Monday, July 26, 2010

Broken

I've been aware for some time that the medical system in this country is broken. Today however I see that more clearly than ever before.

When Squirrel had his accident we had a short term health insurance policy. It covered a portion of his hospital bills but by no means all of them. In January we switched to a "permanent long term" policy that had a fairly high deductible and a premium payment of almost $600.00/month. However it has paid nothing on Squirrel's follow-up tests determining them either to be diagnostic or relating to a pre-existing condition. It has also denied coverage for my (recurrent) sinus infections determining them also to be pre-existing due to having been treated for them previously in less than a year. (Last fall and two this past spring). We have been paying out almost as much on these medical bills as on our monthly premium payment. Slowly there has been progress but there is still a long way to go.

This month B requires some testing done. He made his first doctor's appointment in several years for last week. We went together and blood work, an ultrasound and sleep study were ordered. I phoned our current insurance company this morning to try to find out what percentage of these tests would be covered. Turns out that unless he is hospitalized and having surgery within 21 days these would all be considered diagnostic and would therefore not be covered at all. Considering how much we are paying per month for coverage this is decidedly unacceptable.

So...I'm once again on the search for health insurance. I did...with B's approval go ahead and sign up for a policy that has no deductible, covers all pre-existing conditions with no waiting period, pays 75% of "everything" with a office visit co-pay of $10-30.00 and what sounds like reasonable co-pays on prescriptions. It is a plan designed primarily for "difficult to insure" people who have pre-existing conditions...and not everyone qualifies. In other words, because I deal with depression our family would qualify for this coverage while someone who was as "healthy as a horse" would not. The price is much more reasonable than what we had before and there is a 30 day satisfaction guarantee. So...we will see.

I rarely post anything that could be remotely construed as political or having anything to do with politics. However...right now I feel this needs written.

5 comments:

Karen said...

Broken I would agree--mostly, however I do not think O....care is the answer. Do you?

Edith said...

No I absolutely do not think O...care is the answer. I think that will only make things worse.

Widsith said...

I'm sorry to hear about these challenges with insurance, Edith! I'm learning that where politics really matters is not so much in the theory but where it truly affects people's lives.

The new insurance you've found sounds promising, and I hope it works out for you and the family!

D.C.

ISA Brokers said...

Hi Edith, I hope you do not think I am out of line messaging you like this, but since I work in the insurance industry, my computer alerts me any time someone posts a blog about insurance. I want to begin by saying you are correct, the system IS broken! I promise you I am not trying to sell you anything or suggest ANY kind of insurance plan, I am writing you purely out of curiosity about the plan that you mentioned purchasing in your post, and the nagging feeling in my heart that there is no way such a plan could possibly exist. I would love to look it over if you would be so kind as to share the name of the plan with me. Again I assure you I am NOT trying to sell you insurance. We are a Christian agency that serves missionaries overseas, and this plan sounds way too good to be true. If such a plan does exist, I have a number of hard to insure people who would benefit from such a policy. Would you be so kind as to email me the name of the plan?
my email is kina@isabrokers.com and I cannot stress enought that I am NOT trying to solicit you and hope that you do not think I am out of line in emailing you! Just think of me as the Erin Brokovich of the insurance industry: "I hate insurance agents, I just work for them." ~ Kina

Apple said...

We had five years where we were either without insurance or had minimal insurance. My coverage will end at the end of the year unless I pay a very high COBRA premium or buy another policy. I'm tempted to go without and just cover whatever comes up with what we would have paid for insurance. I was really hoping for some type of National Health Care. I hope the policy you have now really works out.