Fake Health Insurance?

It seems hard to believe that there is such a thing as fake health insurance yet apparently there is. It seems those likely to succumb to this fraud are people with pre-existing health conditions, people looking for low-cost health insurance, those without jobs or those without employer coverage. I've been in this business for years and there is no such thing as cheap health insurance. And, in general, if you haven't heard of the company or are unable look at company financial details on a business site, well, I wouldn't try to get health insurance from them.

Bad past health habits?

Much of the talk about health care reform centers around preventive visits to detect significant health problems earlier. Most health insurance policies have some preventive care coverage. I'm not a doctor, but I have learned that I can get my lab tests done inexpensively at the lab my insurance uses and these tests are substantially discounted. Most lab results come with comments on how the results compare with "norms". For example my cholesterol was 224. Well within normal requirements, and the breakdown of HDL to LDL was also revealed. However my triglycerides were at 200 vs 150 for "normal". A quick check on the Internet revealed that 200 was quite OK for my age, but to lower triglycerides, I should exercise more, adjust diet to reduce fat and cholesterol and lose a few pounds. Total cost - less than $35. So what about youthful discretion's? What impact would these have - read on.

Some insurance may not be needed !

By definition, insurance is the exchange of money with an insurance company for the insurance company accepting financial risk. The litmus test is whether or not the cost of the insurance is worth the exchange of risk. Buying health insurance to avoid the cost of an office visit, probably doesn't pass this test. Buying health insurance to avoid the medical costs associated with a critical illness, such as cancer is definately worth the cost. What about other insurance? Perhaps there are savings by reviewing other insurance coverages. Check this article out - 10 Insurance policies not worth the money.

Too much medical care?

An interesting article about too much medical care, especially in the end stages of life. Life is highly regarded by most Americans. How much medical care is too much? In times of low stress is the time to set boundaries on care for in times of high stress, decisions are difficult. Will that last batch of chemotherapy work? What if it makes things worse? An interesting read.

Transparency in health care

Do you know much a lab test costs for cholesterol levels? Any idea how much a knee replacement would cost? Or even an office visit with your regular doctor? Transparency in health care is the movement to make the actual cost of the medical process transparent to the user. Ideally one could shop area hospitals by cost and reputation and success rates for knee replacements or other medical procedures. Same goes for doctors. Want an idea what a sports physical would cost or other service provided by your doctor? Transparency would require medical professionals to post a list of services and costs for those services. Sounds reasonable doesn't it? You wouldn't purchase a house without knowing the mortgage payment would you? More on transparency in health care.

How much are health insurers spending on you?

Part of Health Care reform is an attempt to regulate how much health insurers spend on their policy holders. This is called a loss ratio and the reform legislation calls for an insurer to spend $0.80 per $1.00 in premium to pay claims and provide services. The other 20% would be for salaries, agent commissions, overhead, buildings and other administrative and non-claim expenses. For large companies, those with more than 100 employees, the ratio increases to $0.85/$1.00 in premium. Read here for more details http://money.cnn.com/2010/05/25/news/companies/medical_loss_ratio/index.htm?source=cnn_bin&hpt=Sbin Does this make sense to you? One study shows that only 7% of cost increases are contributed by administration costs (including insurance premiums). The leading contributors - Hospitals and Physicians http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358.

Here's a great example of discounts for medical services when one has health insurance. http://www.aetna.com/provider/data/ProviderNetwork.pdf . Sure it's an Aetna example, but it translates to other carriers as well. Basically when a provider agrees to join an insurance network, they also agree to the fee schedule. So a $150 list price office visit, gets discounted to $90. And a five-day hospital stay gets reduced from $25,000 to $8750. However, if your deductible is say $3000, you are only out of pocket $3000 on a 100% coinsurance plan.