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Health insurance: Your thoughts on deductibles and cost share

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DUS    364
11 minutes ago, simon43 said:

 So for me, having a deductible sounds like a good idea on paper, but isn't really a good idea, in that it encourages me not to seek medical treatment for an illness that might turn out to be rather serious.  With zero deductible, you can just go to the hospital and be admitted for tests.  

 

Note - hospitals are very happy to admit you, rather than provide these tests as an outpatient, because they know that many medical insurance policies will not pay out for OP tests/treatment.

It's a fair point you're making here. Having said that unless you opt for OPC you will always have to foot the bill for a consultation and treatment as an outpatient yourself (regardless of any deductibles etc).

 

I have a friend who is paying a high premium for OPC with his insurance company so that he won't delay going for a consultation just to avoid paying for it. Personally, I think the premiums the companies are claiming for OPC are unattractively high, especially given the fairly cheap cost for a consultation and basic treatment here in TH.

 

If we were talking about a 20-30% increase on top of the general medical insurance coverage then I might seriously consider OPC. But with OPC premiums being almost as high as the "main" insurance I cannot see myself opting for it.

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impulse    11,980
2 minutes ago, DUS said:

It's a fair point you're making here. Having said that unless you opt for OPC you will always have to foot the bill for a consultation and treatment as an outpatient yourself (regardless of any deductibles etc).

 

I have a friend who is paying a high premium for OPC with his insurance company so that he won't delay going for a consultation just to avoid paying for it. Personally, I think the premiums the companies are claiming for OPC are unattractively high, especially given the fairly cheap cost for a consultation and basic treatment here in TH.

 

If we were talking about a 20-30% increase on top of the general medical insurance coverage then I might seriously consider OPC. But with OPC premiums being almost as high as the "main" insurance I cannot see myself opting for it.

 

And a lot has to do with personal choice and the discipline (and wherewithal) to suck it up and go in even if you have to pay out of pocket.  Different folks have different needs and different idiosyncrasies.  For me, being 100% covered feeds into a little bit of the hypochondriac in me.  But that's just me. 

 

 

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cmsally    2,500

I always thought that the high cost of Outpatient on insurance was due to things such as kidney dialysis, which is often done on outpatient basis. I don't know for sure but seemed logical as something like that is costly and long term.  ??

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DUS    364
42 minutes ago, cmsally said:

I always thought that the high cost of Outpatient on insurance was due to things such as kidney dialysis, which is often done on outpatient basis. I don't know for sure but seemed logical as something like that is costly and long term.  ??

You need to check with the individual insurance company. As for CIGNA chronic diseases/treatments such as kidney dialysis as well as diabetes will be covered without OPC as long as it isn't  a pre-existing condition.

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scubascuba3    732

The thing to do is ask how much your premiums will be in 10/20/30 years when you need it most. See if its still affordable and worth it for you, everyone is different.

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DUS    364
4 minutes ago, scubascuba3 said:

The thing to do is ask how much your premiums will be in 10/20/30 years when you need it most. See if its still affordable and worth it for you, everyone is different.

Hehe.... yes, if your crystal ball gives you the answers to those questions then please let me know. I might want to buy one of the same brand as well then.... ;-)))

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simon43    5,923

When I went to the hospital with a fever, the doctor wanted to do some out-patient tests, (which would not be covered by my insurance).  I explained this and the doctor immediately said 'We must admit you for these tests...'  :)  The subsequent cost of these tests (and my stay in the hospital) were 100% paid by my insurance company - no need even to prepay and claim back later.

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impulse    11,980
59 minutes ago, simon43 said:

When I went to the hospital with a fever, the doctor wanted to do some out-patient tests, (which would not be covered by my insurance).  I explained this and the doctor immediately said 'We must admit you for these tests...'  :)  The subsequent cost of these tests (and my stay in the hospital) were 100% paid by my insurance company - no need even to prepay and claim back later.

 

You do know your insurance company monitors your social media posts?

 

Just kidding.  Or am I?

 

 

 

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simon43    5,923



You do know your insurance company monitors your social media posts?

 

Not a problem.  It was a medical decision to admit me....

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