Consumer’s Health Insurance Blog

Today’s post about hip replacement surgery reminded me of the huge difference in money, time, and anguish that can occur when a hip replacement is needed. We had a family member who has had a hip replaced in the “regular” way – with months of rehab, following a few weeks in the hospital. Had we known in advance about procedures like the one mentioned in the InsureBlog post “Nice joint. Thanks, I’m hip.”, our family member would have saved months of recovery, thousands of dollars in hospital costs, and been back on her feet in days, back at work.

When looking at the cost of health insurance and procedures, we often overlook the non-covered costs to the patient and family, which can sometimes exceed the costs of the procedure. Being out of work for months, needing additional care at home (or in a facility), and the physical pain and accompanying mental anguish are large costs, too. If you are in the market for a hip replacement, or know someone who might, shop around for different doctors and different approaches. There might be a huge difference.

And while I don’t know alternative treatments for many other maladies, there have got to be some other big ones, such as the difference between back surgery versus chiropractic or osteopathic medicine.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   anguish · health insurance cost · hip replacement · money · timeNo Comments.

It took me some time to figure out that a Health Wonk is a Health Policy Commentator, and this week the Health Business Blog hosts the Health Wonk Review, which includes folks saying what the candidates should be thinking about regarding health policy, including health insurance. You’ll notice my post Two Specific Areas for Improvement in U.S. Healthcare is included, along with some other interesting insights. Go read the posts!

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   blog carnival · health business blog · health wonk reviewNo Comments.

The latest cavalcade of risk (#44) bi-weekly carnival  of risk related blog posts is up at The Digerati Life. Check out what’s happening in the world of risk management, insurance, and the like.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   blog carnival · Cavalcade of RiskNo Comments.

Why did I just get a “clarifications and changes” document in the mail yesterday, when the effective date on the “clarifications and changes” was 28 days prior, and the date that the information was prepared is listed as 7/07? Shouldn’t I have gotten the information sooner? What if I had made a claim in the new year, but didn’t receive the changes until today? It’s not as though the insurer didn’t have the changes – they probably filed them with the State of North Carolina in July of ‘07.

My preference would be to get the changes a month or two before they became effective, so that if I had any issue I could take action and make changes. Fortunately the changes won’t impact us, but it would have been nice to be notified ahead of time.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   Health Insurance · HSA · policy changesNo Comments.

As unbelievable as it sounds, some HealthPartners employees are talking about striking over *their* health insurance benefits, as I found at the Minneapolis Saint Paul Business Journal and Pioneer Press. At issue is the need for employees to pay a portion of their medical premium, and a change in the way prescriptions are paid.

Obvious to management is that the costs associated with the group have gone up due to the utilization of medicine, but apparently that same point of view is not shared by the workers. What can management do? They can cave in to the demands of the workers, and find another way to pay the difference: by increasing costs, and premiums to create a larger margin in operations to cover the costs.

But, you may ask, what about corporate profits, and those blood-suckers who run the insurance side of HealthPartners? HealthPartners is the largest consumer-governed, nonprofit health care organization in the nation.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   co-payments · Health Insurance · strike · twin cities1 Comment

I just came across a report on the UPI Newswire where information about a study titled “Co-payments as low as $12 deter women from getting mammograms” by Dr. Amal Trivedi. According to this article, the study found that 8% less women were having their annual mammogram when the copayment was $12 versus when there was no copayment at all. I’d need to look at the study further to know whether the populations of women were socio-economically, geographically, and industry neutral, because I can see a lot of differences in attitude based on these factors.

What I think the important message is from the study, regardless of any population related skewing, is that people will skip having preventative medical screenings if there is a cost. This confirms what other studies have said about people without health insurance postponing care until disease has progressed very far, and therefore having a lower chance of a successful recovery.

What does this say for HSA’s? Do people with High Deductible Health Plans (HDHP) that don’t offer covered wellness features have a lower chance of beating serious disease? Is the problem with delivery of health services for what appears to be a very low price? Perhaps we should focus on other reasons that people would avoid an uncomfortable health screening besides cost. What about not having evening and weekend hours? Or a clinic nearby? I bet that we’d find noticeable percentages in these factors, too. Maybe the provider offerings available in different plans would also make a difference in the rate at which people went. Choosing between an unpleasant clinic and a nice one might also make a difference.

I welcome more studies along these lines. We can have the greatest health care available, but if people don’t take advantage of it, for even $12, we have a problem.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   co-payments · HDHP · Health Insurance · HSA · mammograms2 Comments

In today’s Washington Post, Christopher Lee writes “More Hitting Cost Limit on Health Benefits” and discusses the lifetime maximum benefit on health insurance policy, the lower limit on transplants, and the ways that people are dealing with this issue (and in some cases not making the necessary choices). There are a couple of of other major dangers when buying health insurance that are related to this article, but not mentioned.

I think that people should try to buy a health insurance policy with unlimited lifetime benefits – when they can afford it. It is better to have some benefits than no benefits, so if unlimited benefits can’t fit into the budget, get what you can, and then get more when possible. But there are plenty of offerings that don’t have this level of coverage, and some of them are more affordable than unlimited benefits.

Here are some additional dangers:

1. Annual maximums. This one amazes me, but it is available in the market at a lower cost. You have a maximum annual benefit that runs out at perhaps $100,000. That’s it in a given year. You pay everything else.
2. Supplementary and non-comprehensive insurance. These two types of products may be the only thing purchased by people who don’t know any different, who are dealing with a shady agent, or don’t want to pay for more coverage.
3. Pre-existing conditions. If you’ve got a problem, then it’s hard to get coverage, or affordable coverage. This one gets people frequently, when it is too late to buy better health insurance at the best rates.

There are more. And many other things to know and learn. Read this blog, visit our health insurance book and resources website, and read my health insurance book to do the best you can when buying health insurance.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   Health Insurance · lifetime maximum5 Comments

As soon as I had read the article “12 money mistakes that could cost you $1,000,000“, I wrote a letter to the editor of consumer reports, which I promptly saved to my desktop, and forgot. You see the desktop on my computer goes from a dozen folders to a hundred files in a matter of days, and I don’t always have the time each day to organize the files properly and act on those waiting in the queue. So when I saw the posting at The Digerati Life it reminded me that I needed to take action. Which means posting to my blog, and trying to find the right link to send it to consumer reports. I also found a number of other reactions to the article on the web, such as The Sun’s Financial Diary and Free Money Finance, thanks to the Silicon Valley Blogger. You may have guessed my area of interest in responding: health insurance!

So here’s the letter:

Dear Consumer Reports Magazine Editor,

I always enjoy reading Consumer Reports financial articles, and the February 2008 “12 Money Mistakes That Can Cost You $1,000,000″ was great. However, I think that the cost of #7, Maintaining an unhealthy lifestyle, was far too low. Health insurance rates dwarf those of life insurance. For example, in North Carolina the difference between a preferred plus individual health plan and a guaranteed issue plan for someone with a medical condition can be $800 or more a month. The additional amount paid by the 40 year old male over 25 years (until Medicare) is more than $240,000 due to additional increases due to age. This applies to everyone, since those with group health insurance at work may no longer have health insurance as employers move away from providing this benefit, and also for people that cannot continue to work due to health conditions brought on by an unhealthy lifestyle. Some folks with unhealthy lifestyles can’t even get health insurance, so if they have a medical problem, it could cost a lot more than $240,000.

Of course, this is only the tip of the iceberg. Additional costs can accrue in many other ways from an unhealthy lifestyle. Time lost from work, from family, and from community due to side effects of unhealthy habits. And imagine how much a jury would award in punitive damages if there was anyone to sue – in the millions. Oh wait, there are lawsuits like this, and the awards are huge (tobacco), and publicity is negative (fast food). And the money goes *to* the person with the unhealthy lifestyle. So maybe it’s not a costly mistake, but an investment in future returns. Unless you die first, of course.

Yours truly,
Jonathan Pletzke
Author, “Get a Good Deal on Your Health Insurance Without Getting Ripped-Off”
www.BestHealthInsuranceBook.com

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   Consumer Reports · health · Health Insurance · insurance · Personal Finance5 Comments

While the presidential candidates are talking blue-sky reforms, with all sorts of proposals, they may overlook the specific problems faced by real people in the U.S. today. In a comment on Response to Self Employed and Going It Alone, Steve makes two excellent points that we should all know about and make part of our agenda for change:

1. There is no credit for having paid into health insurance for a number of years. The health insurers assess rates based on health conditions. Two people with the same age and condition will pay the same rate – even if one never had health insurance, and another had it for 20 years. I think that we could find some support for reform around this point. Folks that pay into the system year after year should earn something more than gold stars.

2. There are specific dangers when moving from employer group coverage, whether voluntary, due to company closing, layoffs, or anything really. A number of them are spelled out in the post Why Getting Your Health Insurance at Work Could be Dangerous. This area could certainly use some improvement in terms of policy and specific implementation, including either making the transition better or warning people up-front before they sign up for employer group health insurance. I’ve seen a lot of sad stories about how people fare when they no longer have access to employer group health insurance.

In addition, the advice for Jen in Response to Self Employed and Going It Alone is specific to her. Unfortunately, there is no one-size-fits-all advice for health insurance in the U.S. Each person’s situation is somewhat unique, and they need to discover the best deal for their own situation. That is the purpose of my book.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   employer group health insurance · Health Insurance · health policy · individual health insurance4 Comments

Now that I’ve had a chance at hosting a Cavalcade of Risk blog carnival, I can appreciate the effort that goes into putting one together. Julie Ferguson of Workers Comp Insider has done a great job compiling the latest Cavalcade of Risk. Check it out, there’s plenty to learn from.

I enjoyed reading Joe Paduda’s view of HSA’s. I don’t agree on everything he says. In particular, I’d rather keep the difference in health insurance premium payments between an HSA plan and other options that total hundreds of dollars a month, and invest them myself. Kind of like term-life versus whole-life insurance where the consensus seems to be buy term since it’s cheaper and invest the difference yourself (prudently, of course). For folks that may not be able to manage investing the difference, such as imprudent “investing” in a large screen TV, I concur that they might not be a good candidate for an HSA.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Tags:   blog carnival · Cavalcade of Risk · Health Insurance · HSANo Comments.