In this video, Victoria S. Dorsano walks self‑employed viewers through the dilemma of choosing health‑insurance plans on the marketplace—balancing low monthly premiums against high deductibles and out‑of‑pocket costs. She first clarifies essential insurance terminology (deductible, coinsurance, out‑of‑pocket maximum) to ensure viewers understand how costs accrue. Dorsano then shares a personal case study: a 2020 ACL injury that, under a high‑deductible plan ($3,000 deductible, $6,500 out‑of‑pocket), resulted in $40,000 in surgery bills and $1,100 in additional expenses after insurance paid its share. The experience highlighted the financial risk of high‑deductible plans for active, self‑employed individuals. To mitigate that risk, she explains supplemental health/accident insurance—a low‑cost (≈$20/month) “insurance‑for‑insurance” that provides cash benefits to cover deductibles, out‑of‑pocket expenses, or any other financial need. She details how the supplemental policy reimburses or pays providers directly, creating a safety net for injuries, illnesses, or other high‑cost events. Dorsano recommends these policies for anyone with low cash flow, high‑risk hobbies, or a family history of serious illness, and points viewers to a list of supplemental insurers in the video description. The video concludes with a call to like, subscribe, and share the information with other self‑employed individuals.
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So imagine you're self-employed and it's your first time getting health insurance on your own. You've normally gotten it through your employer, but now you're no longer employed with them and you're trying to figure it on your own. So you go to your healthcare exchange and you're looking at what your options are, and you see some plans that have really, really high monthly premiums but really low deductibles and out-of-pockets, and then the inverse where you have very low monthly premiums and really, really high out-of-pockets and deductibles. And you start to think, well, I'm self-employed, I just started my own business or just started working for myself, my cash flow is kind of low, I don't really want to pay $750 out-of-pocket every single month as a premium to my insurance. That's just not really doable. So maybe I should look at some of these lower monthly premium options that have a higher out-of-pocket and a higher deductible. And you see some options that look good. Maybe there's a plan that comes up that's a $200 monthly premium and then a $5,000 deductible, which is still pretty high, but you're only paying $200 a month, which is great for your cash flow situation. And then you start to think, well, I'm a really active individual and I like to I play sports? What if I get injured and then my injury is really expensive and my medical bills are huge? I'm gonna have to pay $5,000 before my, my health insurance picks up anything. But like I said, you're new to being self-employed, so you don't really have the cash flow available for that either, to have an unexpected $5K medical bill that can really end up putting you in the hole. So what are you supposed to do? Well, the situation I just described is exactly why I decided to get supplemental health insurance. And for those of you guys who have seen my previous video on this, I've talked a little bit about the different types of health insurance you can get as somebody who is self-employed, how you can combine them and all that stuff. But I wanted to talk a little bit more specifically about why I got supplemental health insurance and how that factors into my personal healthcare situation. But before I move any further into this video, I wanna talk a little bit about the different terms that I'm gonna be using, like deductible and coinsurance and out-of-pocket expenses. So the deductible is the amount that you have to pay before your health insurance plan starts really helping you with any of your medical bills. Now, coinsurance is the amount that your health insurance plan has agreed to split with you after you've met your deductible. So let's say you have a deductible of $2,000, you meet that deductible, and then you have more medical expenses, more doctor's visits, things like that that are still covered. Your insurance plan might have something like an 80/20 split where they will pay 80% of that medical expense and then you pay 20%. And that split can look different depending on, you you know, health insurance companies, the plans that you have, all those things. The next is the out-of-pocket maximum, and what that is is really after you've met your deductible and you've been paying coinsurance with your health insurance plan to cover your medical expenses, once you get to a certain point, you may reach something called your out-of-pocket maximum. That's the maximum amount that you will have to pay before your health insurance plan will pay 100% of the covered services. So for example, if I had a $2,000 deductible, I met that deductible, and I have an out-of-pocket of $5,000, I'll be paying an 80/20 split couple it with my health insurance, and if I meet up to that $5,000 that I've paid, uh, you know, total throughout the year of covered medical expenses, then my insurance will then kick into 100% and they'll be covering 100% of covered medical services for that year that you've been covered with your health insurance plan. So now that I've run through those terms, I want to kind of go back to the reason why I got supplemental health insurance and what kind of role that plays for me as somebody who's self-employed, active, and has a propensity for injuring themselves. So in 2020, I injured my ACL, and I had a health insurance plan at the time that I purchased myself through the exchange. And I believe it was about a $3,000 deductible and $6,500 out of pocket. So it was a high deductible plan, which meant that I had lower monthly premiums. And I chose that again because of my cash flow situation, and I didn't really want to spend $500 to $700 a month on health insurance. It just seemed silly. So unfortunately that year I tore my ACL, and that's a very expensive procedure to have that reconstructed. The surgery itself was billed for about $40,000. Physical therapy was close to $100 a visit. Then you have the, the leg brace that you wear for your ACL. You'll have ongoing visits with your surgeon and your doctors, follow-ups. It just gets really expensive over the course of that year. So definitely goes without saying that I met my deductible and my out-of-pocket for that year. That still meant that I had around $65 $1,100 of medical expenses to pay for myself since that's the out-of-pocket amount. So after that, my health insurance picked up the rest of it. But $6,500 kind of on your own unexpectedly is still a lot, especially if you're self-employed and especially if you're new to being self-employed. Luckily, the medical system and the surgery center that I'm a part of and got my surgery done at has a great payment plan system where I was able to break my payments down into chunks and be able to pay that off month by month. So that was really fortunate. A lot of systems don't have that. So I felt very lucky that I was able to do that. However, it made me realize the importance of finding a solution for these instances, especially given that I'm an active person and I love playing sports and getting injured is just part of playing sports, right? So I don't wanna put myself in that position where I have to be in medical debt for some time, but I do wanna make sure I'm also choosing my health insurance plans wisely and not spending a ton of money each month for premium. So I wanted to find a solution that was in the middle, which is why I found a supplemental accident policy. So what does a supplemental health insurance policy do? So supplemental health insurance is exactly that. It's a supplemental policy that helps individuals and families to pay for specific medical instances an existing individual health insurance plan might not cover because they haven't met their, you know, deductible or they don't have the cash reserves to pay their bills. This is basically having insurance for your insurance. And since it's a cash benefit, the money can be used for anything such as medical bills, your mortgage, car payments, even childcare. So if you're somebody who has a high deductible health insurance plan and is worried about, you know, getting injured while you're playing a sport or potentially getting cancer and just being able to afford that deductible or even that out-of-pocket maximum on your own, getting something like a supplemental health insurance policy can really help you to bridge the gap and help to give you that cash benefit to cover the deductible, to cover the out-of-pocket expenses that you might incur. So using the example of my ACL surgery, let's say I injure my other knee, which God forbid, I hope doesn't happen. But let's say that happens and I still have a high deductible health insurance plan, right? But right now I also have a supplemental accident policy, which I'm paying about $20 a month for the supplemental policy. And they're fairly inexpensive. That's just my personal case. But this can vary, you know, person to person, state to state. But they're usually very inexpensive and it makes, you know, your life a lot easier if you do wanna kind of COVID your bases. But let's just say, you know, I tear my other ACL, I have to go get surgery and my out-of-pocket this year is still, let's say $6,500 and my deductible is $3,000. So what this will do is I can then submit my bills, my medical bills to my supplemental policy and they will either pay the benefit directly back to me and reimburse me if I've already paid for those bills, or I can use that money to pay those bills, or they might pay the provider directly. It depends on, you know, the facility, the state, all those things. So it just covers that bridge between, you know, your deductible, your really high deductible, and it just kind of creates a safety net. So insurance for your insurance. So if you're somebody who is self-employed and, you know, wants to opt for a lower monthly premium and you have a high deductible in your plan and you have like a risky, either risky job or risky hobbies like something that's gonna make you more apt to get injured, or even if you're, you know, have cancer running in your family or things like that, you just kind of want protection against. Having supplemental health insurance policies to cover that, that gap of what you could owe in your deductible, your out-of-pocket, is just such a breath of fresh air. It really makes me feel more at ease when I'm playing my sports, when I'm active. I don't have to worry about it being such a huge financial liability if I do injure myself. And like I said, these policies are fairly inexpensive overall, so I highly recommend them. And This is something I just wanted to go into a little bit more depth on because I've had a lot of people ask me about this in the comments on my last video. And I think it's something that a lot of people don't know about. There's several companies that offer this and I'll list some different resources down below in the description of supplemental health insurance companies and different types of health insurance that you can get that are supplemental to your, your main plan. But I just think as somebody who's self-employed, especially if you're an individual who's active or if you're concerned about, you know, illness running in your family and potentially, um, you know, not being able to pay your deductible, your out-of-pocket. It just— it makes sense to have that, and I think more people should know about it. So I wanted to put that out there for you guys. I hope this video was helpful, guys. Again, I thought that this was something that was really helpful for me, and I think it's important information to share out there as options, you know, for individuals who are self-employed and just have to afford their own health insurance and need some different options that are a little unique. And you know that aren't typically like mainstream all the time. So I hope this helps. And as always, guys, if you can like this video and subscribe to my channel, I so, so, so appreciate it. And thank you so much for watching, and until next time, bye!
