Why Are You Still Looking For Medical & Dental Insurance?

I understand that you want some level of security for your family and believe that a standard insurance plan is the only way to achieve that. I am a mother to 3 and grandmother to 3, and I know how important it is to be covered. But let's face it, the insurance companies have pulled the wool over our eyes big time.

I calculate that in my working life I have spent anywhere from $3000 to $9000 per year on medical and dental insurance. This does not include my co-pays, which is what you pay out of pocket when you go to the doctor or dentist; as well as the amount you pay for covered prescriptions. Additionally, eye exams and prescription glasses for myself and my son are not fully covered, so that's a yearly out of pocket of anywhere from $200 to $600 depending on whether or not we indulged in some high end designer glasses.

Not all plans cover every drug so I have at times been surprised at the pharmacy with an unexpected bill for a prescription written by my doctor. Not all procedures are covered either. My gynecologist recommended an outpatient surgical procedure the cost of which put me in debt collection because my insurance company would not cover it! The birth of my 3rd child was a C-Section, and although I had both primary and secondary insurance I still ended up with a $3000 bill for anesthesia because the insurance companies only covered 50% of the total cost.

I have a business partner who had a plan through her company that cost $160.00 every two weeks. Her dental plan required a co-pay of $25 and had a deductible of $500. That means that she needed to pay $500.00 out of pocket every year before her insurance company would pay for anything. On top of that there was a limit on what the insurance company would pay for dental procedures. She did not discover all of this until her bridge and partial needed to be replaced and the insurance company said "No" after the work was partially done.

So an individual can pay anywhere from $1000 to $10,000 per year in insurance premiums and still have to come out of pocket when major events occur?

I challenge you to look back over the course of your working life and determine how much you have paid into your insurance versus how much you have gotten out of it. If you discover that you have paid in more than you've gotten back, then I have to ask again "Why are you still looking for medical and dental insurance?"

What is Consumer Driven Health Care?

I started really taking a hard look at health insurance when I became self-employed (OK I was laid off and couldn't afford COBRA). The cheapest thing that I could find was a $250.00 per month plan with a $10,000 deductible.

If I wanted dental, vision, prescription and all that jazz I would have had to pay extra for an addition to that plan or a separate plan altogether.

I also considered an HSA, you know that tax free thing that you can use to buy aspirin, but God forbid you should lose the receipt? The HSA would have been in addition to the $250 plan and I would have used it to pay for dental, vision, prescription drugs, and doctor visits.

Long story short, I really could not afford to pay that much per month for what really amounted to the simple assurance that if something really, really bad happened we would be covered. I have a young and healthy family and we only go to the doctor and dentist for our once a year check ups; therefore, it made no sense for me to pay $250+ per month for something that doesn't cost $250 for a year.

The insurance model that I was looking at (low cost, high deductible plan with a Health Savings account) is one part of what is called Consumer Driven Health Care. There are 3 levels to a CDHC type plan:

• The tax exempt HSA account to be used as stated above
• The out of pocket payments that you will make when you have run out of HSA money, but haven't met your deductible yet
• And, of course, the high deductible insurance policy

Consumer Driven Health Care should be a way for consumers to have choices as far as how much to pay for health care and when to pay it.

For example, since I rarely go to the dentist, I should be able to make a very small monthly payment. When I do visit the dentist, I could then pay a reasonable out-of-pocket expense for the services I receive.