I've just spent the last two hours shopping for health insurance as my employer doth not provide and I am somewhat perturbed by my recently discovered high cholesterol and the chest discomfort I've had for almost forty-eight hours.
My findings: what a complete fucking joke.
$5000 deductible with 40% coinsurance after the deductible? How can you still call that insurance?
Are you familiar with this concept of coinsurance by the way? Maybe I have lived a sheltered life until now, but I had never heard of it until today. The word itself sounds ridiculous to me. If you don't know:
"Having a health plan that requires you to pay a coinsurance, or percentage participation, rate means that you’ll essentially be splitting the cost of your healthcare with your insurance carrier."
Pardon my French, but since when are we expected to go Dutch with our insurance companies? That's the whole reason they exist. Their sole purpose is to pick up the check.
The problem is I would like to go see a doctor, but I don't have a gajillion dollars to pay for it. So I figure I should look into health insurance. Now explain something to me, insurance companies....If I have to pay for the first $5,000 of my tab, how is that any different than having no coverage at all?
Not to beat a dead horse, but let's run through this one more time because I just don't get it....Let's say I pick one of these plans. I pay $200 a month as my monthly premium. Then I get sick and I want to go to the doctor. That costs me $30 in co-pay. Let's say they need to run a couple tests, an x-ray or some mild lab work. The bill for this little visit comes to $4,000. I now pay 100% of that too because my deductible has not been met (despite the $1,200 I have sent in as premium payments for the last six months). So let's say I need some sort of outpatient procedure done and that cost is gonna come to.....$5,000. I'll have to pay the first $1,000 which finally fulfills my deductible, but I'm not done yet! According to the co-insurance, I am still responsible for 20% of the remaining $4,000 which comes to $800. But I am now, thankfully, healthy. Let's summarize those numbers:
$1,200 = 6 months of premium payments
$30 = Office visit co-pay
$4,000 = Office visit bill including x-rays, tests
$1,000 = Outpatient surgery portion to reach deductible total
$800 = 20% coinsurance amount of remaining surgery bill
_________________________________________
$7,030 = Total paid by me for this medical issue whatever it may be
$3,200 = Amount paid by my "insurance" company for this issue (80% of the surgery subtotal)
Somebody, please, I impore you, tell me I am wrong and explain to me how it is not as royally fucked as it seems to me right now!
To be fair, I was able to find one or two plans that gave me the coverage I was looking for, $0 deductible, reasonable office-visit and ER copay, no coinsurance, and a small copay for generic prescriptions (I'm not even looking at vision or dental for fuck's sake!). They do exist....for a mere $445 a month. Somebody hand me a pen, I've got money to burn!
5 comments:
This scenerio is one of the many reason I am SO thankful Wayne works for Microsoft. Our insurance pays for everthing. No co-pay, no lifetime maximum, nothing. Ever.
Well, I take that back. They didn't cover a 28.00 bottle of mouth wash that Wayne needed to prevent mouth sores, but they did pay the gazillion dollars his tab has come to so far.
Interesting topic today, john. I hope you get the pain checked out soon. Watch it be nothing at all, and then you have a heart attack when you see your bill.
LOL! Well said.
No offense, but I thought the only reason you were marrying Nicole was to get on her insurance? Can you not join hers being the spouse?
(Nicole I'm kidding, I swear.)
That was the plan, Conrad, but we missed the window by one day. One friggin' day. Now we would have to wait until October, which is aboutwo months longer than she'll be there. No need to stipulate for her, she doesn't read this thing.
I can't find fault in your summary there, John... However when I had to have my gallbladder out, my $32,000 surgery cost me about $200. But I guess that's cause I had a PPO through my job... I really know nothing about insurance companies at this point except that they suck. My current insurance won't even "allow" my own doctor to draw my blood. I have to go to a lab they sanction. WTF is that?
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