Ive been looking for health insurance for my son and his daufghter.
Almost every policy I looked at had a $10,000 deductible. The premiums were $500 per month. Plus each had a 20% coinsurance.
This is one way to bypass the patient protection laws. You make going to a doctor financially impossible.
So, lets look at this one way:
$500 monthly premiums = $6,000 per year, not including the $10,000 deductible.
Doctor visit = $250 per visit. To meet the deductible to where the insurance company pays the claims = 40 visits per year just to meet the deductible. The patient not only pays the $500 per month in premiums but also pays the $250 for the visit for the next 40 visits. Once the deductible is met, the insurance pays 80% of its allowable. The patient pays the 20% of the allowable plus the difference between the charges and allowable. Lets say the insurance company allows $80 for the visit. They pay $64, the patient pays $186.00. A young, healthy couple would be paying for their medical visits with the insurance company never having to pay. There is no need to deny for preexisting because they would rarely pay for the medical care.
It looks like they found a way around the laws to protect the patient, so are we protected when we have to pay such high amounts in monthly premiums and super high deductibles. We might be better off putting the $500 into the bank and using it for the routine office visits and negotiating with the doctor ourselves.
Almost every policy I looked at had a $10,000 deductible. The premiums were $500 per month. Plus each had a 20% coinsurance.
This is one way to bypass the patient protection laws. You make going to a doctor financially impossible.
So, lets look at this one way:
$500 monthly premiums = $6,000 per year, not including the $10,000 deductible.
Doctor visit = $250 per visit. To meet the deductible to where the insurance company pays the claims = 40 visits per year just to meet the deductible. The patient not only pays the $500 per month in premiums but also pays the $250 for the visit for the next 40 visits. Once the deductible is met, the insurance pays 80% of its allowable. The patient pays the 20% of the allowable plus the difference between the charges and allowable. Lets say the insurance company allows $80 for the visit. They pay $64, the patient pays $186.00. A young, healthy couple would be paying for their medical visits with the insurance company never having to pay. There is no need to deny for preexisting because they would rarely pay for the medical care.
It looks like they found a way around the laws to protect the patient, so are we protected when we have to pay such high amounts in monthly premiums and super high deductibles. We might be better off putting the $500 into the bank and using it for the routine office visits and negotiating with the doctor ourselves.
