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'Overuse' of Health Insurance?
Old 01-22-2013, 08:02 AM   #1
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'Overuse' of Health Insurance?

Hello folks,

I am appalled at the way these health insurance companies make money. To cut long story short, I have HSA type insurance with $4000 deductible and contract year is Nov'12 to Oct'13. I met $1400 in month of Nov and Dec. I thought (learned through numerous phone calls and emails with insurance company) that $4000 deductible is for the contract year. Today, I learned that it is for the calendar year so that deductible became zero on 1st Jan.

To be very honest with you, it is very annoying. Now, I plan to make sure that I spend at least $8000 for my healthcare, essentially performing the procedures that neither me nor my doc thinks essential but good to perform. I do not know if this counts towards overuse or even abuse of your insurance coverage but I am not here to talk to ethical aspects of it. My question is, should I do that, how it is going to affect my next year's insurance premium. I do plan to ask employer to drop Rx coverage next year because goodrx.com gives lot better prices than my insurance.

To note, this insurance is offered by a small employer who buys it for only 3 employees and we are the only family (and hence I WILL think of ethical aspects as I do not want others to suffer out of my actions).

Many thanks in advance.
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Old 01-22-2013, 08:14 AM   #2
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Now, I plan to make sure that I spend at least $8000 for my healthcare, essentially performing the procedures that neither me nor my doc thinks essential but good to perform.
Ethics aside, this is a bad idea.

Health insurance is not something you want to use as tool to 'get back' at the insurance company because a rep gave you bad info about your deductible. You could very well end up shooting yourself in the foot - figuratively speaking, of course.

Get over it and move on...
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Old 01-22-2013, 08:15 AM   #3
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I have a HSA that the contract starts and renews in Feb. I've just assumed that the deductible is for the calender year, which it is. It does get me a bit each time in Feb as I know the premium increases each year.

IMO, I don't see the rational of purposely spending $8000 a year to meet the deductible. Wouldn't it be better to time the procedure (if that won't impact your health, of course) in the year you'd have a better chance of meeting the deductible?
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Old 01-22-2013, 08:20 AM   #4
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Originally Posted by noelm View Post

To note, this insurance is offered by a small employer who buys it for only 3 employees and we are the only family (and hence I WILL think of ethical aspects as I do not want others to suffer out of my actions).

Many thanks in advance.
The policy is probably underwritten, and future rate increases for the entire policy group will probably be based in part by usage. So, your additional use might spark a price increase for everyone.
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Old 01-22-2013, 08:27 AM   #5
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The policy is probably underwritten, and future rate increases for the entire policy group will probably be based in part by usage. So, your additional use might spark a price increase for everyone.
+1

Thus shooting not only yourself, but your co-workers in the foot (feet)...
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Old 01-22-2013, 08:31 AM   #6
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....... Now, I plan to make sure that I spend at least $8000 for my healthcare, essentially performing the procedures that neither me nor my doc thinks essential but good to perform.....
I think that two or three colonoscopies in a month will cure you of this idea.
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Old 01-22-2013, 08:58 AM   #7
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I think that two or three colonoscopies in a month will cure you of this idea.
And make someone at the insurance company suspicious.
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Old 01-22-2013, 09:10 AM   #8
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And "we" wonder why Americans pay twice the rest of the developed world and our health care costs are increasing at an alarming rate, along with many other causes.

Are you saying it was not shared or published anywhere that deductibles reset on Jan 1, so the period is calendar year?

It's incredible how often people shoot themselves in the foot without thinking things through...
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Old 01-22-2013, 10:11 AM   #9
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Thank you everyone for the info.

I was suspicious that it WILL be troublesome to my colleagues, hence to make it sure I posted a question here. Secondly, the procedures I was referring to are overdue for a while but as a result of my health, I have been postponing, perfectly mentioned by someone, colonoscopy. (It costs $750 at my doctor's office)

Finally, I am not born and raised in this country. This face of insurance system is rather new to me. Although read a lot about it, personal experience is only 2 years old. When I actively started using what is called as health insurance, I was living in Sweden, where it was pretty straight forward. Where it was not, the consumer was informed due in advance so hardly anything appeared as "Surprise!!". So please, don't put me in the arena of insurance overuser. I still have enough conscious left to educate myself before I do something (stupid) like that.
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Old 01-22-2013, 11:11 AM   #10
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Originally Posted by Midpack
And "we" wonder why Americans pay twice the rest of the developed world and our health care costs are increasing at an alarming rate, along with many other causes.

Are you saying it was not shared or published anywhere that deductibles reset on Jan 1, so the period is calendar year?

It's incredible how often people shoot themselves in the foot without thinking things through...
I can speak for OP in that deductible resets can be confusing, especially since OP appears to be running his insurance through employer. When I was working, our year to year deductible changed several times over a 5 year period due to changing of carriers. I changed to an individual plan, as it was way cheaper than staying on with group plan that I was allowed to stay on. I must admit, come Nov. and Dec. the thought of don't get sick or injured, or your $5500 deductible may quickly become a $11,000 deductible after Jan. 1st, enters my mind. I personally have no interest in being probed or poked on, so I wouldn't access more medical care than necessary. Now, if I had met deductible early and was planning on a test of some sort "down the road", I would accelerate it to get it paid by insurance carrier. Fortunately in 3 years of retirement, I have had $0 spent on healthcare, not including dentistry cleanings.
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Old 01-22-2013, 11:39 AM   #11
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Originally Posted by noelm View Post
Thank you everyone for the info.

I was suspicious that it WILL be troublesome to my colleagues, hence to make it sure I posted a question here. Secondly, the procedures I was referring to are overdue for a while but as a result of my health, I have been postponing, perfectly mentioned by someone, colonoscopy. (It costs $750 at my doctor's office)

Finally, I am not born and raised in this country. This face of insurance system is rather new to me. Although read a lot about it, personal experience is only 2 years old. When I actively started using what is called as health insurance, I was living in Sweden, where it was pretty straight forward. Where it was not, the consumer was informed due in advance so hardly anything appeared as "Surprise!!". So please, don't put me in the arena of insurance overuser. I still have enough conscious left to educate myself before I do something (stupid) like that.
My earlier post was overly harsh now that I know your background. Unfortunately you have to have your wits about you regarding health care in the US. Everything is documented somewhere even if unnecessarily complex and arcane, and when deductible period starts/ends is something basic folks should make a point of finding out. I am truly sorry you had to learn the hard way...
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