Trying to Be A Savvy Health Care Consumer

[sharon888]

I'm trying to become a more savvy health care consumer. My COBRA coverage is ending this month and fortunately I qualify for an individual health care policy through HIPPA. (I have preexisting conditions don't qualify for anything else). The cost is high though. In the plan I've chosen, the premiums will be about $700 per month and the deductible is $4,000 (There is a PPO option which covers more, but that one costs $1,300 a month.) So I'm trying to minimize the cost of the health care I have to get. It's not easy though. Not going to the doctor at all would be the most cost effective, but that's not an option since I have an inherited kidney disease and don't want to go into kidney failure by going untreated. Trying to find out the cost of tests and procedures is challenging. And which ones do I really need? I guess this requires looking at your doctor the way you look at your mechanic. Am I getting everything I need to keep my car running well or am I getting procedures I don't really need? And it's not nearly as transparent as getting your car fixed. Doctors don't have a price list on the wall. And the stakes are a lot higher. I didn't go to medical school. How do I know what the best treatment is? The internet is good, but I don't think I'm qualified to be my own doctor. I trust my doctor and I think she's doing a great job. She's kept me from kidney failure so far. My brother is a year younger than I am and has already had a kidney transplant. Anyhow, I guess I was just wondering how people with medical conditions are dealing with the brave new world of health care. Most of the comments I read about high deductible health insurance plans are from people who are healthy and don't have to go to the doctor.

Thanks for listening!

[4jacks]

Sharon, welcome to the boards, sorry to hear about the health care change and your existing condition. I seriously hate doctors and health insurance companies for the exact reasons you listed. Nothing is transparent, you don't know the prices or how much you really need the procedure up front. Nothing else is sold like that. You don't go buy groceries not know the prices and then get an outlandish bill after you've been eating them. I personally love the High Deductible plan with the HSA. It takes money out of the insurance companies and puts it in your own account. The bad thing is the start up cost, as you noted. If you do go to the doctor a lot you won't have any time to build up money in there. The only way to really get a start on this is to build up your own money and start the fund on that. You still get the tax benefits, becuase you lend the account your money. But once you are on it, you have more control of your money.

I think another thing to consider for someone in your situation is to just not have insurance and pay for everything yourself. That can be really scary and I'm sure it's easier to think about not facing the stuff your facing. But mathematically, you are already at the bottom of the insurance pile, paying the highest premiums becuase of your existing conditons, so does it really save you money? What if you put all that money in the bank and saved a big emergency health fund and kept adding to it. I've heard from several sources that doctors and hospitals will actually negotiate with cash paying customers.

[pochax]

dear sharon, you clearly are in a difficult situation and i agree there are no easy answers. the health reform bill that is slowly coming into effect over the next few years do have clauses to help those with preexisting conditions get access to health care but probably not enough to drive down the costs much compared to where you are now. the best advice i can give right now is to see if there are any national or local patient advocacy groups/organizations for your condition. they may have experienced patients or staff members who have navigated this hard road before and may be able to give you the practical advice you need in your situation. i agree that HDHP (high deductible health plans) are not for you since you have a preexisting condition - they are clearly meant for those who are relatively healthy without need for much medical care.

[elenalee]

Thanks for providing nice information regarding health care
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