Thursday, November 19, 2009

Doctors Don't Need Health Insurance

Aetna health insurance plans are some of the best available in Georgia, but some of them are lacking in coverage. I tell folks that, when looking at a health insurance policy, look at what it does NOT cover before deciding if it is right for you or not.

"I'm a health care provider and I don't think I will get sick, so I don't need comprehensive health insurance that includes prescription drug coverage."

That was the line used to justify this woman's position during a phone interview.

She called me looking for dental insurance. Something most people don't need.

She has an Aetna PPO Value 10,000 plan. Not a bad plan . . . until you get sick.

Non-preferred brand name drugs are not covered. That includes most cancer drugs.

Preferred brand drugs are covered but only up to $5,000 per year. Someone who is ill can run through that amount in a few months.

The plan also has a $1,000,000 annual limit on all benefits.

But back to the health care provider.

"I can always change my plan if needed because of portability laws."


Portability only applies to group health insurance plans. She has an individual health insurance plan.

"As long as I don't have a break in coverage they have to cover my pre-existing conditions."

True . . . assuming they will even accept you. Of course if you are really sick, needing a medication that runs $5,000 per month what are your chances of them taking you on as a policyholder?

"I'm not planning on getting sick."

I decided it was time to end this call. Probably should have asked if she worked in Washington. That is the kind of argument I would expect to hear out of those folks.
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