Is Low-Cost Health Insurance Worth It?

Infomercial king Billy Mays, known for screaming about the wonders of cleaning solutions Kaboom!, OxiClean, and other household products, is now starring in a commercial for what he calls "the most important product I've ever endorsed:" health insurance. The bearded salesman started pitching iCan Benefit Group's "health insurance that you can actually afford" in May 2008, pointing to the need for its health plans given that 47 million Americans are uninsured. In the commercial, Mays says iCan's plans include guaranteed acceptance, starting as low as $160 per month for individuals and $260 for families, and can allow you to lower your monthly premium, increase coverage, or both. Concludes Mays: "You can't afford not to make this call."

His pitch shows how difficult it has become for many hard-pressed Americans to afford basic necessities, such as health care, as the cost of food, gasoline, and many adjustable-rate mortgage payments climb, while wages barely budge and employers cut jobs. To protect your assets, it's important that yourinsurance policies give you enough coverage in case something horrible happens to you or a loved one. Mays is understandably "passionate about health care." We all need health insurance, yet many Americans can't afford it, while the cost of the plans and of medical care keeps rising. Mays is pitching iCan's Mini Medical, a type of limited healthinsurance for those who can't afford major medical insurance or have been turned down because of preexisting health conditions.

Low Premiums Mean High Risk

These limited plans are not for everyone, and they could end up costing more if you need expensive care. "The problem is they're advertising these unbelievably low premium healthinsurance plans," says Mark Kenison, a financial adviser who specializes in insurance at Turning Point Benefits Group in Charlotte, N.C. "All you're doing its transferring risk to yourself so your monthly premiums are lower."

Consumers might focus on the low monthly price and not examine the cost and coverage of each health service, Kenison says. Beware of policies that don't set a maximum amount that you'd be responsible for paying for a health service, he advises. For example, iCan's mini-medical plan will probably not provide enough coverage if you get badly injured or need surgery. Looking at an example of the company's lowest-cost offering, iCan's mini-medical plan costs an individual $160 per month in North Carolina—plus an additional, $100 one-time enrollment fee—and covers a maximum of just $1,000 for surgery per year, with anesthesia limited to $250 per surgery. If you're hospitalized, the plan would cover only $200 for the first day and $100 each additional day, with a maximum of $1,100 for up to 10 days. On average, hospital care is estimated to cost $1,931 a person per year, according to the latest figures (2004) from the U.S. government's Centers for Medicare & Medicaid Services.

The low maximum benefits—and the prospect of huge additional out-of-pocket expenditures—bothers some financial pros. "It just feels wrong," says Kenison, adding that most people would be better off getting a major medical plan that limits their risk to a certain dollar amount. If you end up with a large medical bill, members of iCan's health plans have a health advocate to negotiate pricing and hospital charges, says Harold Shatz, managing member of iCan Benefit Group in Boca Raton, Fla. A $40,000 to $50,000 medical bill can be reduced to $10,000 to $12,000 through network pricing and use of a health advocate to examine the bills and find errors, he says.

news source : http://www.businessweek.com/