Health Insurance 101 for Traveling Healthcare Professionals

This post was originally published on (7/22/2021) and updated on (11/1/2022).

Isn’t it funny that you’re a healthcare professional and yet the chances of you knowing how people are able to pay for their healthcare costs are slim-to-none? Well you are in the majority there my friend, no one really understands insurance unless they are required to for a living.

Allow me to introduce myself- your insurance guide/advisor/expert, Parita Patel. If you asked me 2 years ago about how my insurance worked, I would’ve stared at you and shrugged my shoulders immediately. And the last thing I thought I'd do with my life is help people with their health insurance but to be honest, when you’re mostly saving people money AND getting them better protected, I’m happy to have made the career change.

So here is my promise to you, by the time you’ve read this blog post you will 1) hopefully laugh at my corny jokes (or at least I spread a smile across your face) because 2) you’ll be an insurance expert! Let the knowledge drop begin!

Do we need insurance?
Honestly? Yes. As I always say, I’d rather have it and not need it than need it and not have it. I mean no one plans to be in the hospital right? But if it does happen, you better have some insurance working for you to protect you god-forbid one of those situations arises.

How do I choose a great plan?
Vocabulary lesson, commence! There are a few big things to look out for when picking a plan and I’ve listed them below. These definitions are pulled verbatim from the government website for available insurance plans.

• Deductible
  • “An annual deductible is the amount your health plan requires you to pay for health care each year, before your health plan benefits kick in. Before you meet this amount, you are required to pay full price or the designated before deductible amount for health care.”
• ​Monthly Premium
  • ​​“How much your health plan will cost you on a monthly basis."
• Co-Pays & Co-insurance
  • ​The amount you are responsible for with each individual care benefit.
    • Co-pays are what you would pay for the service
    • Co-insurance refers to the split between insurance and insured (e.g. 80/20% where insurance will cover 80% and you are responsible for 20% until either deductible is met or max-out-of-pocket is met).
• Max-Out-of-Pocket (MOOP)
  • “An out-of-pocket maximum is the most you’ll have to pay within a year for health care services. Once you’ve reached your out-of-pocket maximum, your plan begins to pay 100% of the allowed amount for covered in-network, essential health benefits. Costs that count towards your out-of-pocket maximum must include deductibles, co-insurance, co-payments or similar charges."
•  Network (PPO, EPO, POS, HMO)
  • PPO- this is what you want! Preferred Provider Organization- no referrals needed to see specialists, more widely accepted than any other network.
    • AKA Nationwide coverage :)​
  • EPO/POS/HMO = coverage limited to your zip code/county, a handful of doctors accept it, not great if you’re planning to cross any state borders.

So what we really want is a low deductible plan without a ridiculous monthly premium. And if you’re paying a monthly premium, I mean, why should you have to deal with co-pays also, am I right?!

What about my Employer option?
Employer plans can often be great for the employee themselves but if you add on a spouse or dependent, BOOM, you’re going to be paying an arm and leg for only OKAY coverage. #HardPass

Obamacare/Marketplace
You can search in google for health insurance plans and a few government websites should show up. Some states only want you to get their state insurance option so you may be limited depending where you’re at.

Key plan features:

• Most plans cover all preventative services so that’s good!
• Almost all EPO/POS/HMO but you can find some PPO plans depending what state you’re in
• Monthly premiums are based entirely on age & your household income
  • If you’re exceeding certain income brackets the government won’t give you discounts
  • If your income is not as high, they will give you a discount BUT if by the next year’s tax season, you end up doing better than you originally thought when setting up a plan, you’ll be paying allll those discounts back. No fun. Who wants the IRS to be involved in their healthcare right?
• Read the fine print. You will almost always be paying full price for every service until you hit that huge deductible that comes with the plan :(

Health Share/Christian Ministries/Short Term plans
In my professional opinion, stay away.

The monthly premiums are going to be sooo much cheaper but you get what you pay for. So don’t expect it to come to your aid if something happens. There’s a lot to these so if you want to chat more hit me up, I’ll break it down for you.

Private Insurance
People hear private and they automatically think it means pricey. Not true! Private insurance doesn’t get impacted by your income and has no connection to the Government. The coverage itself is great because in most cases they provide benefits up front, rather than having to deal with co-pays or deductibles first.

So what’s the catch? Not everyone can qualify for it. Private insurance is based on your health. It does require some medical underwriting where they review your health history to determine if you can get approval. From my understanding, if there are big things you are needing for your health on a regular basis, private insurance may not provide enough for your pre-existing conditions, so you wouldn’t get approved because the insurance company knows it cannot cover your expenses. Make sense?

However there are private options that are guaranteed-issued which means they won’t do any medical underwriting so at that point just make sure your agent is walking you through exactly how the plans work so that you have full transparency and can see the fine print. Whatever your situation, it’s worth learning about all the options available to you.

How much should I be spending and what’s a “fair” price?
All insurance takes into account your age. The older you are, the riskier you become to insure. As I mentioned earlier, your income impacts the Obamacare rates. Your health impacts whether you can qualify for private. So it pays to be healthy ;)

In my experience, my husband and I did not qualify for government assistance so we were paying full price which was over $675 for us monthly. This was way more than what we are now paying with private! The biggest thing to look out for is whether that plan gives you good coverage or not because even if the monthly costs are the same in two different plans, the coverage is almost not even close.

Oh and don’t forget that year-over-year, Obamacare plans get more expensive while simultaneously often decreasing your benefits. I literally saw my benefits cut in HALF and my premium INCREASE. Pay attention if you’re going with that option! Private insurance doesn’t do that at least, I’ve seen benefits go up year over year and premiums only slightly increase to account for age increase!
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In conclusion, compare the numbers for all the features of a plan from our vocabulary lesson above. That’s the best way to see what option is going to protect you better. Listen, all insurance sucks. We’re strictly picking the lesser of all evils here. At the end of the year when you review your finances and see that you spent a few thousand $ on all your insurances (home, health, car, etc.) and realize you didn’t actually use anything, not even once, you may get upset. But let me tell you this, IF something were to happen, you’re way better off having something to cover you. I’ve seen a kidney stone gone wrong cost someone $82,000. Luckily with the private insurance they only ended up having to pay $3000 but if they didn’t have the coverage, woof.

I hope this helps. For additional information, to book an appointment for either policy review or private insurance set up, feel free to connect with me at www.paritahealth.com. I can’t wait to speak with you!

Thank you,
Parita Patel
Insurance Advisor
NPN#: 19757625
Direct Line: 813-542-9100
E-mail: Parita.insurance@gmail.com
Website: www.paritahealth.com

​Medventure partnered up with Partia to give our users a complimentary gift card and free consultation when you mention "MedVenture" when you book an appointment here: https://calendly.com/parita-patel!