Will Bueché



I don't blog much 

Two plans

Posted in Personal by Will on Monday, December 14th, 2009 ~ 9pm

End of the year letters from health insurance companies are arriving; I received mine and, like many other people across the country, was shocked by another 30% increase in the already substantial monthly fee, after similarly outlandish increases every year before.

Apparently, the health insurance companies are trying to make their billions in profits now, before it becomes illegal for them to do so.

In the meantime however it means I had to find another plan (still with the same company) for next year that would cost about the same, i.e. paying the same but receiving less. (The ideal that health insurance companies are seeking is, of course, to take money in but to give nothing out, so it is sad to see I am contributing to their ability to reach their state of grace.)

I examined two nearly identical health insurance plans, differing in their price by only about $20 each month.

The slightly MORE EXPENSIVE plan requires you to pay for your doctor appointments (which I’ve deduced from past bills are about $140 for simple exams — a visit you might make if you, for example, step on a rusty nail and are concerned about infection). Boo!

In contrast, the slightly LESS EXPENSIVE plan allows you see a doctor 3 times a year for only $30 each visit (before requiring you to pay for your doctor appointments). Yay!

So on the surface, the slightly LESS EXPENSIVE plan is the one to go for.

And on the surface, the slightly MORE EXPENSIVE plan is criminal — because who wants to pay for health insurance and yet get absolutely no help in paying for one’s doctor appointments, right? That’s like paying protection money and not getting any protection until you’re face-down on the ground.

But as it turns out, there’s one reason to select the otherwise crappy MORE EXPENSIVE plan that doesn’t pay for doctor appointments:

On one chart among the many pages and charts that describe and compare each plan was revealed one item which contained a substantial difference:

  • In the MORE EXPENSIVE plan, you’d have to pay $350 for an ambulance ride.
  • In the LESS EXPENSIVE plan, you’d have to pay $3,000 for that ambulance ride.

So if you were to faint from dehydration and wake up in an ambulance on your way to a hospital, you’d be out $3,000 even if you were fine and just needed an IV of saline.

And that is why the more expensive plan makes sense. It keeps you from being financially wiped out if you ever find yourself in an ambulance without any real injuries. It pays for a situation you have no control over, while, admittedly, discouraging you from seeing your doctor in any questionable situation (Notice a funny mole? Don’t see your doctor, health insurance won’t pay for the visit. Coughed up a little blood, but you seem ok now? Don’t see your doctor, health insurance won’t pay for the visit. Not sure if that’s a pulled muscle or a sprain? Don’t see your doctor, health insurance won’t pay for the visit).

[Mind you, in grave situations, either plan ends up about the same — your bills will end up being in the tens of thousands of dollars, and both plans pay for “everything”* over $5,000. *Well, not really everything. In real life, they would try to deny as much of their responsibility as possible, hoping that if you are seriously injured you won’t have the stamina or wherewithal to fight them for what is rightly yours. And ironically, the more expensive plan only pays for $2 million worth of damage, while the less expensive plan pays for $7 million — but frankly, if your expenses are in the millions, you’d be facing bankruptcy anyway.

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