Many employers are looking at ways to cut the costs of their health care premiums and benefit reductions as well as higher employee contributions are being investigated.

As a nation we have a strong desire to be healthy and active. When we have medical conditions that slow us down or cause us to be bedridden we want to get back on our feet as quickly and painlessly as possible.

In order to accomplish this the medical community uses technological advances and constant research to find new and better ways to care for each of us. The costs associated with these efforts are phenomenal and like any other business that has a product or service to deliver they must pass these costs on to the people who use them.

As we seek new and better medications, utilize new surgical procedures and consider joint replacements as well as organ transplants we are all increasing our expenditures on health care. Increased health care costs lead to increased health insurance costs.

Health insurance coverage's can vary widely in the benefits provided and in the costs associated with these coverage's. In Minnesota we have the following basic types of coverage available:

• Group Health. This coverage is typically provided by your employer and is typically one of the best coverage's you can obtain. It is a major medical policy that has few coverage restrictions but it may have deductibles and co-payments which allow some cost relief for the employer while shifting initial medical expense back to the employee on an annual basis. (Please consider looking at the frequently asked questions section of our site under health insurance for answers to basic health insurance concerns and terminology).



• Individual Health. People who do not work for someone or who have no health insurance benefits provided by their employer may purchase their own individual coverage. Individual health coverage is sometimes hard to obtain as the health insurance companies are concerned with the potential costs associated with providing insurance coverage to individuals who may have current health problems.

  Thus when a prospective client applies for coverage they may find that they cannot obtain coverage since in Minnesota the insurance company cannot restrict coverage for specific health problems.

  In reality the health insurance providers have two options-either they insure you or they deny you. Individual health plans are less comprehensive typically in the coverage that they provide. Many companies will restrict or increase premiums if coverage is desired for items such as pregnancy, mental health care, and chemical dependency treatment.

• MCHA Minnesota Comprehensive Health Association. As indicated in the individual health insurance section above it is sometimes difficult for individuals in Minnesota to purchase individual health coverage due to a pre-existing health condition. MCHA option is available when a health insurance company has denied you coverage. This is a nonprofit association which offers a major medical policy with a couple of different deductible options at rates that are relatively competitive to the private health insurance industry. Anyone who is a Minnesota resident and has been rejected by a Minnesota insurer due to a preexisting medical condition is eligible for coverage under the plan.



• State sponsored-MinnesotaCare. MinnesotaCare is a state subsidized health plan for families that meet program and income guidelines. To get MinnesotaCare a person must not have had access to employer-subsidized health insurance for at least 18 months prior to applying. The plan provides comprehensive immediate coverage for health and dental concerns. It has maximum coverage restrictions that make it different from most major medical policies.

Special Coverage's We Would Suggest:

• Many insurance companies offer co-pay plans with individual and group health policies. This will increase your premiums slightly but it is a way to receive immediate benefits from your health insurance company. Simply stated, it means you make a small payment for each visit you have at your clinic and the insurance company pays the balance of the bill. This immediate benefit compares to situations in which you might first need to satisfy a deductible prior to receiving any coverage from the health insurance company.


• Be aware of potential limitations in the coverage provided by the type of plan you select.
• State sponsored-MinnesotaCare has maximum coverage restrictions that could mean that if you suffer a major health problem you may not have enough coverage with the plan.
• If you need pregnancy coverage in most cases you will need to endorse an individual health plan and pay an additional premium to receive limited coverage.
• Group health plans typically provide the highest level of benefits but with these benefits come additional costs and thus as utilization of the coverage increases your premiums will most likely increase.


• Direct your attention towards coverage that provides coverage for the large losses rather than seeking coverage that provides immediate benefits.


• Consider high deductibles as this can reduce your cost for the coverage.


• Consider a plan that uses a Preferred Provider Option, as this is another way to reduce your premiums. This simply means that the health plan has made agreements/arrangements with medical facilities for reduced costs on procedures that you might need.
  If you consider the Preferred Provider Option make sure the doctors, clinics and hospitals used by the health insurer are the same ones that you would consider using. If you select this option and then visit a doctor, clinic or hospital that is not a member/network provider you will receive reduced benefits or possibly not by covered by your health insurance company.