Tip Regarding Health Insurance Plans

[TromboneAl]

When my health insurance premiums went up, I compared the costs of the $2,500 and $5,000 deductible plans.  I made the following surprising discovery:

The $5,000 deductible plan is a better option, even if you have lots of medical expenses.

That is, when you factor in the premiums, the $5,000 deductible is almost always cheaper.  Even if you have expenses over $5,000, the $5,000 deductible plan will cost only $58 per year more.  If you have less than 2,500 in expenses, you will save $1692 per year with the larger deductible.

The moral is to check the numbers in your spreadsheet before choosing a plan.  The people at the insurance company are clueless about this, and think that if your expenses are greater than $2,500 that the larger deductible is a better deal.

 

[Sparky]

Yeah, we have a $5,000 deductible policy also.

Our doctor said that we would save lots of money with this policy. But it only works if you're pretty healthy.

Even paying retail for doctor visits and lab work (the doc offered a reduced rate, but his front desk keeps forgetting about it), monthly health insurance rate for 2 is $193 - COBRA was $950 for both.

Twice per year doctor visits @ $87 each, plus $180 lab work each = $534 + $193/per month = $2,850. Plus high blood pressure and high cholesterol meds for both for 1 year = $3,720.

Total $6,570.

As opposed to $11,400 COBRA, not counting copays.

 

[Patrick]

When my health insurance premiums went up, I compared the costs of the $2,500 and $5,000 deductible plans.  I made the following surprising discovery:

The $5,000 deductible plan is a better option, even if you have lots of medical expenses.

That is, when you factor in the premiums, the $5,000 deductible is almost always cheaper.  Even if you have expenses over $5,000, the $5,000 deductible plan will cost only $58 per year more.  If you have less than 2,500 in expenses, you will save $1692 per year with the larger deductible.

The moral is to check the numbers in your spreadsheet before choosing a plan.  The people at the insurance company are clueless about this, and think that if your expenses are greater than $2,500 that the larger deductible is a better deal.

Al, I don't follow your logic on this. Usually you have to pay more to get the lower deductible. The higher deductibles are cheaper, premium-wise, because the insurance company pays less - you are accepting a greater portion of the risk. If I'm an individual in poor health and expect to have large medical expenses, $1692 paid out for a $2500 benefit (increase in amount the insurance company pays because the deductible is $2500 instead of $5000) seems like a good deal to me.

Patrick

 

[TromboneAl]

Patrick and Sparky,

My point is that even if you are not healthy, even if you have a lot of medical expenses the $5,000 deductible is only $58 per year more expensive.   But if you have less than $5,000 in expenses, you'll save money.

Here's how it comes out:

Premiums for $2500 deductible: $6228 per year
Premiums for $5000 deductible: $4536 per year

Let's say you have $4,500 in medical expenses:

$2500 deductible plan:

You pay 2500 + 30% * (4500-2500) = $3100
Premiums: 6228
--------------------
Total: $9,328      

$5000 deductible plan:

You pay 4500 (deductible not reached)
Premiums: 4536
--------------------
Total: $9,036

In other words it doesn't only work if you're healthy.   Even if you have expenses of $80,000 in one year, the higher deductible plan is only  $58 more expensive.

Your total risk is $58 for the year, and potential benefit is $1692 per year (amt you save if expenses are less than $2500).  Maybe I've made a mistake, but I think Blue Cross is cheating everyone who gets the $2500 deductible plan.   Every person who has the $2500 deductible and has expenses less than $4500 is paying more than they need to. (But don't tell Blue Cross or they might raise the premiums for the $5000 deductible plan ).

If people are interested I'll post my spreadsheet.

 

[sgeeeee]

Hi Al,

After shopping health insurance a couple of years ago, like you, I decided that high deductible was a better deal too. But making the comparison was usually more difficult and less clear-cut than your examples. One thing I noticed is that I never seemed to be able to compare apples to apples. One plan included prescription drugs in the deductible, another one did not -- and another one required a co-pay for prescriptions while still another one used a different co-pay schedule. One plan included co-pay coverage for office visits, another one treated office visits like all other services. etc. etc. My spreadsheets got fairly involved and depended not only on the amount of medical care, but the type (prescription drugs, office visits, urgent care visits, hospital visits, etc.). But I still ended up concluding that high-deductible was by-far the best bet.

 

[sailaway]

Pardon the repeat post I made in another thread but it applies better here.

It has been mentioned about the ideas of saving health care costs such as cutting pills in half saves usually 50%. This is absolutely true and unless one is taking a specially designed slow release medication with a special delivery system, most medications can actually be done this way.

Another way people with high deductables or are forced to go without insurance can save money on big ticket items is to be honest and forward. As an example, when I see a patient that truly needs a big ticket test such as a CT scan, ect. I write them a script and tell them to call several centers, either hospital based or independent. Be honest and say that you need this study done ordered by your doctor and you will walk in with cash in your hand in 100 dollar bills and you are calling around to se where you can get it done most economical. Every one on the centers in general will discount immediately 30% and I have seen 50% if they know that you are captain of your ship and have cash in your hand. I do this almost daily.

Another way for patients in similar conditions that have to go to the hospital and come out with a big ticket is after receiving all hospital bills to call the business office and be honest by explaining that you are on a fixed income and will have to make payments for years. But if you tell them you are willing to "mortgage the home" what will they offer as a discount for cash in their hand? Every hospital has a policy for this and has a person hired to handle just such situations and all will make an offer

Another way is when you are going to have a proceedure done such as surgery I tell the patient to address the surgeon honestly beforehand and ask his bill, tell him your situation, and offer to pay him cash in advance. Virtually every physician will understand and greatly discount. If he won't, fire the doctor and find a caring one.

Some doctors don't realize that a patient has no insurance or a high deductable and to voice this honestly will often get samples or at least maybe an Rx that will not break the bank.

Get to know the office help and bring in fresh vegitables etc, be kind and thank them for their help. Soon one can often just call the nurse who has worked for "Doc" for 25 years and ask if any certain sample has come in and you might get loaded up.

Of course I am from a big city of 4,000 and thngs might be different elsewhere.

Sailaway

 

[Yipee-Ki-O]

Gosh Doc, while I'm happy for you that you've reached the point where you can retire early, your good fortune will certainly be a loss to the community where you practice. As a pharmacist, I've seen far too many doctors who sign every prescription, "Dispense as Written." I've often wondered whether it's because they don't know any better or if they have fallen victim to big pharma's advertising skills. I really admire someone like you who has the patient's best interest at heart.

 

[BUM]

Gosh Doc, while I'm happy for you that you've reached the point where you can retire early, your good fortune will certainly be a loss to the community where you practice. As a pharmacist, I've seen far too many doctors who sign every prescription, "Dispense as Written." I've often wondered whether it's because they don't know any better or if they have fallen victim to big pharma's advertising skills. I really admire someone like you who has the patient's best interest at heart.

Worrying about pill prices gives me a headache. My doc is furious with patients coming in and asking for meds by brand name. "I've been successfully treating hypertension with a 10 cent tablet for 20 years. Now patients are demanding this $3 pill that they saw on TV!"

I do the "cut-the-pill-in-half routine myself as does DW...have been for years, wondering if our next plan wont have rx benes.

Generic question: Whats the average shelf life on the average pill?

BUM

 

[unclemick]

Duh

Forgive my dumbness - what is the cut the pill in half routine and how does that save money if you have a prescribed dosage?

 

[LovesLife]

Unclemick,

Sometimes it is cheaper to get a double strength dose and cut it in half. Your dr. prescribes the higher dose with instructions to cut in half.

LovesLife

 

[Mr._johngalt]

Hi unclemick! At your age I would counsel against
trying the cut-in-half trick with Viagra. You probably
need the full shot..........just guessing

JG

 

[unclemick]

Not yet - but like when she trashed my webtv and got me a computer - she may make make me an offer I can't refuse in the future. At which point - being frugal - I will shop for the cheap generic version.

Heh, heh, heh - hope to get a few SS checks before 'that point arrives'!

The clock is ticking.

 

[Yipee-Ki-O]

BUM,

Sorry, that question isn't answerable. Our stock at work ranges from a few months (6-month minimum) to several years. Drugs don't immediately lose their potency once they hit their expiration dates. The Claritin tabs I'm taking this allergy season expired in March of 2003. They work fine. Your medications will last longer if you keep them away from the medicine chest in the bathroom.

 

[sailaway]

I am not a pharmacist but I believe medicine's shelf life is much longer than the expiration date. If one has a great friend as his pharmacist and an Rx I think sometimes he might give you some stock that has recently out dated rather than throw it away as might be required, but again I am not a pharmacist.

One aspect of the pharmaceutical companies way of competeing that I see now that was not prevalent as so in the past is that the "80mg" dose is priced the same as the"40mg" dose. "Tell them to cut it in half Doc"

Also I am now starting to see combination drugs now priced the same as one of the single ingrediaents.. Example Caduet has come out which is Lipitor + Norvasc in one pill and priced as Lipitor alone. The the doctor can Rx the double strength and the patient can break them in half, thus a 75% reduction in the original costs.

Sailaway

 

[Mr._johngalt]

I am not sure about shelf life. Years ago I took a
tranquilizer, but only very infrequently. Had almost a whole bottle left. I just recently
threw out my last prescription which was dated about
10 years ago. I carried them around a long time
(just in case), but finally the uncertainty over their
potency offset my reluctance to dump some "perfectly
good meds."

JG