My “to do” list for today included “shop online for health insurance”. I must have lost my mind along the way, because that is something no one wants to do. However, in light of my recent 34 day hospital stay, for which I have already received bills totaling more than half a million dollars, I figured I needed to find out how much I it will cost me to insure my old self.
So, I googled “pre-existing condition health insurance” and got 3,760,000 results. I started on the first page. All of the websites I visited require that you put in your name, address, phone number, and email address before they tell you that someone will call you. I do not like this type of shopping, because I want to be able to look at the plans and pricing before I talk to someone. I want to have time to get my questions written down, so that I will have a chance to sound like a sane and intelligent person. Anyway, I went ahead and filled out three forms, for three different companies. I have received two phone calls so far.
The second phone call was a very nice lady who told me that because I have diabetes, I am NOT eligible for major medical insurance. I can only get an “indemnity” plan. Because I didn’t know the difference in major medical and indemnity plans, I had to look it up. This shopping for insurance is harder than it has to be.
I googled “what is an indemnity plan” and this very helpful page came up. So, the idea is that with an indemnity plan, you are allowed you to direct your own health care and visit almost any doctor or hospital you like. The insurance company then pays a set portion of your total charges. Indemnity plans are also referred to as “fee-for-service” plans.
According to Finweb, there are essentially two classes of comprehensive major medical plans: those that provide first dollar coverage, and those that do not. With first dollar coverage, as soon as covered medical expenses are incurred, the policy immediately begins to pay benefits. Consequently, policies with first dollar coverage effectively have a deductible amount of zero. Without first dollar coverage, the insured must first pay out-of-pocket a specified deductible amount, and when that amount of incurred covered expenses has been paid, the policy will then begin to pay benefits.
So, because I don’t qualify for major medical, there is no further need to discuss or look at them. The very nice lady sent me a link to two plans that I AM eligible for. One of them costs $159 a month, but for any PRE-EXISTING CONDITION, I would have wait 12 months to be covered. That includes anything related to my colostomy and intestinal tract, diabetes, kidney stones, and plantar fasciitis. Those would be the most probable reasons I would need to go to the doctor.That is like paying premiums for a whole year for absolutely nothing.
Of course, the very nice lady told me that starting January 1, 2014 if you have pre-existing conditions, they will be covered immediately. But, that is a year and a half away. I need coverage now. And then I thought, that is ONLY six more months than
Sooo, do I chose the cheaper plan and hope that the only reason I would have to go to the doctor would be something new to me, OR do I choose the more expensive plan, at $228 a month, and only have to wait 30 days for doctor visits for any reason to be covered??? Decisions, decisions, decisions!
What about the 1/2 million bill? Do you have to pay for all of that yourself? Egad!
beware of “nice”…shop around. look on independent insurance agents and brokers of america. be sure and write down what people say so that you can compare what they each tell you. some may just push for their most expensive plans even if you qualify for something cheaper. are you a aarp member or aaa? you can also get insurance with them. even though you are a seasonal worker, there is probably a human resource manager who can steer you in the right direction.
forgot…as for your existing bill, contact the hospital and doctors and ask about ‘charity care’. some have a program where they have set aside money to ease patient debt. my sister had her husbands entire hospital bill paid in full. do it now…before they turn you into a collection agency, it will be much harder to settle if that occurs.
We have already done this, waiting to hear what, if anything, they are going to do for us.
Thanks for the insight, Karen. I will have to start shopping for health insurance within the next few months myself so this was helpful to read.
It took me months of research last winter to find a health insurance I could afford and suited my needs. Good luck with this. I finally went with AZ Blue at $210/mo. So far so good. But I had no preexisting conditions. What about Obamacare? Will that be helpful?
This is Obamacare. I am shopping in the Georgia pool. Basically, if you have pre-existing conditions, you have to wait 1 year to be covered for those conditions. Starting on January 1, 2014, there will be no penalty for pre-exisiting. So, I wait 12 months, or I wait 18 months and get insured in 2014.