RE: When insurance is no longer insurance
Exactly. Insurance covers risk, not certainty. The way Health insurance is mandated to cover regular physicals, vaccinations, etc. would be like if your car insurance had to cover detailing and oil changes.
Years ago, you could shop around. I did it with my third pregnancy which was the first I was uninsured for. As an example of how my incentives changed, while the first two I simply went for every test ordered, on the third, I turned down Triple-Screen testing, reasoning that I wouldn't abort a baby shown to have some anomaly, and anything that the doctors could actually mitigate or correct (like spina bifida) would show on a standard ultrasound in time to address it. I also turned down the 5 hour glucose since I'd had no sugar issues in either previous pregnancy. Even though I was high risk, having developed pre-eclampsia during both previous pregnancies, and even though I had to have a C-Section, my third pregnancy came in at under $12,000 (yes, that's twelve-thousand) for the cash price discounted for paying by month 7. That's including hospital, all doctors including anesthesiologist, all of the testing and ultrasounds leading up to it, and infant care. This was 7 years after my first pregnancy was billed to the insurance company at $39,000.
Recently though, I've tried to shop around and you're right, you no longer can. All of the doctors are part of "health care systems" and here in PA there's only one insurer and in my county only one level of insurance I can buy. To insure me, hubby, and three kids is $1200 per month, and they cover almost nothing except standard visits until I meet my $6500 per person deductible.
When I had to have 'lady surgery' and I went in for my initial consultation with the OBGYN, the insurance company refused to pay. I called and said, "My policy says women's health care is covered 100%." They asked, "Well was this your only visit this year?" I said, "Yes, but why does that matter? It says women's health is covered and he definitely looked at my vagina so I think it counts as women's health!"
This kind of crap happened with almost every charge. Finally I let the insurance go, because I was paying an arm and a leg for almost no coverage and adding a stressful chore to my life.
Wow, thanks for taking the time to leave such a great lengthy response. This is about the best personal insight I could've asked for.
$1200 per month and $6500 per person deductible! That's crazy expensive! That means you have a $32,500 deductible each year in addition to premiums of 1,200 per month or $14,400 per year. You'd have to pay $46,900 out of pocket each year before they'd cover a dime of your expenses.
You should check out https://libertyhealthshare.org/. It's what I use for my health coverage.
For your family of 5, if you're between the ages 30-65, you'd pay $449 per month with a yearly deductible of $1,500. With that, you'd get 100% of your family's medical expenses covered, up to $1,000,000 per incident. It's not an insurance company, so be sure to familiarize yourself with it before signing up.
Thanks for the tip! I will check them out 😊