Friday, March 13, 2009

Insurance

If we can be (semi) serious for a moment, I’d like to hear your opinion / experience. To recap on my basic medical situation, last year I got tired of the rotten overpriced insurance my employer provided so I decided to drop it, save the money, and just go to the VA hospital in case of an emergency. Within a month (after paying premiums for five years and never once going to a doctor), I had an infection that required surgery and lots of other treatments to survive. I went to the VA clinic only to discover they had recently decided that if you make more than a gas station attendant you were too rich for their blood (literally). So I went to a clinic which sent me to an ER and now I’ll be paying for everything out of pocket for the next year and a half, assuming I get to keep my job and they don’t cut our salaries again.

My company, who I won’t name because I forget what they’re calling themselves today (they’ve changed names at least three times since I was hired), just rolled out their annual benefits plan. The best thing about it is that I can choose not to choose any of their “benefits”, except for the 401k hemorrhage which is a mandatory pay loss. We have two available medical insurance packages. One is cheap ($1,732 annually), from a company I’ve never heard of but inspires as much confidence as “Uncle Bob’s Super Happy Fun Wow Medical Insurance”, and is ideal for those who won’t attempt preventive healthcare, don’t need medication, and only have occasional emergencies that require no outpatient care and no more than two days of hospitalization at a time totaling less than $24k per year. Otherwise, you’re not covered. The other is from Aetna, has a moderately high deductible ($1,500) before the insurance kicks in, but covers most costs for most things after that. The major drawback is the price - $4,960 per year for just me.

Apparently fearing they were losing our business, before the company rolled out their package, Aetna sent us each a letter offering to buy direct from them. I checked their site, found the package offered through work, and compared. They are identical except the lifetime payout limit is $5 million from Aetna and only $1 million through work, dental is not included in the work package, and the annual cost is less than half. That’s right – my employer negotiated a deal for reduced insurance at only a little over twice the street price (I assume they’re skimming the extra cost for themselves). I work for the sort of people who view their employee base as trapped sheep waiting to be shorn. I’m sure that if I ever fell asleep in my cubicle, I’d awaken in a sleazy motel in a tub full of ice missing a kidney (and they’d find a way to deny any medical claims filed as well).

So now I’m opting out of all the work insurance and applying for a package straight from Aetna. Anyone who has any suggestions or experiences regarding any insurance companies, please let me know. There’s plenty of time for you to respond because the application process only requires a little more paperwork than the combination of buying a house, incorporating a business, and filing a lawsuit against god. Hopefully I'll live long enough to complete it.

15 comments:

Tracy Lynn said...

Just keep track of the paperwork that describes coverage. ALL OF IT. You'll need that if they attempt to deny any of your claims.

Matt said...

I agree with Tracy. I'm not sure that any of the insurance companies are white hats, so finding the lower cost alternative generally makes sense to me. Particularly if your employer won't go to bat for you if there are problems.

Ricardo said...

I wish I had a hot tip for you on this one but my experience has been that they are all scam artists and it's really a matter of picking the lesser of 2 evils. I find it rather shameful that as a veteran you are being denied benefits to the VA. OK so you make money but you also put your ass on the line for your country. The least they can do is help all veterans out. the system there needs an overhaul for sure. a big one.

SJ said...

As the only human to have had a positive experience with my insurance company combined with the fact that I have no clue how things work in the USA: No tip, sorry.

Sam said...

I have no clue, the last time I had real insurance was when I was a minor and under my Dad's blue cross which started scamming everyone near the end of our tenure anyhow so... I suck at things not Canadian... My disability status gives me government coverage and if I could afford real insurance then I'd lose disability because obviously I'm not disabled if I can afford real coverage lol

Circe said...

Oh don't get me started with insurance. Basically, they're about as low as car salesmen in my opinion. My state health insurance just changed names or companies or something, again, and they 'are behind' on paying my treatment center (by 4 months). Last week, the day before my weekly treatment, we get a call from the administrator informing me I will not be able to get treatment the next day unless I pay the whole amount, $2,600, and I should just put it on my credit card. Um, and I will be getting reimbursed when? and I've been paying my insurance premiums taken out of my check for how many years??? I was PISSED. So I made arrangements to go to a center in a different city and for some reason they are not having problems with this insurance company. TBC and I also got on the phone and called 2 numbers for my ins co. and my HR contact at work and boy were they livid that I was being denied treatment. Anyway, miracle of miracles, the day before I'm to go in to alternate center, my center calls and my ins. has finally paid up most of it and I can come in to their center! Course, I'm leery this will happen again. I detest insurance companies...Vultures.

Circe said...

Also, now that they've changed hands, they are wanting explanations for everything AGAIN so I think this is going to be an ongoing problem.

And I agree, pick the lesser of the 2 evils because evil is what they are.

Avitable said...

I've had Aetna in the past, and they paid for Amy's back surgery after she herniated a disc. As long as it was outpatient (e.g., she was home within 24 hours) they covered all of it. We had no problems with it at all.

Monogram Queen said...

Yikes, that sounds like such a scam. I am lucky to have good insurance. The hubs is crap though. I'm very glad you found SOME coverage though Grant.

GreenJello said...

Want to hear something ironic?

I work at a HOSPITAL, and my health insurance has worse coverage, higher deductibles, and higher premiums than just about anyone else I talk to.

Their excuse? "Healthcare workers use their benefits more than the average person." Hello? I work in a HOSPITAL surrounded by SICK PEOPLE!!!

R said...

You could just avoid getting sick until the Gub'mint steps in with a solution. Which they'll be doing any day now.

Then we'll all live in the land of happy gumdrop waterfalls and candyfloss clouds. Oh, and chocolate. There will be lots of chocolate.

Grant said...

tracy - you mean I can't rely on them to take care of me at their expense?

matt - my employer periodically makes the news for screwing employees out of their insurance payments, so I'm better off with them out of the picture.

ricardo - I just want to make sure I go with an insurance company that at least does what it claims - take my money, but pay out in times of need.

sj - so your tip is that I should move to India? Do you have a lot of Japanese women there?

sam - can I apply for disability if I claim a crippling case of yellow fever?

circe - I'm trying to avoid a company like yours.

avitable - I've had Aetna dental in the past and had no problems with it. The current plans seem designed to encourage you to stay away from doctors, but as long as they hold up their end of the bargain I won't complain.

mq - my employer is all about scamming its employees for nickels and dimes. I call them slumlord management.

greenjello - seeing as how you are surrounded by sick people, it makes sense that you would need more healthcare and therefore should receive less. Remember that insurance companies didn't get into the business to help you, they're trying to make a buck like everyone else.

r - I think I'll camp out on the White House lawn in the meantime.

Kerry said...

Good lord! I hate health insurance companies. I've had all kinds of insurance and by far the best i've had was the state health insurance offered to government employees. It "had my back" and covered the most! Because of where I was employeed, it didn't cost me a dime, unless I added family... and then it got expensive.

I dont' think i've offered one bit of advice or tip. Yet me think....

yep. Don't have anything for ya ;) Good luck! Document document document! Keep copies!!

messiah said...

Grant ma boy....
The only concern I would have is that your current condition may deny you coverage if it flairs up again. I've seen fine print that states in mostly ambiguous terms that you are covered unless there is a 'previous history' in which case there is either no coverage for said condition reoccurrence, or additional remuneration required.

Not that it will happen, most issues aren't like that - I believe it's in case you have a history of heart problems or are in the middle of a major issue and applying. YMMV.

Being Canadian, there is less worry about coverage, and more worry about dying before you can get in to see the f**king specialist.

Err... sorry, that's my 9 month delay speaking as I continue to wait.

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