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Life & Health Insurance/Can't Afford Silver Plan On


QUESTION: "In your opinion, what are my options when I cannot afford the premiums on the Silver Plans that are subsidize.

For me, they are just offering EPO Plans (I have always had HMO Plans), where you have to pay the 20% co-insurance when you have met your deductible and out of pocket cost. .  We, all know how high hospital bills are. If my bill is 40,000.00.  I have to pay 8.000.00

In your opinion, would going with a Bronze, Plantium plan be more practical.

Any tips will be appreciated.

Thanks in advance."

ANSWER: Ya, well if you knew you would need the coverage, and benefits so long as the added premium offset the max Out of Pocket costs of your Silver.

In the real world you know what your budget allows, It doesn't sound like you have any significant disposable income, so you do the best you can with what you have.  It has been my experience in most cases providers are open to both "bargaining", and allowing some reasonable repayment period.  In you example of the 40K they claim, they will get 80% within weeks from the Insurance company.  You are far from the first person to have this problem.  While they may threaten you it's a given they will not take legal action.  Say you offer them $75/mo.  , $900/yr.  they know if they take you to court a judge is going to look at your finances and advises he feels, after all the conditions are examined he also feels $75/mo is all you can afford.  So knowing the probable outcome they decide to forget the thousands in legal fees and accept it.

Finally even if you fall behind medical bills don't seem to hurt your credit score.  

A final thought Obama promised us a $250 reduction in monthly premiums. much more coverage And having a take all comers policy.  In the Insurance business it's referred to as "adverse selection".  Everyone KNEW Obamacare was not going to fulfill anything the President was saying. In a brief Actuarial exam it just couldn't!!  as premiums increase those who are not healthy, have moderate to serious health problems.  As premiums increase these people will find a way to pay it.  On the other hand the younger, healthy people just either go naked, or take some really high deductible, five or ten grand and bring premiums down to something they can afford.  There is where a Health Savings Account comes in.  Voluntarily they start making tax deductible contributions. This money grows tax free also.  It can only be used to pay various medical expenses.  This way you can use these funds to pay for small expenses, what would today just count to your deductibles and co-payments.  Like any savings plan over time it grows, and the more accumulated the faster and greater it goes.  If someone started even $25/mo @ age 25 it is not unusual people go to 40yrs or more.  By the time you needed it those small deposits would reach into thousands and thousands of dollars.  All done with tax free money and tax free growth.  

So next time you hear about how great Obamacare is, look below the surface.  

Best wishes,


---------- FOLLOW-UP ----------

QUESTION: Thanks for the information.

Do you know when you pay for medical bills at the hospital or a medical facilities, what is the usual case?  Do they charge interest on the bill or there is usual no interest on the bill when you are making payments?

Any information will be appreciated.

Thanks in advance.

As stated in my first answer they will have 80% of the billed fees in a relatively short time.  It's not that they don't care, but they are all businesses, and they live in the real world.  So I would suggest contacting them when they write, or call you.  Really no reason to postpone, well unless like I am to often, a procrastinator, LOL.  

They know the play book.  They spend thousands in dollars and loss "good will" including regulators who have various levels of control over them, and if they piss off the public it could have a very chilling impact on any future plans.   What is REALLY important is to pay them SOMETHING on a regular basis.  In our example from earlier you agree to pay them $75.00, however a time may well come when you just can't pay that.  Either call and advise them, or just send in the check for whatever you can with a note.  They do NOT want to sue you.  They don't want to write it off of course, but they know unless you have a nice nice nest egg, they can attach what's the point?

As for percentages, I wouldn't bring it up, but if they ask for a few percent courts might well have done that anyway.  When all is said and done we can but hope the problem which ran up the bill is cured.  As for your credit history even if they made some negative comments you are entitled to have your side added also, and as long as you were doing as we discussed I don't think any lender is going to get to upset because again, you owned up to it, and made an agreement to address it.  It's not like you just ignored them.  

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David Clark


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I've been in the business since 1975, I ran my own agency in New Jersey from 1980 to 1998. I now am a semi-retired sole practitioner in South Florida.

CLU Courses, no designation. LUTC, more seminars then I could count.

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