auditor0007
Gold Member
So I was accepted for my state's high risk pool insurance that has been set up through the new healthcare legislation. Now my healthcare costs are going to increase dramatically, but at least I am covered in case I ever become seriously ill.
Here are the details. I live in Ohio. The reason I need the insurance is that I am self-employed. I had a private policy in Colorado, but when I moved to Ohio, I was denied coverage due to pre-existing condition. Same company that insured me in Colorado denied me in Ohio. Swell people, they are.
Anyway, the rate they are charging me is $392 per month. If I were a non-smoker, the rate would be $293. I've actually quit, but it was just recently, so I still have to claim being a smoker. No problem with that, for now. My deductible is $2500 per year, but doctor's visits are covered with a co-pay, and I have prescription drug benefits.
So, how much will the insurance companies lose on me with my pre-existing condition? Nothing at all. In fact, the only payouts they will have is for a couple of doctor visits per year, less my co-payment. I am not on any prescription medication, and all of my other healthcare needs will fall under the $2500 deductible. Truthfully, costwise it would have been much cheaper just to remain uninsured, but then again, I now have the comfort of knowing that I am covered if something should serously go wrong, and that is what insurance is for.
Here is the thing that bothers me, and this holds true for any insurance. Now that I am covered, I will be billed at the discounted rates the insurance company has set up with my providers, and I will be forced to use only the providers that are in my "network of providers". Those discounted rates are much higher than what I have been paying while I was paying out of pocket.
Now I do have an option. If my provider is in my network, then I can still pay cash, and I can then submit the paid bill to the insurance company to go toward my deductible. This would allow me to continue paying the reduced rates I get by paying cash. The only thing is that the forms I need to fill out are ridiculously complex. Now I understand why 30% of our costs go towards administrative fees. The paperwork is a nightmare. Not sure what I'm going to do yet. I am thinking I may just not tell my healthcare providers that I am insured and continue paying out of pocket. If I have a big medical expense, then I'll just have to eat the $1000 to $2000 that would have gone against my deductible. So long as I don't have a large bill, then I'll probably save myself an extra $1000 to $1500 per year.
Here are the details. I live in Ohio. The reason I need the insurance is that I am self-employed. I had a private policy in Colorado, but when I moved to Ohio, I was denied coverage due to pre-existing condition. Same company that insured me in Colorado denied me in Ohio. Swell people, they are.
Anyway, the rate they are charging me is $392 per month. If I were a non-smoker, the rate would be $293. I've actually quit, but it was just recently, so I still have to claim being a smoker. No problem with that, for now. My deductible is $2500 per year, but doctor's visits are covered with a co-pay, and I have prescription drug benefits.
So, how much will the insurance companies lose on me with my pre-existing condition? Nothing at all. In fact, the only payouts they will have is for a couple of doctor visits per year, less my co-payment. I am not on any prescription medication, and all of my other healthcare needs will fall under the $2500 deductible. Truthfully, costwise it would have been much cheaper just to remain uninsured, but then again, I now have the comfort of knowing that I am covered if something should serously go wrong, and that is what insurance is for.
Here is the thing that bothers me, and this holds true for any insurance. Now that I am covered, I will be billed at the discounted rates the insurance company has set up with my providers, and I will be forced to use only the providers that are in my "network of providers". Those discounted rates are much higher than what I have been paying while I was paying out of pocket.
Now I do have an option. If my provider is in my network, then I can still pay cash, and I can then submit the paid bill to the insurance company to go toward my deductible. This would allow me to continue paying the reduced rates I get by paying cash. The only thing is that the forms I need to fill out are ridiculously complex. Now I understand why 30% of our costs go towards administrative fees. The paperwork is a nightmare. Not sure what I'm going to do yet. I am thinking I may just not tell my healthcare providers that I am insured and continue paying out of pocket. If I have a big medical expense, then I'll just have to eat the $1000 to $2000 that would have gone against my deductible. So long as I don't have a large bill, then I'll probably save myself an extra $1000 to $1500 per year.