2. In 2011, the average family’s health insurance
premium increased to more than $15,000.1
In 2008, the average American family spent less
than $2,500 per year in out of pocket medical
expenses. 1 This means that a family with a $2,000
major medical deductible is not likely to spend
enough on out-of-pocket expenses to meet their
annual deductible.
The results is a monthly health insurance premium
that is far too expensive for the amount of benefits
that are actually used.
1
Kaiser Family Foundation
3.
4. With low-deductible plans, consumers have
peace of mind that a major medical event (i.e. an
accident or critical illness) won’t deplete their
savings or leave them bankrupt.
Unfortunately, the reduced risk of a low-
deductible insurance plan comes at a higher cost
in the form of higher monthly premiums.
5. By choosing a plan with a higher deductible, a
consumer receives comparable benefits for a
lower monthly premium.
The drawback of a high-deductible plan is the
considerable amount of money that the insured
would pay in the event of an accident or critical
illness.
6. Accidents can create a serious financial burden on major
medical policy holders.
Compliment your health insurance coverage with an accident
plan that will help cover your deductible, co-insurance and
other expenses related to a covered event (up to pre-
determined benefit amount)
7. Every minute:
◦ Two people in the U.S. suffer a coronary event1
◦ A person dies from a coronary event1
◦ Two people are diagnosed with cancer2
◦ A person suffers a stroke1
Critical Illness insurance plans pay a lump-sum amount upon
diagnosis of a covered illness or condition. This benefit can
be used to cover medical expenses, household expenses, and
even help offset lost income from missing work during
recovery.
1. Heart Disease and Stroke Statistics – 2008 Update, American Heart Association
2. Cancer Facts and Figures, American Cancer Society, 2006
8. Every minute:
◦ Two people in the U.S. suffer a coronary event1
◦ A person dies from a coronary event1
◦ Two people are diagnosed with cancer2
◦ A person suffers a stroke1
Critical Illness insurance plans pay a lump-sum amount upon
diagnosis of a covered illness or condition. This benefit can
be used to cover medical expenses, household expenses, and
even help offset lost income from missing work during
recovery.
1. Heart Disease and Stroke Statistics – 2008 Update, American Heart Association
2. Cancer Facts and Figures, American Cancer Society, 2006
9. Major medical • Accident • Critical Illness
Sample family: • Male (40) • Female (37) • 2 Children
Major Medical ($25 co-pay) Major Medical (no co-pay)
Major Medical ($25 co-pay)
+ Accident and CI + Accident and CI
Deductible $1000 Deductible $5000 Deductible $5000
Office visit co-pay $25 Office visit co-pay $25 Office visit co-pay $0
Medical Premium $580 Medical Premium $398
Accident Plan $59.95 Accident Plan $59.95
Critical Illness $48 Critical Illness $48
Total Total Total
$965.00 $687.95 $505.95
Premium Premium Premium
Total savings: Total savings:
$277.05 per month $495.05 per month
$3,324.60 per year $5,508.60 per year
Pairing an accident and critical illness policy with a higher
deductible major medical policy creates a combined benefit plan
that greatly reduces your monthly medical insurance premium.
In addition to helping policyholders satisfy their deductible on a
major medical plan, the critical illness plan may also provide funds
to cover any additional out-of-pocket expenses or lost income that
may result from a serious illness.
10. Major medical • Accident • Critical Illness
Sample family: • Male (40) • Female (37) • 2 Children
Major Medical ($25 co-pay) Major Medical (NO co-pay)
Deductible $5,000 Deductible $5,000
Office visit co-pay $25 Office visit co-pay $0 benefit
Monthly Premium $965 Monthly Premium $398
Annual Premium $6,960 Annual Premium $4,776
Total savings on Premiums:
$182 per month
$2,184 per year
11. Major medical • Accident • Critical Illness
Average PPO
Major Medical ($25 co-pay) discounted price Average retail price for
$80 $120
for office visit office visit
Deductible $5,000 w/o co-pay
Office visit co-pay $25
Additional Premium ÷
Number of office visits
Monthly Premium $965 27.3 Cost of office visit w/o co-pay
needed to justify 27.3 =
additional premium $2,184 ÷ $80
Annual Premium $6,960
Average number of
10
office visits per year
Major Medical (NO co-pay)
Average # of office visits
X Co-pay
Deductible $5,000 Annual out-of-pocket $250
$250
Office visit co-pay $0 benefit costs for office visits =
10 ÷ $25
Monthly Premium $398
Additional premium
“True cost” for plan + Annual office visit co-pays
$2,344
$2,344
Annual Premium $4,776 with co-pays =
$2,184 + $250
“True cost” of plan
Total savings on Premiums:
True out-of-pocket $234 ÷ No. of annual office visits
$182 per month $234
cost for each office visit =
$2,184 per year $2,234 ÷ 10
12. Enjoy the lower premiums of a higher-deductible major medical plan, and manage your
exposure for out-of-pocket expenses by adding an accident and critical illness policy to your
health insurance program.
Major Medical Personal Critical Illness
Plan Accident Plan Plan
Medical with co-pays $10,000 per occurrence $10,000 lump-sum
($5,000 Deductible) ($100 deductible) benefit per occurrence
$ ________ $ ________ $ ________
HSA or no co-pays
($5,000 deductible)
$ ________ Total Monthly Premium
$ ________
