Not to make this healthcare week here at Reverse Pyromania, but I want to follow up on something Mister mix wrote this morning.
In figuring out his ACA plan for the coming year, MM wrote, “The other part of the horrible experience I had yesterday is that the Colorado exchange gave me a “choice” of like 93 different policies, each with slightly different terms. It was all fuckery.”
Choice. It’s a great thing, right? Not so fast.
The problem with choosing a health insurance plan is there’s too much choice, which makes the whole thing a crapshoot. Here are decision points one must consider when looking at which healthcare insurance plan to opt into:
insurance company (if there is even more than one provider in your location)
premium amount
deductible
Individual deductible
family deductible
co-pay
lower co-pay for urgent care visits or not
how many urgent care visits are included at fixed cost vs. part of deductible
lower cost for lab tests for chronic illnesses or not
out of pocket maximum
individual
family
drug coverage:
fixed dollar co-pay or part of deductible
low/no cost for certain chronic illness drugs or not
generic drug coverage (fixed dollar co-pay or part of deductible)
non-generic drug coverage (fixed dollar co-pay or part of deductible)
preferred drug coverage (fixed dollar co-pay or part of deductible)
specialty drug coverage (fixed dollar co-pay or part of deductible)
in network vs. out of network (how the heck do I figure out who is “in network” and who isn’t)
does it include vision or not
does it include kids coverage or not
Kids vision, kids dental, only one or both
Health Savings Account (“HSA”) eligible or not
Basically, someone looking to choose a plan has to take swag guesses at what may happen to them healthwise (and/or their family if they have one) in the coming year:
how often will I or my family get sick
Will little Johnny get injured playing sports or in school
Will little Jane get the flu and then also have croup in a separate instance
Will anyone on my plan come down with a chronic or major illness
What drugs will we need
Will we get sick/injured somewhere “out of network”
On and on and on and on - you get the picture
You know who doesn’t have to make these ridiculous choices? Every resident of every other developed country in the world.
