Episode•May 7, 2020•21 min

Breaking Down Health Insurance with Morgan Robinson | Ep.38

Join Tiffany as she sits down with Morgan Robinson, a licensed health insurance agent. They break down deductibles, copays, HDHPs, gap insurance, and more. You don't want to miss this! This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy OP3 - https://op3.dev/privacy

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Key Takeaways

1
Deductibles must be met before insurance coverage kicks in
Traditional plans often require paying 100% of costs until the deductible is reached
Marketplace deductibles reached about $8,100 for individuals in the recent year
Preventive services are typically covered at 100% without needing to meet the deductible
2
Private insurance can offer lower premiums for healthy individuals
Private plans are underwritten, requiring good health to qualify
Lower-risk pools mean lower premiums compared to marketplace plans
Marketplace plans spread costs across all participants, including those with pre-existing conditions
3
Short-term gap plans are temporary solutions only
Gap insurance is meant for brief coverage periods between jobs
These plans are significantly cheaper but offer limited coverage
Always review fine print carefully before relying on gap coverage
4
COBRA coverage requires paying 102% of the premium
When leaving a job, employees must cover both their share and the employer's portion
The extra 2% covers administrative fees
COBRA has time limits and can become very expensive
5
HSAs provide triple tax advantages for medical expenses
Contributions are tax-free
Growth is tax-free
Withdrawals for qualified medical expenses are tax-free

Intro

Tiffany discusses health insurance fundamentals with licensed agent Morgan Robinson, covering deductibles, plan types, and coverage options beyond employer-sponsored insurance.
Morgan Robinson is a licensed health insurance advisor with US Health who helps clients find affordable coverage without sacrificing benefits.

– Introduction to Health Insurance Confusion

Morgan explains that health insurance is often avoided like going to the dentist—people know they need it but dread the process. Most default to employer plans without understanding the details.

It's like going to the dentist. People know that they have to, but they kind of cringe on the inside.
– Morgan Robinson

– Morgan's First Experience with Deductibles

Morgan shares her early 20s experience signing up for employer insurance without understanding deductibles, then receiving a $500 bill after her first doctor visit.

I did my co-pay. But I have insurance. Right. But I did paying, you know, the co-pay and I've been paying monthly like I'm supposed to. What is this? Your deductible is this much.
– Morgan Robinson

– Understanding Deductibles and Coverage Percentages

Deductibles represent the amount you pay before insurance coverage begins. Traditional plans typically use 80-20, 70-30, or 60-40 splits after the deductible is met.

The deductible this year in the marketplace was about $8,100 for an individual.
– Morgan Robinson

– High Deductible Health Plans and HSAs

HDHPs pair well with HSAs for healthy individuals due to triple tax advantages, but pose challenges for those with ongoing medical needs.

It has a triple tax advantage. So the money that you put in is tax free and then it grows tax free. And then when you take the money out for medical expenses, it's tax free.
– Tiffany Grant

– Marketplace vs Private Insurance Options

In North Carolina, consumers can choose marketplace plans (higher risk pool, higher premiums) or private insurance (underwritten, lower risk pool, lower premiums for healthy individuals).

With the rate that you're going to be paying for, of being a healthy person, you're basically paying for somebody that is sick. That's why the rate is so much higher.
– Morgan Robinson

– Temporary Gap Plans and COBRA Explained

Gap plans provide short-term coverage between jobs but shouldn't be relied upon long-term. COBRA requires paying 102% of premiums (including the employer's share plus administrative fees).

When you leave your job and they offer COBRA to you, you're actually having to pay 102%, not just 100%.
– Morgan Robinson

– Getting Help and Avoiding DIY Mistakes

Morgan emphasizes seeking professional help rather than navigating insurance alone, noting that consultations are free and mistakes can lead to costly consequences.

Really seriously, don't do it by yourself... It can be very frustrating and confusing. And you don't want to end up with something that you don't understand.
– Morgan Robinson

– Preventive Care Coverage and Unexpected Needs

Preventive services are usually covered at 100% without meeting deductibles. Tiffany shares a personal story of breaking her foot after leaving a club, illustrating why coverage matters even for healthy people.