Monthly Archives: October 2008

October 29, 2008

Consumer Driven Healthcare – My Experience: Part Deux

Shortly after we purchased our discount plan we were blessed with the opportunity to move into our dream home. This meant we had to prep our existing home for sale, prep the new home for occupancy, pack up and un-pack. This required driving 23 miles back and forth every day for 2 months during the summer.

Towards the end of the process my husband began to experience chest pains. We were in the middle of a heat wave and he is a young, healthy guy – so he did not believe that it was important to tell me what was going on. Which begs the question: why are men so afraid of doctors and pain?

Well one night it got too much for him and we had to rush to the emergency room . They kept him all night and most of the next day, they couldn’t determine if it was a heart attack or an inflammation of the lining around his heart (When the pericardium becomes inflamed then there is more fluid build up, and swelling occurs. This makes the pericardium rub up against the heart causing pain.).

We left with drugs , a prescription for more drugs and a follow-up appointment. To our dismay, we discovered that every doctor that walked into the room billed us separately, and the hospital also billed us ($14,000 for a one night stay?), and the radiologist billed us, and I think there was a bill for toilet paper!

The total cost for his one night stay was well over $20,000, yikes! And here we were with only a discount plan that hospitals do not accept. Fortunately, our plan also includes a hospital advocacy program. As soon as the bills started rolling in I faxed the bills over to the group that does the advocacy and over the next few months they were able to get all of the doctors and other providers to agree to discount the original costs by as much as 50%.

Visit to the emergency room: $14,000

Various fees room doctors: $6000+

Having my husband around at a final cost 0f $10,000 : Absolutely Priceless

October 29, 2008

Consumer Driven Healthcare – My Experience

My health care package as a corporate worker included an HSA or Health Savings Plan. This is a plan where you pay in x amount of dollars per month with a yearly maximum. You are then able to be reimbursed for non-prescription medical items, co-pays at the doctor or dentist and services that your insurance may not cover. The cost of the HSA is in addition to whatever you are paying for insurance and is considered pre-tax dollars (or is that post-tax?) which means it isn’t taxed as income.

Bottom line is that you pay a little more but are able to be reimbursed for cough syrup, your glasses and visits to the chiropractor. The downside is that you have to send in receipts and they can question your charges and not reimburse them, once you run out of money you’re on your own, and if you don’t use it all you lose it (your own money, gone).

As an entrepreneur I could have chosen a similar package, but I just could not afford to pay for something I could potentially lose. My search for a plan for my family led me to a discount plan which cost $150 per month and came with a couple of discounts for different items like vacations, tires etc. But it was marketed to me as insurance and when I got the package and read through it, I was pissed because it required a lot of out of pocket , and I couldn’t see paying over $100 per month and then having to still pay a fee once I got to a provider!

I cancelled that plan and my search then led me to a discount plan which cost only 49.95 per month and covered everything – dental, vision, prescription, chiropractic, medical, lasik, hearing aids ( you know I have that tinnitus thing and really need to get that taken care of), and cosmetic surgery (dental and medical).

Next Up: Find out how a discount plan saved me 50% on my hospitalization costs!

October 29, 2008

What is Consumer Driven Health Care?

I started really taking a hard look at health insurance when I became self-employed (OK I was laid off and couldn’t afford COBRA). The cheapest thing that I could find was a $250.00 per month plan with a $10,000 deductible. If I wanted dental, vision, prescription and all that jazz I would have had to pay extra for an addition to that plan or a separate plan altogether.

I also considered an HSA, you know that tax free thing that you can use to buy aspirin, but God forbid you should lose the receipt? The HSA would have been in addition to the $250 insurance plan and I would have used it to pay for dental, vision, prescription drugs, and doctor visits.

Long story short, I could not afford to pay that much per month for what amounted to simple assurance that if something really, really bad happened we would be covered. I have a young and healthy family , and we only go to the doctor and dentist for our once a year check ups. Therefore, it made no sense for me to pay $250+ per month for something that doesn’t cost $250 for a year.

The insurance model that I was looking at (low cost, high deductible plan with a Health Savings account) is one part of what is called Consumer Driven Health Care. There are 3 levels to a CDHC type plan -

  1. The tax exempt HSA account to be used as stated above
  2. The out of pocket payments that you will make when you have run out of HSA money, but haven’t met your deductible yet
  3. And of course the high deductible insurance policy

Consumer Driven Health Care should be a way for consumers to have choices as far as how much to pay for health care and when to pay it.

For example – since I rarely go to the dentist, I should be able to make a (very) small monthly payment, and when I do visit the dentist I could then pay a reasonable out-of-pocket expense for the services I receive.