tag:blogger.com,1999:blog-12333976.post6049092502060881106..comments2024-02-18T15:43:14.717-05:00Comments on Moved to LivinLaVidaLowCarb.com/Blog: Health Insurance Just Needs To Be AffordableJimmy Moorehttp://www.blogger.com/profile/08590225257991702645noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-12333976.post-26568636149200139692007-02-02T09:20:00.000-05:002007-02-02T09:20:00.000-05:00"Here are my three bare minimum basic requirements...<i>"Here are my three bare minimum basic requirements for a GOOD healthcare plan:<br /><br />1. I must be able to use it with my family doctor whenever I get sick or go for a routine checkup and have full coverage with a copay of no more than $25.<br /><br />2. Major coverage (around 90%) for any big medical emergencies that may need addressing, such as heart attack, stroke, cancer, etc.<br /><br />3. Prescription drug plan that has a $10 copay for generics and $25 copay for prescriptions.</i><br /><br /><br /><br />That sounds like an absolute fantasy health insurance to me!<br /><br />Well, you *might* be able to get coverage that good.... if you're willing to pay about $2,000/month for it... per person. Assuming you can find coverage that good at all.<br /><br />Aside from someone I know who works in a government office (local police - and she actually has 100% coverage on everything, amazingly enough), no one I know has that kind of health insurance any more. Ours has become more costly, covering less and less each year, for the last several years.<br /><br />Forget being able to go to your usual family doctor, you're required to go to one that's contracted with your insurance company, unless you want to pay a lot more for the privelege of choosing your own doctor. You might be able to find one group in your area that's in your plan.<br /><br /> I have one friend whose health insurance was so bad that there was only one doctor in one group in a city 50 miles from where she lived that was affiliated with her husband's work insurance. If she got sick on a day that particular doctor was out of the office and ended up seeing another doctor in the group (or if she was switched to another doctor after making her appointment in advance, because her regular doctor had an emergency, or felt the need for a vacation), she'd be charged full price. Her insurance wouldn't pay a penny.<br /><br />Around 80% coverage for hospitalization or emergencies seems to be pretty good these days - many plans only cover 70%. Don't forget to get pre-approval from the insurance company before being admitted though, or you'll end up footing the whole bill yourself again.<br /><br />The prescription plan you want doesn't sound too far off the mark for what most prescription insurance seems to offer these days, except that the copay for the non-generics will have at least 2 price tiers - the cheaper drugs that they want you to use first, and the more expensive drugs that they'd prefer not to have to pay for at all. Which is why they make you pay at least $60 or $80 of the cost of higher tier drugs, in order to discourage you from using more expensive drugs. Allergic to all of the cheaper drugs? Tried all the cheaper drugs with no results? Too bad, you'll still pay the higher cost for the ones in the next tier. <br /><br />Oh, and don't forget deductibles, in addition to the copays and finding an "in plan" doctor. We had a choice this year of having a huge deductible (several thousand dollars), or going with a somewhat smaller deductible for a larger monthly payment. If you added up the monthly costs, plus the deductibles, plus the copays, up to the maximum out of pocket worst case scenario costs for the two choices, they ended up costing almost exactly the same for the year (except that the <i>lower</i> deductible plan never reached a maximum amount on the prescription portion, so it had the potential of costing a lot more). <br /><br />So how did they convince nearly everyone to go with the higher monthly payment/lower deductible plan? By saying that you'd have to pay the full higher deductible amount before anything at all would be covered. Never mind that you were going to be paying nearly that much more in monthly costs with the lower deductible plan, whether you needed any health care or not during the year.<br /><br /><br /> Insurance is quite a racket, the balance is always tipped to make sure they make a good profit on whatever plan you use. The insurance companies are in it to make money, there's absolutely no mercy.Caliannahttps://www.blogger.com/profile/00055882170095208056noreply@blogger.com