<p>My medical records showed a recent diagnosis of both high blood pressure and high cholesterol, although neither met the guidelines for treatment, just observation. Didn’t prevent me from getting the preferred rate from BC/BS, although my cholesterol numbers at the time could have fallen on either side of the line, depending on whether they used the LDL standard or the HDL/LDL ratio standard.</p>
<p>I am concerned that the new health care law will prevent me from continuing my policy. I have a high deductable policy that covers major illness and I pay out of pocket for routine doctors visits and so forth because of the deductable. That’s ideal for me. I’m healthy. I buy one prescription ($4 a month at Walmart). And, frankly, I go to the doctor once a year for a physical and then maybe if I’m on my deathbed. I don’t even really want my doctor prescribing the cholesterol testing and stuff, unless I get to pick the test. I can go to private lab and get a more comprehensive test (VAP or NMR particle count) for less money ($79, if I recall). I hate paying for a lesser test that doesn’t even give me the info I want.</p>
<p>In a typical year, I save probably $5000 with that kind of policy, yet still have full coverage for catastrophic illness (the deductable would first eat up the $5000 I save in a typical year, so it’s a wash compared to a more expensive policy). I think the new law prohibits my policy.</p>
<p>^Idad, we used to have the type of policy you talk about until the rate became higher than the one with a lower deductible. Go figure that one out. My H hated to lose the MSA account savings feature, but I had to show him that it would cost us more for the insurance, and we would pay more out of pocket too. The plan we have now has just a copay for in network Dr. visits. The other way, I paid the full amount up to a very high deductible, although it was limited to the fee schedule for in network doctors.</p>
<p>I am not sure if we will get to keep our plan either. Our local bc/bs has decreased the options over the last several years, and I am thinking we will get only one or two choices when all of this is done. I like to have out of network benefits, so that if we really needed it we could go to any doctor anywhere (subject of course to higher coinsurance - which used to not be the case). I would be really upset if I could go to only in network doctors because that would really be awful in the event of some catastrophe (which is why I have insurance in the first place).</p>
<p>My d had acne and got a prescription for it at 14. A pretty mild prescription for a soap. Anyway, flash forward and switching insurance, acne was a precondition if she got an rx. Her sister had acne but we didn’t have to say predcondition as no rx. one with prescription was asked to pay about 15percent more a month. So yeah you can get insurance, but you pay more. Oh and if you hide the so called precondition, they can deny coverage for anything as you lied on application. Not sure how this plays put now</p>
<p>IDad, it’s nice that you were able to get the preferred rate with your blood pressure/ cholestrol. We were not. That’s one problem with the system we now have – it’s capricious. </p>
<p>IDad and anothermom, you probably will be able to keep your current coverage, although you will sacrifice some of the protections in the new law:</p>
<p>I was shocked when I signed up for a college health plan as staff and didn’t have to put down any conditions. I am a breast cancer survivor.I was thrilled. I kept my insurance from old plan and paid a huge premium to do that. I may cancel it and I may not. It is worldwide. But I am covered on that plan. But I am insured in the USA! Amazed, to say the least.</p>
<p>Yeah. It’s crazy. I just assumed that lower deductable was better. But, then I spent several evenings looking at the various plans and actually working through what my total annual cost would be in several scenarios: a typical year where I get my annual physical and never see the doc again, a major illness, etc.</p>
<p>The plan I ended up with was priced attractively for an individual, but would have been horrible for a family (the combined deductable was too high). That type plan was attractive from one company, but not from another. No rhyme nor reason.</p>
<p>It does put me in a position to be a real pain in the butt to my doctor. Since I’m basically paying out of pocket, I plan to ask about every test he orders and find out exactly what I will gain from scheduling a follow up appointment in 60 days. IMO, two of the three doc visits my doc scheduled last year (when I had a cadillac HMO) were a complete waste of time and money. This year, I made him schedule all my blood work BEFORE the annual physical so that we could discuss the results then and there and not schedule a “follow-up”.</p>
Deductible isn’t the only determinant of price. There are all kinds of things that can vary and can affect the premium: Number of office visits covered and the co-pays, annual out-of-pocket max (which is not the same thing as the deductible), surgery coverage, hospital coverage, ambulance coverage, annual physicals, labs, physical therapy, prescriptions, etc. </p>
<p>Another great feature of the new health law is that insurers must follow a uniform format in their benefit descriptions, clear and user-friendly. Before the law, it’s very difficult to shop for insurance because it’s just about impossible to compare apples to apples. Soon we’ll be able to look at side-by-side comparisons and see exactly what we’re getting for the price.</p>
<p>Oh, yeah. Government-designed forms are always clear and user-friendly! Why, that’s just what I say every year when I fill out the IRS forms. “Gosh darn, these things are clear and user-friendly!” :)</p>