What Does My Premium Payment Pay For?
Health insurance is very expensive these days. Your ACA qualified health insurance plan must cover 10 these 10 “essential health care benefits”.
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- Outpatient Treatment – “Ambulatory Services”
- Emergency Care
- Hospitalization
- Maternity and Newborn Care
- Mental Health and Substance Abuse
- Prescriptions
- Rehab services and devices
- Laboratory
- Preventive / Wellness
- Pediatric Services – dental and vision
All of these services separately are very expensive, but these plans must cover all these services. Prescription coverage alone accounts for a huge percentage of your premium.
Before you blame the insurance company’s for being “greedy”, it’s important to note, there is a clause in the Affordable Care Act that is called the MLR – Medical Loss Ratio.
This MLR states that when a family or individual buys a medical plan, 80% of every dollar collected and paid to an insurance company MUST pay medical claims/research. So that leaves the insurance company to pay ALL of their expenses with the remaining 20%. .20 cents on the dollar for their employees, buildings, broker costs, etc.
We read an article a while back stating that the residents in Florida, almost 1 million customers, received a $65 refund because of this rule. The insurance company collected too much money in premiums, and had to refund their customers the overage collected. Here in Nevada we’ve had many customers receive a medical loss ratio refund too.
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Seeking Guidance With Nevada Insurance Enrollment
Navigating through the many options of insurance can be confusing and chaotic, but speaking with a locally licensed insurance agent will help you to obtain the right coverage you need. You’ll have the peace of mind knowing that you are adequately insured when life complications arise. We work hard to find the most competitive quotes for your needs. Contact us today to begin the process of finding the best insurance plan for your family.
Related Articles:
♦ What Is Covered by The Affordable Care Act (ACA) Health Care Plans
♦ What You Need to Know About Obamacare Health Insurance
♦ How Are Health Insurance Premium Rates Determined?
♦ Health Insurance plan “Unaffordable”? Need Exemption?
Read More: Health Insurance in Las Vegas, Nevada
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