Good plans vs. bad plans

Consumer Reports ran a series on individual health insurance last May. It is still very relevant. Here’s a key excerpt:

“We think a good health-care plan should pay for necessary care without leaving you with lots of debt or high out-of-pocket costs. That includes hospital, ambulance, emergency-room, and physician fees; prescription drugs; outpatient treatments; diagnostic and imaging tests; chemotherapy, radiation, rehabilitation and physical therapy; mental-health treatment; and durable medical equipment, such as wheelchairs. Remember, health insurance is supposed to protect you in case of a catastrophically expensive illness, not simply cover your routine costs as a generally healthy person. And many individual plans do nowhere near the job.” [emphasis added]

We agree with CR. However, we would like to have seen more emphasis on the old adage, “You get what you pay for. If it looks too good to be true, then it is.” It should not be a surprise when a cheap plan pays little to nothing for protracted cancer treatments. This is why a good health insurance agent will try to point out what plans don’t cover, as well as what they do cover. Let’s face it — sometimes limited coverage (“bad” plan) is better than no coverage. The fundamental questions any insurance agent must ask himself are, “Did I help to improve my client’s situation, and does my client understand the limitations?” However, a good agent will steer clear of limited plans when a more comprehensive plan is within the client’s means. Note that CR recommends a minimum lifetime maximum of $2 million. Again, we agree with CR. Yet how many people know their lifetime maximum off the top of their head? Do you? Do you know – beyond the deductible – your plan’s limits and exclusions? If not, let us take a look with you. Perhaps your annual renewal came back sky high. Perhaps it’s time to let us help you!