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Health Insurance and Holistic Care



Holistic medicine has a lot of advantages over traditional medicine. For one thing, it tends to treat the whole person, and address many of the root causes of disease, rather than just treating the symptoms. Holistic medicine also focuses more on natural remedies than chemicals with unpronounceable names and dubious effects.

Still, despite the advantages of holistic medicine, the reality is that there are some instances where you will need to rely on traditional medicine, and traditional medical insurance.

For example, chiropractic medicine can treat the misaligned bones that cause back pain, but it can’t set a broken bone so that it heals properly. For that you will need a trip to the emergency room, and a cast, which can end up costing a lot of money if you don’t have health insurance.

A healthy diet can reduce your risk of heart attack or stroke, but if you have one anyway you will most likely end up in the hospital. If the stroke does extensive damage, you will also need physical and speech therapy, both of with are too expensive to pay for out of pocket.

Every day there are stories of people who have opted not to purchase health insurance suddenly finding themselves in need of expensive medical care. Some of these people have histories of health problems, but there are also those who have done everything right in terms of taking care of themselves and their families’ health, and they still end up in need of major medical care.

While a lot of these people successfully appeal to their fellow man for help in paying their medical bills, that approach is not an option for everyone. That is why it’s important to have some type of healthcare coverage, to protect you in the event of an accident or unexpected catastrophic illness.

Marketplace or Direct?

If you qualify for the subsidies, your best option is to shop through a marketplace or exchange. If you do not qualify for the subsidies, your best option is to shop for plans directly from the insurance providers.

Providers like USHealth Group Insurance often have independent brokers who can discuss your insurance needs and help you find the best plan for you and your family. A broker might even know of plans that cover some holistic treatments, such as chiropractic and naturopathic care.

Insurance Categories

Per the terms of the Patient Protection and Affordable Care Act, all insurance plans must cover the same essential services including:

  • Preventative care;
  • Mental health and addiction treatment;
  • Newborn and pediatric care; and,
  • Treatment for Chronic diseases.

However, the way the insurance policies cover and pay for services, as well as the amount that you pay for coverage, can vary. Plans are categorized as bronze, silver, gold, or platinum based on these differences.

Bronze Plans

Bronze plans tend to have the lowest premiums, but higher deductibles. Also, these plans tend to have 60/40 coinsurance, which means the insurance company pays 60 percent of the cost and you pay 40 percent, once you meet the deductible. Bronze plans could also have higher copays for office visits and prescription drugs.

If you are reasonably healthy and can safely predict that you will only use your health insurance for preventative and catastrophic care, a bronze plan is probably the best option because it will have low monthly premiums and your preventative care will be covered without a copay. You will end up paying more out of pocket if you do end up with a catastrophic accident or illness, but it will be far less than if you had no insurance coverage at all.

Silver Plans

Silver plans tend to have slightly higher premiums than bronze plans, but they also have lower deductibles and a 70/30 coinsurance – which means you only pay 30 percent of the bill, and the insurance company pays 70 percent, once you meet your deductible. Silver plans could also have lower copays for office visits and prescription drugs than bronze plans.

Silver plans are good if you are reasonably healthy, but have a few heath concerns, such as a family history of diabetes or heart disease. The premiums are a little higher, but you will have lower out of pocket costs for things like prescription drugs and sick office visits.

Gold and Platinum Plans

Gold and platinum plans tend to have the highest monthly premiums, but they also have the highest coinsurance. Gold plans tend to be in the 80/20 arena, and platinum plans can go as high as 100 percent, which means the insurance company pays 100 percent of the cost after you meet the deductibles. Gold and platinum plans also tend to have the lowest deductibles of all the plans, which means your out of pocket costs for care are significantly lower.

Gold and platinum plans are good if you have existing health problems and know that you will need to have regular procedures, such as chemotherapy, or ongoing respiratory care. The monthly premiums are usually the highest in the business, but your out of pocket costs for care are almost non-existent.

These plan descriptions are not set in stone. Ultimately it depends on the individual provider and where you shop for your coverage. Shopping by individual provider, you could find that USHealth Group has silver plans that actually have lower monthly premiums than some Anthem bronze plans. Conversely, you might find a gold plan through an exchange that actually has a higher deductible than some bronze plans. This is why it’s important to shop around and compare all aspects of each plan, not just the deductibles or monthly premiums.