Sunday, August 16, 2009

Insurance Coverage- what is the companies responsibilities.

HOME

I have a home that would take $400,000 to replace, I have an insurance policy for $200,000. I have a fire and a total loss. The insurance company pays me $200,000. I am backrupt, I still owe $300,000 on my home. Do I get to call up the president to tell him the evil company wont pay me $400,000? NO OF COURSE NOT.


CAR

I am insured for $500,000 liability 0n my car. There is an accident 5 people are badly injured. I fell asleep at the wheel and was at fault and was sued. The injured were awarded $1.5 million. The insurance company paid $500,000. Do I get to call up the president to tell him the evil company wont pay $1.5 million? NO OF COURSE NOT.

HEALTH

I am 21 I work at a company that offers health insurance, I dont buy it or take advantage of the 90 day period allowing previous illnesses. I am diagnosed with cancer, treatments will be $200,000. I try to get in plan at work and am turned down for pre-existing conditions. Do I get to call up the president to tell him the evil company wont give me $200,000 in return for my $300 a month payment? YES OF COURSE.

INSURANCE

Insurance is a business decision. It is balanced decision of probable loss versus cost of insurance. Some areas of the country flood insurance would be rediculous, others not so much. If a family has insurance with a $3,000,000 cap and they exceed that, that is a business result. The insurance company fullfilled it's obligation. They have no more requirement for compassion than the other examples of Homeor Car coverage. It is easy for the president to twist this into something it isnt.

Saturday, August 15, 2009

How my insurance works

I am retires and 67 years old. I have medicare part B. This costs me 100 per month deducted from my social security, We have been paying into this with payroll deductions for 40 years or so. I don't have and real idea what that total has been. I also have a suppliment from Country Companies that costs about $150 per month. Medicare pays 80% and the suppliment pays the 20%. So I pay $250 per month for health care.

I have a drug policy that was just raised to $71 per month. My copays range from $7 to $30. I pay out of pocket about $125 per month for drugs. When the donut comes up I pay over $400 per month. I am on heart medications and insulin.

So my total health care bill is about $6000 a year. On retirement income this is pretty high. My gal is at about $4000 a year. $10,000 a year is about 25% of our retirement income. Obviously we are living on savings, and hoefully that will last.

Maybe there would be some way for us to get more for our $10,000 or actually pay less. But for us, with our medical history we have nothing to complain about.

Obviously if this doubles over the next 10 years we will have some issues. However there is no evidence this gov can provide that improvement, and we dont want the burden to be passed on to our children and grandchildren.

United Health Care

I had United health care from a policy at work.My gal has same coverage.

She went to hospital at 72 with legionnaires , she was in intensive care with an induced coma for 30 days,it took them 20 days to diagnose the disease, she had assisted breathing tube constantly, After her hospitalization she had 30 days in a rehab center. When she entered the rehab she couldn't even stand up. I went there 3 times a day and exercised her with these rubber band exercising things. I took her to the garden for walks and did everything I could. The rehab center had a tough counsellor who forced her to exercise and get around.

She is now at 76 more vital and energetic than I am at 67. She tends her garden,manages our 4200 sq foot home and takes care of me.

United probably paid out $200,000 for her care. I never heard a word from anyone, except that rehab was limited to 30 days care.

I went into hospital with pneumonia for 11 days, 4 or 5 in intensive care, I am diabetic so complications are always possible. This was at least $30,000.

United had one of their nurses called me 2-3 times, she called me to make sure I was getting the care I needed. She also explained to ME where my coverage could help me even more, she asked why I wasn't turning in the test strips cost to united (they covered drugs as well), she actually had her company spend MORE for my care.

I believe United is a GOOD company, they in no way are totally self serving and profit motivated.

These companies are in no position to defend themselves from a rabble rousing president and administration.

Obviously most policies have LIMITS, we understand that. Your health care providers should understand your coverage and work within those limits when possible. The reason the health care people can claim less problems with Medicare is they understand medicare COMPLETELY and wouldn't begin to think they can argue or debate with the government.


BUT BELIEVE ME, THE INSURANCE COMPANIES ARE NOT ALL BAD.