Critical Event Expenses

Takeaway tip: Try your best to have the value of your deductible set aside. I know that this is not always possible, but if you are able to, it goes a long way in helping you navigate critical events and illnesses. This week, I wanted to focus on the cost of critical care and whether you will be asked for upfront payment/insurance coverage before the ER or hospital will administer treatment.

Typically, in a true emergency, if you’re rushed to the hospital with your arm cut off, having a heart attack, or something evidently life-threatening, they will sometimes ask the person you’re with for the insurance information, but at that moment they will be most concerned about getting you stabilized and getting you out of danger. If you are at risk of dying, they are going to treat you and worry about the money later.

Sadly, this is not true for everything. It seems to me that most people understand that if they have no insurance, they are going to be asked for payment and that they can refuse to see you if you are sick. However, where I find that people are surprised, is regarding when treatment will and will not happen. This is because there is no hard and fast rule because every facility is different. My experience, (which comes in the form of my client’s experiences) has been that when it comes to elective treatment, you are definitely required to offer some form of payment before they provide treatment.

But what many people do not realize is that some things that you would presume are not elective, but are actually defined as elective, meaning that they can refuse treatment to you if you don’t fork over the money.

An example is cancer treatments. Even with insurance, this is what blows most people wait, even if you have insurance. There are cancer treatment facilities that require you to pay any co-payments, deductibles, and out-of-pocket expenses before they will begin treatment. A lot of people are shocked by this. And I can understand why. They think that they have insurance and the facility will just file the claim and send you a bill for your deductible. No, no, no, no, no. In reality, they actually want that money upfront, and they can refuse treatment if you do not pay them.

In the above example, it is clear to see that understanding exactly what your deductible and copayments are is important. This way you know what you will be expecting to pay in a critical event, that may even be deemed as an elective.

This is why I strongly encourage all of my clients to have their deductible set aside. I encourage you to have a separate medical fund that you can use for critical events as well as for the routine stuff since it all counts towards your deductible. Some people have a health savings account, but not all plans work with a health savings account, so you could just have personal savings account that you’ve chosen to use only for medical expenses. As your health insurance agent I am expecting that if I’m saving you tons of money on your premium,  you’re going to put some of that aside.

If setting the full deductible amount in savings is impossible for you, there are other things that you can do to assist in planning for critical events and the expenses that may arise. One option is supplemental coverage. Supplemental coverage is basically another policy that will pay out a set amount of money upon diagnosis or critical event. You can see some of my other blogs for more information on that.

In summary, I wanted to be sure to pass this information along – firstly, not all things we would deem critical are seen as electives by the health care system, and so if you have a critical illness, it is important to know your plan and deductible and plan accordingly, either by saving your deductible or having a supplemental coverage plan, or both!

Please feel free to book a consultation with me if you need more information or help with your particular situation.

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