You Should Know What Your Insurance Premium Actually Buys

[marmar]

from ourfuture.org:



You Should Know What Your Insurance Premium Actually Buys
By Isaiah J. Poole

December 8, 2009 - 3:25pm ET


Imagine that you're choosing between two health insurance plans. One has a $15 co-pay for doctor visits and says it covers hospital charges up to 80 percent of "reasonable and customary" charges. The second has a $20 co-pay and covers only 75 percent of "reasonable and customary" hospital charges. The first plan is clearly the better deal, right?

Not necessarily. Do you know how each company defines "reasonable and customary" and how different those definitions are between the two plans? Suppose Plan A rejects twice the expense claims filed by patients and their doctors as Plan B? In that scenario, the more certain 75 percent of Plan B, with you paying the remaining 25 percent, becomes a lot cheaper than the 80 percent advertised by Plan A that in reality leaves you paying 40 percent of a bill when you expected to pay only 20 percent.

Making that type of information public and easily accessible is the goal of health reform leaders trying to get insurance industry transparency language that has already been approved by the House included in the Senate's health care bill.

"Under the status quo, health insurance is essentially a black box," said Rep. Rosa DeLauro, D-Conn., in a call with reporters today organized by the Institute for America's Future. "The fact is that countless Americans buy coverage that they thought was comprehensive, only to realize that it has gaps once they get sick." ..........(more)

The complete piece is at: http://www.ourfuture.org/blog-entry/2009125008/you-should-know-what-your-insurance-premium-actually-buys

[LiberalFighter]

1. All the more reason to take private insurance companies out of the business.