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Do you actually KNOW what your health insurance plan covers?

The health insurance industry spends $1.4 million per day assuring legislators that their health plans are wonderful, and that Americans love their health insurance. Yet 76% of Americans favor reform to include a Public Plan.

So, the real questions is, do you like your insurance? What you pay? Do you know if there are hidden caps, exclusions, or deductibles that make it more expensive?

How could you find out? Could you call your insurance company and ask them what you're covered for, and what could send you into bankruptcy? (62% of all bankruptcies in the US are due to inadequate health insurance.)

Update:

MikeGolf--I feel your irritation. Could it be that all of the plans you are considering each year are grossly overpriced for what they provide? Maybe people in other countries get more and pay less.

What are your exclusions? Caps? Do any of you know what the limitations of your insurance might be, say, if you got serious cancer or other debilitating, long-term illness?

Update 2:

cadcommando--If you read my profile, you'll find that I'm a retired systems interoperability expert. I did the first electronic transfers for health care for the insurance companies.

15 Answers

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  • Anonymous
    1 decade ago
    Favorite Answer

    Yes. I have Medicare. It covers about 80% of hospital services provided treatment of an illness. There are limits on stay lenghts and a time lapse is required before the benefit used can be used again. Compensation for specific procedures are defined by the program.

    The GOP prescription drug bill was for the insurance and drug company profitability thanks to Frist. No one read that bill and AARP sold out its members for its own insurance sales. My prescriptions have doubled in price.

    Special interests and GOP demagogues want to prevent ANY health care reform They are doing to health care what they did to home ownership. The rich get richer. The ordinary citizen is led about by lies and liars to their personal detriment. I am amazed at how ignorant individuals are about the ways insurance companies limit their access to good health care. Profit matters more than persons. The death panels ARE the HMOs and PPOs.

    Source(s): Decades of dealing with insurance benefits and claims for services in a non-profit mental health service provider.
  • 1 decade ago

    My family and I have 90/10 coverage with a $500 deductible. ER visits are $150 and office visits are $20. Prescriptions are either $30 or $40. for all of this, I pay $500 a month... and that's not including dental or vision.

    This might sound good, but the truth is that for the limited amount of office visits my family makes, I might as well take the $6000/year and open a tax deferred health savings account and negotiate my own rates with doctors and hospitals. What I don't use I keep.

    As an actual healthcare professional, I see the other end. I am a witness to the the games that insurance companies play and let me tell you in no uncertain terms... These games jeopardizes your life in the wrong circumstances. I hope none of you need a brush with death in order to realize that a public plan is the best option.

  • ?
    Lv 7
    1 decade ago

    Our insurance is great. Covers everything except a yearly physical.

    There is a 250 deductible for the year, no copay. Zero cost to me. Part of retirement package. Also purchased a Catastrophic policy that costs 200 a year per person. Used to get free prescription coverage till the Government screwed that up and now makes us pay for a government policy Part D so that is 450 each per year

  • 1 decade ago

    My company offers 2 HMO for my area. The price for each is identical and the plan brochures are word for word identical. There is no choice.

    Just this week I went to the HMO Web site to see what chiropractic coverage I had for my wife. After 20 minutes I gave up - there was absolutely no information on coverage.

    My experience with HMOs over the years is that they increase in cost every year, the coverage decreases every year and more and more they deny claims and force us to appeal the denial. The appeals are always successful so obviously they are trying to see if we will get stupid and pay for costs the HMO is supposed to cover. If it was up to me I'd jettison every stinking private health care company and put it into the hands of the government like all the other western democracies have. It's insane to have a system of health care using for-profit insurers who have a vested interest in denying care.

  • 1 decade ago

    My health insurance is just okay. $398.00 per month. $25.00 copay for office visits. $75.00 for the ER. No prescription drug coverage. No vision coverage. I do have dental. Yes, there is a whole booklet telling what is covered and what isn't and the limitations.

    You can find out by reading your policy - or, like you say, calling the provider (you will be on hold for at least 30 minutes and then get some surly kid that doesn't have answers).

  • 1 decade ago

    Are you one of Obamatar's paid union workers? Do you go to Town Hall meetings and try to intimidate those that oppose Obamacare?

    I have to guess that you are because you are spouting off the same, tired, lib lies that all of the other puppets are using. And you have a statistic in your rant that is just plain false. 76% of Americans DO NOT favor a public plan. It is closer to 60% of Americans that oppose a gov takeover of healthcare.

    You have not read the bill. Obama has not read the bill. None of the legislators have read the bill. How can anyone truthfully answer a question when they know nothing about the content of the bill? The answer is that you cannot. So all of the misinformation that Obama is accusing the opposition of spreading is actually his.

  • 1 decade ago

    During 'open enrolement' last year I spent an evening reading and comparing the details of all the plans my company offered. Then I chose the one that fit my needs the best.

    BTW - why should it be the insurance company's fault if you did not read the brochures and information beforehand?

    The thing that annoys me is the people at my company who year-after-year chose the cheapest plan - then complain about how it sucks.

  • Anonymous
    1 decade ago

    Good point.

    Most people get the insurance their employers pick and they only make one decision once a year, hmo or ppo, and have no idea what is covered. That is until something happens.

    Personally I don't understand any of their jargon so I just pay extra and get an hmo.

  • 1 decade ago

    Mine is great $238 a month...$25 co pay...$75 ER...$5 generic drugs...my child's birth and prenatal care was free...yes I read the book they sent me...I have dental with a different company...and vision with the same...

  • Anonymous
    1 decade ago

    I am not convinced that the contract with my insurance company is worth the paper it is written on. I have fought for days over payments for legitimate expenses (18 months in one case, finally received payment).

    The insurance companies will lie, cheat, steal and refuse coverage. Yes, I have sued an insurance company over being lied to by their representative (won that one also). Our insurance companies will steal from us if we let them.

    Don't let them. Tie the ******** up in court if you must, but insist they honor their contracts.

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