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Wednesday, September 29, 2010

Health Insurance - it makes me CRAZY!!!!

I called our insurance provider today to ask who the least expensive service provider (hospital) is in our community - they cannot give out that information! How exasperating!!!!
I was told by our insurance provider that they have contracted specific pricing with each hospital and that they cannot let me know what it is and that my only option is to call the hospital ahead of time to find out what they will be charging. This option works well if you are scheduling a test or procedure ahead of time, certainly you can call around and find out who has the best price, but it really would not work well in an emergency situation. I suspect that the insurance provider pays the exact same amount for specific procedures at any of the hospitals so probably my out of pocket will be the same regardless.

BUT WHAT IF all of the medical facilities had transparent pricing, so you knew exactly what the charge would be and could compare prices to determine who has the best price? WOW what a novel idea and one the medical providers hate, because obviously we would all flock to the best price hospital and it would only be a matter of time before the others in town would have to offer competitive pricing in order to keep patient count up. This would be a win win for the patient and the insurance company.

Instead we have mystery pricing, there is the amount the hospital would love to charge, the amount they will contract to charge with the insurance company, the amount they will charge if you can pay cash up front, the amount they can charge to medicaid/medicare, the amount they can charge to the uninsured. Could you imagine going to Sears to buy a sweater, there is no price tag on the sweater, you will not know the price until it is rung up at the register, and then you HAVE to buy it, and your price will be completely different to the next person in line buying the exact same sweater, because their insurance is different to yours? It really doesn't make sense at all does it? But this is exactly how medical billing is done.

It is unfortunate that medical billing has become such a murky, convoluted mess, and there seems to be no way out of it, and I seriously doubt that any of the Obamacare solutions will make it simpler, or cheaper. Most medical bankruptcies occur to people who have insurance - think about that, they have insurance and still cannot afford to pay the remaining balances owed.

The best thing to do is make sure that you fully understand your insurance coverage, have a savings account with at least your full family deductible saved, and then add to it, this way when a medical situation occurs you are not left high and dry, work towards saving $10,000 as a medical emergency fund, you cannot afford not to. And, take care of your health, an ounce of prevention is worth a pound of cure.


Pen Wilcock said...

It may be like a motheaten blanket riddled with holes to keep you warm, but I am sooo gratfeul for our UK National Health Service.

Barb Szyszkiewicz said...

It's very scary--there is no way to find out the "real cost" of a medical service, because they charge what they THINK they can get out of you (or your insurance plan, as the case may be.) If any other industry tried that, consumers would revolt.

A Woman that Fears the Lord said...

You're right! It's a mess. We pay $900 a month for our medical insurance.. the same amount you'd pay for rent.. which we can't because we're spending it on medical. :-) I guess it's optional for me... but not for my husband. Life is interesting. We're blessed to have such options compared to other countries. I try to remind myself of that!

Rome_is_Home said...

Found this out the hard way!
Food can be like medicine, the right kind can so much improve our health as I have found out the hard way now prediabetic with kidney issues, I am gonna try to reverse what damage I can and take better care of me and the family :)
Insurance is such a nightmare I agree, I am saving more in our health care spending account cause of such high prices on everything!
God bless