t. In case of long-term serious illness, for example, most insurance plans pay only to a specific limit.
Americans pay a great deal for health insurance. And the costs keep rising. To help keep costs down, a national health care system, such as the one in Canada, has been proposed by legislators.
In the Canadian system, everyone pays a share of the cost through taxes. Since all Canadians pay into the system, everyone has medical care coverage. There are differing opinions about how this system would work in the United States, since Canada has a significantly smaller population than the United States.
It may be tempting to leave health care costs to “the experts,” but it’s up to you to ensure your health by becoming a smarter consumer of health care. Stay alert to health care trends; understand and work for reform; make informed choices.
Today’s teens can expect to be health care consumers until the middle of the 21st century . . . or beyond.
Find an opportunity to sit down with your parents to get a picture of your family health insurance program. (See “Health Talk” on page 11.) This is excellent preparation for that day in the not-so-distant future when you will be making these decisions on your own.