Friday, November 15, 2013

Everyone in the USA is better off with quality health care.

Health care costs have gone up for the sixth year in a row, (click here) increasing at rate higher than inflation. Those who can still afford health care are often finding that their benefits are being trimmed while their co-pays and deductibles are increasing. With these growing costs is the growing importance of getting the most out of your health care coverage. Unfortunately, health care policies are often complicated and confusing, filled with jargon that can confuse anyone without a law degree....

Purchasing Health Care Insurance isn't as difficult as it seems and the Gold plated or Platinum plated policies is not necessary the BEST for any individual or family in the country. The Platinum plated health care provides THE SMALLEST COPAYS for a higher subscription price. The wealthy may or may not subscribe to these plans, it is the anticipated health care costs any family or person expects in a year that dictates the policy they purchase.

My physician is the best. She worries about me and cares a great deal about my wellness. She and her colleagues are priceless. The least I can do is take her advice and care to heart and seriously follow her recommendations. But, for the visit to the office it costs $95.00. I have a $20.00 co-pay. That is all I pay to her when I visit that office. She bills the insurance for $95.00 and it is between them what she recieves, but, on the reconciliation statement I only look at the services charged to be sure they are correct and I look at the amount I owe and it is always $20.00. That is not the physicians invoice it is the reconciliation statement from the insurance company and when I go back to her office for follow-up or whatever, there is never a balance. I pay the $20.00 before my appointment and that is all I pay.

When I have a prescription, my out of pocket is $3.00. And no I don't have Medicaid. I have a Blue Cross and Blue Shield policy. I fill most of my scirpts at Walgreens. Why? Because Walgreens honors my scripts no matter where I am even Alaska when I visit the ice fields. That is why I go to Walgreens. They give me good service, always look for the most economical method of obtaining my medications and respect any question I have. 

$3.00

That is all I pay. My full year deductible is $6100.00. That means IF and that is fairly big IF. If I accumulate services and medications and whatever totaling $6100.00 over one year the insurance than pays 100% of those costs. I have met the yearly deductible and I pay nothing after that.

I will not accumulate $6100.00 out of pocket in any given year. It won't happen. I know it won't happen. Why would I pay for a more expensive health insurance policy for a lower annual deductible if I know I will never meet it anyway? That would be throwing money right into the profits of the insurance company and I would be a jerk for shooting myself in the foot.

The companies are in business for profit and completely let you believe the Platinum policy is where all the millionaires go. NOT. 

The only way to decide what policy to purchase is knowing what your REGULAR health care costs are. And the great thing about the Patient Protection and Affordable Care Act is that all the preventive costs are FREE. I don't have to put those costs into my medical budget in any year now. It is great. I don't have to pinch pennies to be sure all my preventive care is complete it is now included in my subscription costs. I like it that way. I have my preventive appointments made already. It is all taken care of. NO WORRIES.

If I didn't have my health care insurance I would be paying far more out of pocket costs every year to keep up with my preventive costs and any anticipated illness and prescriptions than my subscription costs. Absolutely would, no doubt in my mind. I could not achieve all this wonderful care without my health insurance company. Why? Because THEY have a contract with my doctors and I don't.

If I didn't have insurance I would have to pay my physician $95.00 per visit, not $20.00. She doesn't get $95.00 for her service from the insurance company and she is a very happy and comfortable person with her contracted services with many insurance companies. 

And because the insurance isn't paying her $75.00 knowing I paid $20.00 they are making money through their contracts. Absolutely they are. 

Everyone is taken care of, me, my doctors and all those providing me care and the insurance company. I don't begrudge them their subscription fees/PREMIUMS because I could not do alone what they do as a company. 

For all those folks that are falling into this TRAP by the Right Wing Politics in the USA; they are not doing the right thing for themselves. They are paying high out of pocket costs thinking they are saving on PREMIUMS and they doing themselves a favor by BEATING THE SYSTEM. NOT. They are avoiding care and even when it is covered by their bare bones policies they aren't covered for the 'bad news' should it come.

I realize personal decisions are important. But, when it comes to health care costs being a smart shopper for insurance is knowing what your costs will be per year and honoring your wellness by receiving vital preventive care and following physicians advice. 

I wish I had a magic wand to clear up the thinking of the nation because The Patient Protection and Affordable Care Act is the best thing that has happened to every American in this country. I believe that beyond any doubt.