Throw Out the Highs and the Lows

Throw out the highs and the lows, then work with the ones in the middle. This was advice given to me a long time ago by a lady I admired. She was a consultant with one of the alphabet houses in Nashville and handled some big regional, and national accounts. One day I was calling on her as she was sorting through various bids for coverage on one of her accounts.

Despite what most casual insurance buyers think, this is a tedious process. Most insured “shop” their coverage maybe every 2 – 3 years while a few will more often than that. To the untrained eye all plans with the same deductible and “roughly” the same coverage should offer the same coverage.

They don’t.

To the casual buyer, once policies with the same deductible and copay are grouped together, you look for the lowest price.

This is a fatal flaw and one of the reasons I encounter so many people who are dissatisfied with their health insurance plan.

In truth, there are often subtle differences from plan to plan. On the surface they may LOOK the same but once you look at the policy you will see glaring differences.

One plan may include lab work in an office visit copay while another may not. This difference alone can mean the difference in paying $30 - $40 to see a doctor and paying $200 or more.

Looking further, one plan you are considering may pay 20 – 30% of charges for emergency transport (ambulance) while another pays all charges after a $150 copay. OK, you may not use an ambulance that often, but my guess is the last thing you want after a medical emergency is to be stuck with a $500 (or even larger bill).

Did you know that emergency transport companies are hidden providers? They do not participate in any network and are free to charge whatever they want. Ground transport, even for short distances, is usually $500 - $1000 and your plan may only pay $200 or so. If you have to go by med-evac (helicopter) the bill starts at $7000 and goes up from there.

I actually heard a guy complain once about his coverage for an airlift trip to the ER. Seems he was injured in an auto accident and was transported by air to the nearest trauma center. The trip lasted less than 10 minutes and the bill was over $6000. (He must have gotten a break). His plan paid about $800, leaving him over $5000 out of pocket. He felt he was not liable for the charges since he was not conscious at the time and was unable to authorize the use of the hospital.

My guess is he has been unconscious most of his life and this was just one more venture into the Twilight Zone . . .

Back to the point of this post. Do you know how much your carrier pays for ambulance transport?

When you “shop” your coverage do you just look at the items you use the most or do you search for those once-in-a-while things that can really cost you money? Do you look for the lowest price or throw out the highs and lows and work with the ones in the middle?

Will you survive a health crisis only to be faced with a financial crisis over how to cover $5,000 or more in unpaid medical bills?

There is a reason why some plans are less expensive than others. More often than not it is because of what they DON’T pay that makes the difference.

Years ago there was a popular ad for oil filters that ran on TV for what seemed like forever. As I recall there was a mechanic standing in front of an engine he was overhauling . . . a job that runs several thousand dollars. (This was back in the day when folks repaired their cars vs. trading them in on a new model). He talked about how a cheap oil filter can ruin an engine, but implied if you used a particular brand of filter you could avoid engine problems. The closing line to the ad was, “you can pay me now or you can pay me later”.

In other words, you get what you pay for.

You can buy the cheap plan and save a few bucks now, but will it cost you more in the future?

Bob Vineyard, CLU (Filling in for the multi-talented Prof who is currently on assignment in the Southwest.)