Driving Home a Point

Seems only yesterday (but it was actually the 13th) we were posting on how a million dollars didn't go very far these days.

Now we are back.

Consider Gladys Lester who battled cancer for 19 years only to discover she had exhausted her $1,000,000 plan limit.

Or Australia Montoya who hit her plans' $150,000 per illness limit in less than 2 years.

Patients with advanced breast cancer can ring up $160,000 annually just for chemotherapy. One of Montoya's hospital stays was billed at more than $200,000.

The time to find out about plan limits is BEFORE you need the benefits, not after.

Caps come in many forms: lifetime caps, annual caps, prescription caps, caps per illness. Most people don't realize their policies are limited until they find out the hard way.

Many plans are starting to limit how much they will cover for Rx benefits. The people who buy these plans never believe they will require expensive medication.

In tight spots like this, patients figure out ingenious ways to work the system. Lester has used Local 1262's unlimited prescription plan to order chemotherapy drugs through her drugstore. By purchasing a drug like Herceptin — a $6,499 anti-cancer medicine that costs her a $30 copay under her prescription benefit — she keeps the charge off her hospital bill.

Gaming the system in your favor is a common occurrence.

Rather that resorting to playing games, why not just buy a plan without limits from the start?