Surprises with your healthcare plan

Recently, we had a pet that needed to get rushed to the vet ER in the middle of the night. And this got me thinking about life and how quickly it can all change. Planning for surprises with your healthcare plan is a great way to plan for those emergencies.

So we took our pet to the ER and they did stabilize her and while doing so they went over the treatment plan and payment with us. Basically, our pet needs this treatment or she is going to die. So they went through the whole treatment plan and wanted to know how we were going to pay for it.

Most people believe that when they have healthcare this does not happen, but it does. If it’s a true emergency like if you get your arm got cut off or you are having a heart attack they will get you stabilized, (and are required to treat you in an emergency)however they will ask the person who is with you for your insurance information.

Most people understand if they have no insurance that the hospital or doctor is going to ask for payment and that they can refuse treatment if they cannot pay. This is why a lot of people go to the ER, when they’re sick, they feel like they can get treated, but they still ask about payment. Going to the ER when you are just sick can be dicey without insurance as you could end up with a large bill. However, what I find people are most surprised about is when treatment will happen and when treatment will not happen.

There’s no hard and fast rule because every facility is different, but mine and my client’s experience have been for non-elective treatment is they require payment first or they will refuse treatment.

Let me give you an example (even with insurance), this is what happens. There are places that do cancer treatments that require you to pay your copayments, deductible, and out-of-pocket expenses before they will begin treatment. A lot of people are shocked by this, and I agree. With insurance, you think they’ll just file it and send you a bill for your deductible and payments later, but this just not the case. They actually want that money upfront and they can refuse treatment if you do not pay them. It’s good to know up front that, if you’re diagnosed with cancer, you want to make sure you’re able to cover your deductible and copay.

There are some places I believe will make a deposit however, each facility is different. If this happens to you or a loved one at the moment you are not worried about the payment or where you are going to get the $10,000, that’s why you see people do ‘go fund me’s. But, there are other ways to mitigate it, such as understanding what your deductible is. I understand not everyone can do this, but I strongly encourage all my clients to have their deductible set aside, by having a separate medical fund that they can use for things like this, even just routine things.

When you have a deductible to meet, you want to be able to pay it.  Some people have health savings accounts, though not all plans work with health savings accounts. You could also have personal savings account that you use for medical expenses. I counsel people who do this to set money aside so when you have out-of-pocket costs you have the money to cover that. Or if it’s something that’s very expensive, you should have at least $10 000.

There are also supplemental coverages that you can get that will give you a lump sum payment if you are diagnosed with a critical illness. These policies can be lifesavers covering up-front deductibles and living expenses if you are unable to work due to a critical illness.

To sum up this article, my best advice is for you to be aware of what your policy is, and what you would be looking at in terms of deductibles and out-of-pocket expenses if you do have some kind of critical illness going on.

Unfortunately, a lot of people presume that because they have health insurance, that they are all ‘good’ however, that is not the case. There are other things you can do to, fill in that gap in case you have a major life event. Visit or my Facebook page JKapp Consulting and book an appointment with me to discuss how you could avoid surprises with your healthcare plan. I am here for you when life is good, but also when those big life emergencies happen.

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