Monday, August 03, 2009

Inanities in the Health Insurance World #2

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A person is quitting the group insurance to get individual right now. Getting the individual plan would save her $12 a month. It's the same EXACT friggin' plan.

Just because of this savings, the person will waste a bunch of administrator's time (NOT DOCTORS) just to save $144 a year. And this process will probably repeat itself next year, wasting more time and money.

What, you thought your insurance premiums was going to the doctors? Nah, it's going to feed this process/status quo. After all, this employee will probably go see a doctor twice next year. But in the meantime, they probably make at least $1k off her next year. Paying a couple of brokers fees and admin time will justify the profits.

But this is how the system works. Every year two or three major insurers in your area compete. And every year they switch off being the better deal. And every year your employer switches. It's the name of the game, baby.

Inanities in the Health Insurance World #1

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A client's employee moves out of state to expand their business. The employee goes to a doctor about 3-4 times in the new state, making sure to visit a doctor that was under the company's carrier. Employee gets a bill for $3k.

Why? (Here comes the inane part)

Carrier considers anything out of state, including its own doctors, out of network and therefore nothing applies.

They generously have a visiting plan, but certain restrictions apply. You know how that goes. Anything that isn't an emergency/life & death situation, well too bad.

For those of you who don't get the inanity in this, umm, do we live in the UNITED States of America? How does going out of state constitute going out of the service area? We are AMERICANS. These states are OUR states. A comprehensive UNIVERSAL plan would pretty much eliminate this possibility, doncha think?
 

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