While trying to pick the health care coverage with the best pricing, I'm trying to factor in the worst-case scenario. So I'm ignoring the deductible, which only tells you the most you could pay for one medical event. Instead I'm adding the monthly premium and the out-of-pocket maximum for each option. That will tell me which plan would cost the least should I have expensive medical issues. (And judging from the past few years, and the fact I have the final trimester plus labor and delivery to get through in 2010, I should definitely plan to be reaching my out-of-pocket maximum.)
I have two options for medical, plus optional additional dental and vision plans. What I've done is tried to figure out the highest possible cost for each plan for me as an individual; for me and the baby; and for me, NT and the baby. Then when NT gets details of his job's options, I will figure out the highest possible cost for each option for just him; for him and the baby; and for him, me and the baby.
I'll then pair up the different ways that all three of us can be covered, adding together the maximum costs, for instance, of having just me on my work plan while NT and the baby are on his work plan. Then I'll compare, and the combination that results in the lowest maximum annual cost will be the option that I go with.
Sounds fail-safe, right? Although have you seen the movie or read the book Fail Safe? They think there's no way they could make a mistake, and next thing you know New York and Moscow are getting blown up. So we're watching the documentary "Sicko," and there are all these stories of people who had coverage, but when they were diagnosed with a serious condition, the insurance company found a way to disqualify treatment, such as calling a proven method "experimental," or to kick the person out of their coverage altogether, as they did with a woman by pointing out that she hadn't disclosed the "serious" condition of once having had a yeast infection on her application, so therefore she should never have been covered. I think she had cancer.
So I do realize that under the current conditions in the U.S., all this scrupulous planning to make sure I have enough money for the maximum out-of-pocket could be for naught if one of us were diagnosed with something serious, because there's a good chance the insurance company could find a way to deny payment for the treatment.
But what else can I do? I still have to make the best plans I can, and find the best deal, and try to have enough money in the bank to cover what the insurance companies say would be the most I'd have to pay.
And bide my time till we can move to England...hoping no health disaster befalls any of us between now and then.
Watching 'Sicko,' trying to plan our health care
November 15th, 2009 at 05:46 am
November 15th, 2009 at 04:33 pm 1258302834
Our current medical coverage is so good compared to most plans offered by the same company, that I am wary they are going to change it drastically down the road. Like they suck you in and change the rules - quite possible. Why else would anyone sign up for twice the out-of-pocket? Unless they really think they are that healthy and safe?
Anyway, all you can do is try your best. I shop the same way. I always feel well aware that none of my insurance (home or health) is "fail safe." You hear too many stories otherwise...
November 15th, 2009 at 04:44 pm 1258303456
November 15th, 2009 at 06:57 pm 1258311464
The sister of DF's brother in law lived in the US for several years and gave birth to children there - she had private health cover. So when DF's sister and brother in law told her that they were having their baby in the public hospital she flew off the handle about it and told them their baby was going to die or that the birth was going to be horrible - after it was all done and dusted they said that they couldn't have asked for anything better during the birth and that everything went smoothly. I've talked to a few people here and the difference between private and public seems to be that you get your own room, and that the doctors in private prefer to induce or C-section the baby sooner rather than leave it go naturally. Oh, and you don't have to bring your own nappies to private hospitals. Hmmmm....
November 15th, 2009 at 07:31 pm 1258313501
November 15th, 2009 at 08:38 pm 1258317494