5 strategies to reduce the premium of your major medical expenses insurance.
It will always be better to have insurance and not use it, than to need it and not have it. And, after the pandemic, insurance for major medical expenses has become essential .
Why does the cost of your major medical insurance premium increase?
Felipe López, insurance specialist, explains that the insurance premium for major medical expenses increases due to three factors, mainly:
age
medical inflation
the high annual loss rate of the insurer in this branch
1. Increase the deductible and coinsurance
The first tip that could help you reduce the amount of your premium is, as some advisors say, “play with the deductible” .
In this case you can increase it or increase the coinsurance. These two factors can influence more in the decrease of the premium.
What is deductible and coinsurance
Deductible
The deductible is the amount you pay each year before your plan begins to pay for covered services. This does not include costs for preventive services, which are covered regardless of the deductible when provided by a doctor in your plan’s network.
Coinsurance
Coinsurance is the percentage you pay for covered medical services after you meet the deductible. For example, if the allowed amount for a service is $100 and your coinsurance is 20%, you’ll pay $20 for that service after you meet your deductible.
2. Decreases the number of hospital visits
López explains that another recommendation to reduce the premium of your major medical expenses insurance is to reduce the level of hospitals to which your policy gives you access.
In places like Mexico City, doing so could lower your policy premium by about 15%, he says.
3. Reduce the tabulator of medical fees
Although this action could help you reduce up to 10% of your policy premium, Eloy López explains that not all policies allow you to reduce the tabulator of medical fees
4. Hunting discounts
Ask if your insurer has a good health discount and, if you can, apply for it by getting a medical exam.
Some insurers give a preferential rate if your health is excellent, explains Eloy López. This can be up to 20% less than the normal premium.
5. Eliminate some clauses
Check your contract and the additional clauses that your policy has, to see which ones you can do without.
Currently, flexible policies allow you to remove and add additional clauses, explains López.
Some Common questions and answers
What If you miss a premium payment?
Your health insurance company may cancel your coverage if you are late in paying your monthly premium.
But before your insurance company can terminate your coverage, you have a short period of time to pay called a ” grace period .”
The grace period is generally 90 days — if both of the following conditions are met:
You have a Marketplace plan and qualify for advance payments of premium tax credits .
You already paid at least one full month’s premium during the benefit year .
Note: If you don’t qualify for the premium tax credit, your grace period may be different. Contact your state Department of Insurance for more information on grace periods in your state.
What If you reach the end of your grace period?
It is important to pay all premiums during the grace period so your health insurance company does not terminate your coverage.
The 90-day grace period begins the first month you don’t pay, even if you make payments for the next month afterward. For example:
You miss your premium payment for May
You submit premium payments on time for June and July, but have not yet paid for May
Your grace period ends July 31 (90 days from May 1).
If you haven’t paid your premium by July 31, you lose coverage retroactive to the last day of May.
If your coverage ends due to non-payment
If your health insurance company terminates your coverage because you did not make all outstanding premium payments in full by the end of your grace period:
You have the right to appeal your health insurance company’s decision if you believe your coverage was wrongfully terminated.
Outside of Open Enrolment, you do not qualify for a Special Enrolment Period if you lose coverage due to non-payment only. (You may qualify for a SEP for other reasons.)
If your coverage ends before the end of the benefit year and you’re not enrolled in Marketplace coverage by mid-December of that year, you’re not eligible to be automatically enrolled for the following year.
When you apply for and are eligible to enrol in a Marketplace plan, you may be able to enrol in the same plan you lost if it’s still available. If your insurance company has clearly outlined (on paper or electronically) the consequences of non-payment on future enrolment prior to your loss of coverage, you may be required to pay the amount due on your insurance carrier to complete your enrolment. premium due for coverage in the last 12 months.
Whether you choose a new plan or the same plan that was cancelled, you must pay your first monthly premium directly to the insurance company to complete your enrolment.
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