Thursday, May 16, 2013

Medical Insurance Marketplace

Today I finally feel like I've returned to my normal self after all the stresses of last weekend and giving my presentation. I am pleased to report that my presentation, "Exercise Your Successful Patient IQ," was a success in spite of my major case of jangled nerves.  I spoke to a full room of attentive and engaged people who asked good questions and made excellent comments.  I hope to do this presentation, or one similar, again in the future.

One woman listening to my presentation kept asking about medical insurance or commenting on how her own medical insurance had little coverage...but was cheap.  Well, with medical insurance coverage, we do get what we pay for.  My presentation did not even mention medical insurance which is a huge topic, and I knew once I brought it up I'd descend into a morass of complaints, questions and negative comments.  It deserves its very own presentation. 

There are two things I wish now that I'd told my audience last Saturday regarding medical insurance.  The first is: know specifically what coverage you need and how much you are willing to pay to have it.  Necessary coverage is not the same as "wanted" coverage.  The second is: remember, insurance companies are not our friends.  They are not considering your best interests, only the company's, and
their purpose, their mission, is to make money.  Even nonprofits are obsessed with the bottom line in order to break even or, a true accomplishment, to have a surplus that can be applied to the next fiscal year's costs.

The paragraph immediately above will remain the same under the Affordable Care Act once it achieves full implementation in January 2014.  Are you ready?  Is your state ready?  By now, your state government needs to have passed legislation creating an online insurance exchange, if it prefers to have its own vs. the federal insurance exchange.  It also needs to have hired people to run it, get it set up and online for consumers to use starting in October of this year.

I'm proud of the Minnesota Legislature, at least the Democratic members since the Republicans voted against it, for passing an online insurance exchange as required/recommended by the Affordable Care Act.  Minnesota is moving forward, as it should, to implement the ACA by January 2014.  I think that people will discover that the ACA is much better for them than the naysayers would have them believe.  I've already seen news reports of insurance companies scrambling to make their policies more attractive than their competitors' policies on insurance exchanges.  That means better deals for the consumer.

Frankly, I cannot wait to begin shopping for my individual major medical insurance policy in October.  The coverage that I have now has been perfect for my medical needs, and I will use it as my template.  I suspect other people will take similar approaches to their shopping process.  Here are some questions to help you get started:

Do you need family or individual medical coverage?
Do you buy your medical insurance through your employer?
What is your family members'/your physical condition?
Do you or anyone in your family have a chronic illness?
What level deductible can you afford?
Do you need coverage for medications?
Do you want to keep your current medical team/doctor?

After answering these questions, you'll have a good idea of the kind of medical coverage you'll need.  Someone who's healthy, young, active, and not in a physically threatening job could probably buy minimal coverage with a high deductible and very low premiums.  Someone with a chronic illness, or in a job where physical injury is possible like construction, might want to buy maximum coverage with a low to medium deductible and higher premiums.

Just remember, folks: insurance companies, no matter what they say or how they market themselves, are not your friends....

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