Shop Around
Last Sunday, columnist Michelle Singletary wrote in the Washington Post about shopping for healthcare--for individual healthcare services, like an office visit, or a knee arthroscopy. Several interesting points: People underestimated the cost of healthcare. Of course! They are insulated from the cost, and it’s really hard to find out even if you try. For a small fee at healthgrades.com, you can get costs for a limited set of procedures as well as ratings for some procedures at some hospitals.
She mentions a Humana site that helps families budget for healthcare. Huh? With a traditional employer plan, you have no idea how much healthcare is going to cost. Let’s assume insurance pays 80%, but 80% of what. If you need a $200,000 operation, that 20% balance suddenly gets huge. With a high deductible plan, however, you know exactly what healthcare will cost next year--at least you know the most it could possibly cost. That’s insurance.
It will soon be “open season” for federal employees to select a health plan for next year. OPM publishes a guide that compares prices and customer satisfaction ratings. This is helpful, but not definitive. For one thing, it’s not insurance, and a serious illness could still put a hole in your budget. For another, coverage is not standardized: plan A covers operations 1,2, and 3, unless you’re left handed, but plan B covers only left handed people for operation 2 and no one for 1 or 3. In short, you never know what your healthcare is going to cost until you get the EOB.
So, what do you do? My condo assn. is looking for coverage for their 12 employees. I’m recommending they self-insure for the first $5K and buy a high deductible policy for costs over $10K. Most will thus pay nothing, and no one will pay over $5K. I’ve heard of companies adjusting the self-insure point with incentives--higher if you don’t smoke and have a BMI under 25, get your flu shot, etc.
