Shop carefully for health-care insurance

Published on

Marketplace Morning Report – NPR

The following commentary by FTCR President Jamie Court was broadcast on the Marketplace Morning Report on NPR Radio, on Wednesday, December 14, 2005. Listen to the commentary here.
SCOTT JAGOW – Anchor: This is Marketplace. I’m Scott Jagow.

For some workers, it’s time to choose a health plan for the coming year or make changes to the existing policy. At the same time health savings accounts and the like are giving people a lot more decisions to make about their health insurance. Consumer advocate Jamie Court says shopping for health care isn’t like shopping for Christmas presents. Buyer, beware.

JAMIE COURT – FTCR: As everyone knows, health insurance premiums are on the rise, so more and more employers are cutting back on benefits and forcing patients to pay more out of their own pockets. The Orwellian terminology for the change is so-called
consumer-driven health care. What the insurers behind these products really mean is if you get sick, you should pay for it. That sounds all well and good, but it undermines the whole notion of insurance.

Insurance is supposed to be about spreading risk evenly in the form of reasonable premiums across a wide group of people. That so-called insurance pool diminishes any one person’s costs and the system’s risks. Instead new policies are being tailors for narrow demographics. The young pay less for less; the old pay more for less. No matter what your age, you have to watch out for some red flags in this new market.

If you’re on your company’s plan, you’re likely to have only a few options that the employer picks for you. But, remember, whatever plan you pick now, you’ll be stuck with it later if you get really sick, so don’t be cheap with your health. If you can afford it, try to find a plan with the most flexible network of doctors and hospitals, even if it comes with more out-of-pocket costs for you and your family. You never know when you’ll need specialty care at a remote medical facility. It would be nice to make sure you’re covered if you do.

If the co-payments on your plan are just too high and you’re thinking about canceling your coverage, think twice. If you let your health-care coverage lapse now, you may never be sold another affordable policy. That’s because the rules, generally, only protect you if you have continuous coverage. When you sign up for a new plan, find out the maximum amount you’ll have to pay out of your own pocket if your doctor ever checks you into a hospital.

The scam in some new health plans is that there is no out-of-pocket maximum for how much you have to pay for your own treatment. But there is a limit on how much the insurers will pay for a whole range of treatments, from hospitalization to chemo.

Insurers direct such skeletal benefit policies at the self-employed through so-called association health plans with names like the National Association for Self Employed. When one woman’s husband died from cancer, that association’s health plan left her with about a half-million dollars in bills. On his death bed, Doug Christensen asked his wife, Dana, to divorce him, so she would not have to be responsible for the bills. Dana refused.

The Christensen story, reported in the LA Times, is a chilling reminder health insurance is no longer a guarantee of protection. If you don’t get the fine print of your health insurance policy, it just might wind up getting you.

JAGOW: Jamie Court’s author of “Corporateering” and runs

Your comments: listener–[email protected]. In Los Angeles, I’m Scott Jagow. Thanks for listening.

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