What You Don't Know About Your Health Insurance Can KILL You!


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What You Don't Know About Your Health Insurance Can KILL You!

  1. 1. What you don’t knowabout your healthinsurance can kill you!Poor health insurancechoices are endangeringyou, your family and yourlifestyle
  2. 2. HOW MANY LIVES HAVE BEEN TAKEN? According to the Urban Institute analysis, from 2000 to 2006, 137,000 people died because they were uninsured This is due to people delaying or going without needed medical careSource: Robert Wood Johnson Foundation, ―Uninsured and dying because of it.‖ 2008 Copyright 2009 2
  3. 3. UNRELIABLE INSURANCE = HEALTH RISK Nearly 1.3 million full-time workers lost their health insurance in 2006 In 2007, 37 million large and small business workers were uninsured because health benefits were not offeredSource: National coalition on health care, 2009 Copyright 2009 3
  5. 5. THE FACTS ARE FRIGHTENING It is estimated 46 million Americans do not have health insurance 46M 40% A staggering60% or 24 million of Americans are not insured relative to self-employment or working for a 24M small business Total Self-employed/small businessSource: NASE, 2009 Copyright 2009 5
  6. 6. SMALL BUSINESS EMPLOYEES PAY MORE An employee in a firm with less than 10 employees pays 18% more for health insurance than a worker in a firm with 200 or more Healthcare costs are continuing to rise for small businesses causing many to become uninsured Having no or inadequate insurance will result in a price you never want to paySource: NASE, 2009 Copyright 2009 6
  7. 7. SELF EMPLOYED – HIGHER RISK FACTORSA study showed… 45% 45% of small business owners are using 40% 39% credit cards to finance their business 40% are using commercial loans or credit lines (often guaranteed by personal assets) 39% are using their personal assets 12% 12% are using home equity financingRisk for the self employed is extremelyhigh, you’re health shouldn’t be part of it Credit cards Credit lines Personal assets Home equitySource: Business Week.com October 26, 2008, AllBusiness.com Copyright 2009 7
  8. 8. SELF EMPLOYED HAVE MORE TO LOSE  60% of small business owners operate as sole proprietorships Which means… if the business fails the owner is personally liable for the debt 60% When you’re self employed you have more to lose… You’re business You’re assets You’re healthSource: P. Reynolds, Entrepreneurship in the U.S., Miami, Florida International University, 2004 Copyright 2009 8
  9. 9. EMPLOYMENT BASED INSURANCE TANKS Employment is no longer a guarantee of health insurance coverage A rising reliance on part-time and contract workers means fewer workers have access to employer-sponsored health insurance The number of uninsured rose 2.2 million between 2005 and 2006, and has increased by approximately 8 million since 2000Source: National coalition on health care, 2009 Copyright 2009 9
  10. 10. UNEMPLOYED BECOMES UNINSURED Unemployment rates Employment based insurance simply is not enough From 2007 to 2009, 5.1 million Americans have lost their jobs In March 2009, the unemployment rate sky rocketed to 8.5%, the highest it’s been since 1983 2006 2007 2008 Mar-09 Oct. By Oct. 2009 it is projected to be10.3% 2009Source: Department of Labor. ―The employment situation.‖ March 2009; The financial forecast center, 2009 Copyright 2009 10
  11. 11. UNINSURED WILL CONTINUE TO GROW Increases in unemployment during the recession have grown the number of uninsured people by 3.7 million working- age adults A study by the University of California at Berkeley researchers found… Even if the economy fully recovers, the number of uninsured working age adults will grow by 4.2 million by the end of 2012Source: UC Berkley labor center, As Congress debates health care reform proposals in President Obama’s budget, new report documents the impact on health coverage of NOTimplementing health-care reform, 2009 Copyright 2009 11
  12. 12. THE YOUNG ADULT IS BEING HIT THE HARDEST A national 2009 survey for young adults ages 18 to 29 showed:  19% are unemployed or looking for work  41% have been affected by cuts in wages or hours  23% have recently lost health insurance  Over 50% have lost their health coverage within the last five years Because of scarce wages and difficult times…  20% are delaying, leaving college or Volatile times call for critical transferring to a less expensive school decisions – going without insurance is not an option  22% are postponing marriage or waiting to start a familySource: PR newswire, April. 2009 Copyright 2009 12
  13. 13. THE UNINSURED MIDDLE AGED ADULT Uninsured 18% The number of uninsured middle aged adults is increasing every day… 13% In 2006,  18% ages 35-44  13% ages 45-54 were uninsured Ages 35-44 Ages 45-64Source: CDC: Health insurance coverage: Early release of Health insurance estimates, 2006 Copyright 2009 13
  14. 14. DEATH – THE ULTIMATE CONSEQUENCE In 2008, an alarming 9 million children 24 min = went uninsured 1 death Every 24 minutes someone dies in the US, because they were uninsured and Every could not get the medical help they 24 hrs = 6 hrs = 60 deaths 24 minutes 15 death needed death occurs The consequence of risking your own life or the lives of your children is too 12 hrs = great 30 peopleSource: Cover Robert Wood Johnson Foundation Cover The Uninsured Oct 2008; BC Culture, What’s your excuse? Dave Nalle, 2006 Copyright 2009 14
  15. 15. INJURIES – NOT IF BUT WHEN Something as minor as a broken bone can cost$5000 in hospital charges A knee replacement costs nearly $16,000 A complicated heart surgery will cost close to$200,000 and typically the hospital requires $100,000 up front Not being insured only saves you today’s premiums… it may wipe-out tomorrow’s financial futureSource: Forbes.com, Forbes, Steve, ―Open heart survery—90% off..‖, 2007; BC Culture, What’s your excuse? Dave Nalle, 2006 Copyright 2009 15
  16. 16. CAR INSURANCE MAY NOT COVER YOUR INJURIES If your car insurance limits are too low, you could be putting yourself in financial risk If you’re seriously injured, making payment could force you to…  Liquidate property  Savings  Other assets  Future earningsSource: Carinsurance.com, 2009 Copyright 2009 16
  17. 17. UNINSURED CHILDREN SUFFER 10.7% of all children in the U.S. are uninsured Uninsured children are less likely to receive 50% wellness check-ups, immunizations, and dental care 50% of uninsured children did not receive a wellness checkup in 2003, compared to 26% of insured childrenSource: National coalition on health care, 2009; HealthPAC online 2009 Copyright 2009 17
  18. 18. RESULTS OF UNINSURED CHILDRENApproximately 20% of uninsured children do not receiverecommended immunizations Receive immunizationsImmunizations is a proven tool for controlling and eveneliminating infectious diseases such as… Smallpox, in it’s prime threatened 60% of the worlds 20% population and killed every 4th victim don’t Measles, remains a leading cause of death among young children globally • Approximately, 197,000 deaths occurred in 2007, mostly children 5 & under Polio is a highly contagious disease which can lead to paralysis or even death • In 1952, there were approximately 60,000 cases These diseases are just as real and dangerous to the with more than 3,000 deaths in the U.S.Source: HealthPAC online 2009; WHO: Benefits of immunizations, 2009; Kids health, Polio, 2009 20% as they were in 1952 Copyright 2009 18
  19. 19. EXPERTS AGREE: NO ONE SHOULD BE UNCOVERED Over 15 million people ages 18 to 34 live without medical coverage "I strongly advise that no onego without health insurance, even for a few months. Youre exposing yourself to a major financial expense that can take years to recover from or ruin your credit history. In fact, lack of medical insurance is the No. 1 reason cited by people who file for personal bankruptcy‖ - Ray Martin, Finance expert/counselorSource: CBS News, ―Health insurance for young adults.‖ 2006 Copyright 2009 19
  21. 21. RISK IS INCREASING… In 2008, more than 33% of micro-business owners did not offer health insurance 46% Of the 46% that do offer health insurance, only 18.6% cover full-time employees This is a major decline from 2005, when 46.2% 18% reported covering full-time employees It is up to you to protect yourself 2008 2005Source: NASE, 2009 Copyright 2009 21
  22. 22. UNDERINSURED ARE IN DANGERThe number of underinsured adultshas hit unprecedented rates… 2003In 2007 it approached 25 millionadults compared to the 16 millionin 2003Many adults just don’t 2007understand coverage really is apossibilitySource: The commonwealth fund. Sara R. Collins, Ph.D., Jennifer L. Kriss, Michelle M. Doty, Ph.D., and Sheila D. Rustgi, 2008 Copyright 2009 22
  23. 23. MASSIVE MEDICAL DEBTS - A COSTLY DANGER Results of being underinsured… In 2007… • 71 million working-age adults reported a problem paying their medical bills • 7 million adults 65 or older reported medical debt problems • Nearly 49 million said they were paying off long-term medical debtSource: The commonwealth fund. Sara R. Collins, Ph.D., Jennifer L. Kriss, Michelle M. Doty, Ph.D., and Sheila D. Rustgi, 2008 Copyright 2009 23
  24. 24. BANKRUPTCY – THE ULTIMATE FINANCIAL DANGER A Harvard University study analyzed 1,700 bankruptcies across the United States Medical problems 50% were related to medical financial problems High An astonishing, 75% of the individuals who chance of bankruptcy claimed (medical) bankruptcy actually had health insurance Poor Having poor health insurance coverage is coverage like trying to cure pneumonia with over- the-counter cough medicineSource: AHCJ: Association of Health Care Journalists, Andrew Van Dam, 2009 Harvard University 2005 Copyright 2009 24
  25. 25. INADEQUATE COVERAGE EFFECTS THE MIDDLE-AGED Middle aged adult A survey showed… Middle-aged Americans seem most worried about paying their health care bills Among insured individuals ages 45 to 64, 84% were concerned health care costs would exceed their ability to pay 84% afraid can’t pay for health careSource: HonNews, E.J. Mundell, Most Insured adults worry about health care costs, 2009 Copyright 2009 25
  26. 26. YOU’RE NEVER TOO YOUNG TO GO WITHOUTINSURANCE Accidents, illness and disease is inevitable even for the young adult Medical debt could result in…  Large debt load  Ruined credit  Lower standard of living  Moving back in with your parents Are you willing to take these risks? Copyright 2009 26
  27. 27. IS IT POSSIBLE TO BE INSURED? In 2007, underinsured adults earning between $20- $40K spent 10% or more of their income on health care Those earning between $40-$60K spent 36% of their income on 36% health care 10% $40-60K $20-40KSource: The commonwealth fund. Sara R. Collins, Ph.D., Jennifer L. Kriss, Michelle M. Doty, Ph.D., and Sheila D. Rustgi, 2008 Copyright 2009 27
  28. 28. YOU CAN’T AFFORD TO BE UNDERINSURED ―Health insurance is one area where you simply can’t afford to be underinsured …remember, insurance is all about planning for the worst. And if you or anyone in your family were to ever develop a severe illness, you would want to make sure you could afford the best care for them‖ - Suze Orman, Personal finance expertSource: Suze Orman internationally acclaimed personal finance expert : The Suze Orman Show : Will & Trust Kit : FICO Kit : Insurance Kit : Women & Money Copyright 2009 28
  30. 30. THE WRONG AGENT - SUBSTANDARD LIVING Selecting the wrong agent and then obtaining the wrong coverage leads to financial troubles 39% A study showed adults who experienced medical bill problems… 29% 30%  29% were unable to pay for basic necessities like food, heat, or rent  39% used their savings to pay billsUnable to pay Used savings Took on credit for basic card debt  30% took on credit card debt necessitiesSource: The commonwealth fund. Sara R. Collins, Ph.D., Jennifer L. Kriss, Michelle M. Doty, Ph.D., and Sheila D. Rustgi, 2008 Copyright 2009 30
  31. 31. RESULTS OF THESE CHOICES - DISASTROUS Inadequate or no health care coverage Below-par quality of health and life Long-term illness or early death Emotional devastation Financial ruin"The Institute of Medicine report shows theevidence of being uninsured is stronger than ever.People without insurance do not get the care theyneed, and too many people live sicker and diesooner as a result”Risa Lavizzo-Mourey, M.D., M.B.A. Robert Wood Johnson Foundation President and CEO Copyright 2009 31
  32. 32. INADEQUATE AGENT = UNDER PAR HOSPITALS Many people with inadequate health coverage go to community health centers to get care… A study showed people who attend a community health center will more likely deal with…  Long waits for appointments  Discontinued services  Bed sores  Infections  Death in low risk procedures  Out-dated or lack of necessary equipmentSource: Dewan, S. & Sack, K. A Safety-Net Hospital Falls Into Financial Crisis. The New York Times, 2008 Copyright 2009 32
  33. 33. INADEQUATE PLANS RESULT IN OUTDATED EQUIPMENT Doctors agree outdated medical equipment such as…  Microscopes  X-ray machines  Scanning machines  Cameras  Defibrillators are unsafe and put patients lives at riskSource: ABC news, ―Old medical equipment risking patient care‖, 2006 Copyright 2009 33
  35. 35. CHANCES OF ESCAPE ARE SLIM In the U.S. 1 out of 3, 33% of individuals will develop… • high blood pressure • diabetes • stroke • heart attack • Every 34 seconds a person dies from heart disease • 50% of men and 33% of women will develop cancer within their lifetime • 25% of individuals develop asthma and allergiesSource: Webmd: Death from Heart disease, 2007; American Academy ofAllergy Asthma & Immunology, 2009; American Cancer Society, 2008.;American Heart Assoc., 2009; Car accident statistics, 2005
  36. 36. REALIZE THE CONSEQUENCES Accidents are the top killers among young adults & children Accidents, cancer and abnormality at birth accounted for 63% of all deaths ages 5-9 Accidents, homicide and suicide accounted for 76% of all deaths ages 15-29 Every 13 minutes a person dies in an accidentSource: National Center for Health Statistics, National Vital Statistics Reports March 7, 2005; car accident statistics, 2005 Copyright 2009 36
  37. 37. COMMON BACTERIAL INFECTION IS INEVITABLE Blood infection, pneumonia and middle ear infection is the #1 reason for childrens doctor visits in the first few years of life Every year, approximately 76 million people become ill from disease-causing substances in food  Of these about 5,000 die Each year there is14.2 million cases of bronchitis Even if you escape major illness, minor illness requiring medical assistance is unavoidableSource: National institute of diabetes and digestive and kidney diseases, 2009; WD, ―Statistics about acute bronchitis, 2009 Copyright 2009 37
  38. 38. FINANCIAL CRISIS AT MEDICAID AND MEDICARE When Medicaid and Medicare were passed in 1965, employment-based insurance was the nation’s principal source of health care coverage ―It was obvious, however, it could never come close to covering the entire population‖ - The people to people Health Foundation, Inc. Medicare is projected to be broke by 2016 or 2018 Employment-based and government insurance are not enough, no one can rely on theseSource: Enthoven, A. & Fuchs, V. (2006). Employment-Based Health Insurance: Past, Present, And Future. Health Affairs, 25(6), 1538-1547. Retrieved November 10, 2008 from Proquest;Bush, H. (2007). Florida Forecast: Partly Cloudy. Hospitals & Health Networks, 81(12), 40-2, 44, 1. Retrieved November 10, 2008 from ProQuest Copyright 2009 38
  39. 39. WHAT HAVE WE LEARNED?Going without or having inadequate healthinsurance is tied to too many unknowns...It is a risk you should not take no matter whatage or how healthy you are…The only definitive result of lack of coverageis DISASTER 39
  40. 40. THERE ARE OPTIONS FOR RESPONSIBLE INDIVIDUALS WHO… Understand there is a moral responsibility in health insurance choices Understand the link between protecting the quality of their lives and adequate health insurance Understand the risks of being uninsured or underinsured Are responsible and want to control their healthcare decisions Want the most cost-effective, best coverage for their situation
  41. 41. WHAT’S IN IT FOR YOU?
  42. 42. HEALTH BENEFITS OF HAVING INSURANCE Children with health insurance…  Are more likely to be healthy  healthier children do better in school  Miss less days from school  Are more likely to be treated for ear infections, reducing the likelihood of lifelong hearing loss  Are more likely to receive basic medical care for asthma and experience far less asthma-related attacks and emergency room visitsSource: HealthPac online, 2009 Copyright 2009 42
  43. 43. IT’S MORE COSTLY NOT TO HAVE HEALTH INSURANCE ―Some sort of illness hits everyone eventually, but many diseases - when caught early - can be nipped in the bud and full health returned… it’s important to visit your doctor on a regular schedule - at least annually or possibly more often as you get older. If detected soon enough, a full cure will more likely occur… Either invest a relatively small amount (in which may be covered 100% by insurance) in order to stay in good health, or pay a huge amount later to treat the disease that is bound to eventually hit us‖ - World Research FoundationSource: World Research Foundation, 2009 Copyright 2009 43
  44. 44. INSURANCE IS KEY TO SAVING YOU MONEY A study by the Institute of Medicine shows the average uninsured American would gain between$1,645 and $3,280 annually if they were insured The money represents the value, in dollars, a person is missing out on in terms of health care by not having insurance Having insurance saves you money and more importantly saves your healthSource: Tribtotal media, ―Lack of adequate health insurance costs the nation., 2003 Copyright 2009 44
  45. 45. HEALTH INSURANCE – NAMED AS A LEADING HEALTH INDICATOR Uninsured patients are 1.6 times more likely to die in 5 years from cancer than those with private insurance ―Health insurance provides access to health care. People with health insurance are more likely to have a primary care provider and receive appropriate preventative care such as a recent Pap test, immunization, or early prenatal care‖ - Healthy People 2010 CampaignSource: Healthy people 2010, 2009; American Cancer Society, 2007 Copyright 2009 45
  46. 46. HEALTH INSURANCE PREVENTS ILLNESS Adults with health insurance are twice as likely to receive a routine checkup than those without  Mammograms in women over the age of 50 result 99% in 20-30% reduction in breast cancer deaths  Early detection of skin cancer results in a 99% survival rate  Early detection of prostate cancer results in a 100% 100% survival rateSource: American cancer society, 2008; ―Healthy people 2010‖, 2009 Copyright 2009 46
  47. 47. INSURED WOMEN VS. UNINSURED Women without insurance are twice as likely to Late cancer stage diagnosis be diagnosed in late stages of cancer than those with insurance 30%  Only 38.1% of uninsured women receive a mammogram compared to…  74.5% with private insurance 15%  20-30% of uninsured women were diagnosed with stage III or IV breast cancer compared to…  15% with private insurance Uninsured InsuredSource: American cancer society, 2007 Copyright 2009 47
  48. 48. INSURED MEN VS. UNINSURED 5 year survival rate 66% Only 50% of uninsured patients survive colon cancer for 5 years compared to… 50%  66% with private insurance Only14% of uninsured men ages 50 to 64 receive a prostate cancer examination compared to… 37.1% with private insurance With insurance Without insuranceSource: American cancer society, 2007 Copyright 2009 48
  49. 49. UNDERSTAND…KNOWLEDGE IS POWER Health insurance
  50. 50. INVEST IN YOUR FUTURE - EDUCATE YOURSELFApproximately 90% of health-insuranceshoppers fail to fully read enrollment andcoverage materialsThat means 90% of individuals do not fullyunderstand their coverages including… Out-of-pocket expenses Deductibles Co-payment Co-insurance 90% failed to educate themselvesThis can be costly as well as deadlySource: How to make the best choices for your health benefits. Medmutual.com, 2009 Copyright 2009 9
  51. 51. THE INNER WORKINGS OF HEALTH INSURANCE Imagine you have a $100,000 heart surgery Surgery $50K that is covered by your insurance plan that has a… Room  $2,500 annual deductible $25K  20% coinsurance after deductible Dr. Fees  $2,000 out-of-pocket limit per year $25K  $5 million lifetime maximum Total You would be responsible for $4,500 $100KSource: EHI, ―How does health insurance work?‖, 2009 Copyright 2009 51
  52. 52. UNDERSTANDING CO-INSURANCE & OUT-OF- POCKET EXPENSES After the deductible is paid the insurance company typically pays a percentage of the bill, known as coinsurance… $100K For a health insurance plan with 20% Bill coinsurance, the insurance company will pay 80% of the covered expenses $2,500 You become responsible for the remaining client deductible 20% until your out-of-pocket limit is reached 80% 20% covered out-of- by pocket insuranceSource: EHI, ―How does health insurance work?‖, 2009 Copyright 2009 52
  53. 53. THE BENEFITS OF HEALTH INSURANCE – BREAKING IT DOWN For a $100K heart surgery you will pay… Out of pocket cost for $100K surgery  $2,500 for the deductible $100,000  $2,000 for the coinsurance Making your total cost  $4500 The insurance company will pay…  $95,500 $3,500 Which scenario do you prefer… With Insurance Without Insurance Paying $100,000 or $4500, having insurance will determine which dollar amount you end up withSource: EHI, ―How does health insurance work?‖, 2009 Copyright 2009 53
  54. 54. THINGS YOU SHOULD KNOWAn individual with a long history of medicalcomplications… may have a hard time finding individual coverage should expect their premium to be higherThe higher the deductible the lower your premiumwill be a high deductible will protect you from catastrophic eventsIf somebody offers you an insurance benefit solutionthat looks too good to be true, then it’s likely it’s togood to be true Copyright 2009 54
  56. 56. TOP-QUALIFIED AGENCIES… Understand your needs come first in regards to coverage and premium Provide the largest doctor and hospital networks Have educated and experienced career agents (no part-time agents) Extend their service beyond the sale Must have a long record of successful results Utilize a wide choice of trusted premier carriers Have large lifetime maximums Copyright 2009 56
  57. 57. TOP QUALIFIED AGENTS ARE CRITICAL When insurance companies pay out more in claims than they receive in premiums and/or medical and operating expenses rise, your premiums go up Top-qualified insurance companies collaborate with top-qualified agencies to provide satisfactory coverage in a cost-effective manner “In order for individuals, families and business owners to make informed decisions regarding their health coverage, they need accurate information on both price and quality of service providers” - NASESource: NASE, 2009 Copyright 2009 57
  58. 58. TOP AGENTS ARE WELL ESTABLISHED Finding an agent that has been in business for at least five years and is there for the long haul is vital You never know what the future will bring Having the right insurance agent will result in the right insurance plan for you, giving you peace of mindSource: insuranceagents.com, 2009 Copyright 2009 58
  59. 59. TAKE THE NEXT STEP… Bring yourself peace of mind by… Facing Employing Obtaining Educating harsh a top the right yourself coveragerealities agent Copyright 2009 59
  60. 60. THE CRISISHaving an under qualified agent will result in… Inadequate or no health care coverage Below-par quality of health and life Long-term illness or early death Emotional devastation Financial ruin 60
  61. 61. THE RESOLUTION  Face the reality of your risk  Invest in your future through education about health insurance benefits  Understand how insurance companies work  Understand how to select an agent and company to work with 61
  62. 62. THE SOLUTION Have and retain a good quality of life Peace of mind that securing your future health and assets brings Able to leave a legacy Able to enjoy your family & other close relationships Feel good about being a responsible human being 62
  64. 64. As a trusted guide we educate ourclients, empowering them to makeintelligent and informed decisions that fittheir benefit package to their lifestyle. Weare committed to this journey of proactivelyhelping them navigate their ever changingneeds and protect their lifestyle throughouttheir lifetime
  65. 65. OUR COMPANY’SPHILOSOPHY & CULTUREWhat is your philosophyWhat is your business culture like?Friendliness, customer centered…Etc.
  66. 66. UNIQUE SOLUTIONS We have over 70 million policy holders We have one of the largest doctor and hospital networks available We’ve been in business since 1892 We have a wide choice of trusted premier carriers We have career agents that are here to stay We have a wealth of knowledge with a deep understanding of both national and regional issues We are easily accessible We have the largest lifetime maximums We are a Managing General Agency (MGA) We are here when things go wrong or you have questions Our service extends beyond the sale We put our client’s best interests first We represent two of the strongest HSA companies in the country including one of the companies that helped design the HSA concept
  67. 67. TOP QUALIFIED AGENTS What do you want your customers to know about your staff… Professionalism Length of time with company Experience levels Etc.
  68. 68. CLIENT SATISFACTIONWritten by All About Health InsuranceShould include the following:Your guaranteeYour assurancesEtc.
  69. 69. TESTIMONIALS"Cathleen Torisi was not onlygenerous with her time in explainingthe various pros and cons of each ofthe plans under review, herknowledge and expertise wereinvaluable in helping us make theright choice. Anytime we had afollow-up question on our policy, shewas more than happy to answer it.‖ - Brian McCallen, Golf/Travel Specialist
  70. 70. Protect your family…Protect your future…Utilize a company that will make this happen… CALL NOW 877-344-CALL