Comprehensive Insurance

Friday, 12 July 2019

Rx Anecdate: Contra-Narrative

At my recent annual physical, i was prescribed, at the tender age of 39(shut up), my first-ever maintenance med: 10 mg daily of Lisinopril for moderately high blood pressure.

[ed: this came as somewhat of a shock, inasmuch as I'd heretofore been considered a carrier]

It's become fashionable of late to dump on Pharmacy Benefit Managers (PBM's) and specifically Aetna and CVS. Well, I'm insured under an (HSA-compliant) Aetna plan, and I had the scrip filled at my local CVS for the princely sum of .... wait for it ... $2.21 for a monthly supply.

I think we can swing that (at least for the nonce).

#ForWhatItsWorth

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Thursday, 11 July 2019

From the 'Be Careful What You Wish For' files

Shot:

"Cone Health CEO Terry Akin urged staff to contact legislators to advocate for hospitals' position on the issue."

Chaser:

"Burn in hell, you sorry SOBs"

#Pithy

Short take: North Carolina Health Plan honchos have proposed a new reimbursement scheme for Tar Heel State hospital systems that include some pretty draconian caps, and one provider's manager followed orders (maybe a bit too zealously).

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Bon voyage!

The name of the French national health care system, La Sécurité Sociale, pretty much guarantees that this would be the outcome:

"French Quadriplegic Being Starved To Death By The State"

In 2008, then 31 year old Vincent Lambert was left in that condition as a result of a terrible car accident.

Flash forward 11 years, and the poor man was ordered starved to death by the (warm, compassionate, caring) French government:

"The Cour de Cassation overruled an appeals court which had directed doctors to keep Mr Lambert alive pending a review of his situatoin by the Unitoed Natons Committee on the Rights of Persons With Disabilities."

This echoes Iceland's take on Down Syndrome babies:

"Iceland is on pace to virtually eliminate Down syndrome through abortion."

Inconvenient, non?

#Medicaid4All

[Hat Tip: Ace of Spades]

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Wednesday, 10 July 2019

Sigh: Some folks just don't 'get it'

So, working with a customer who needs a short term medical plan for his wife, who is an American citizen living abroad. I was able to find only one carrier that didn't require a recent stateside residence, and so I quoted that carrier. As always, I quoted using the maximum lifetime benefit (in this case, $1 million). The client asked about $1,000 and $2,000 deductibles (which I think is a mistake, but that's what he asked for).

So I quoted as he asked, and the premium came out to $325 per month for the $1,000 deductible plan, and $256 a month for the $2,000 version.

He balked at that, claiming that I'd previously quoted a much lower rate. I pointed out that we had been looking at a $5,000 deductible (which would have been well under $200 a month). He thought that still might be spendy, and he would check with his home country's options. I wished him well and told him that I'd be happy to write this plan if the home country option didn't pan out.

This morning, I get this in email:

"This quote sounds good to me.

What if I take insurance for 250 G instead of million and keep deductible to 1000 or so?

This [home country plan] is world wide known. May be you can also use them check it out.

The currency conversion is Rs 70 to a dollar, so the premium is about $150 for 3 month.

Please let me know your thoughts."

[ed: it was unclear if that was $150 a month for 3 months, or $150 one-time premium]

This is becoming tiresome (we make very little on Short Term plans, and he's quickly using up the commission)(and my patience).

I replied:

"Great!

No, I can’t sell for non-USA companies.

>> $250 G

No, I can’t do that: I will only sell the maximum benefit (for a number of reasons: E&O liability chief among them, also you really don’t save all that much lowering the maximum vs raising the deductible)."

We'll see what he does.

Not really on tenterhooks here.

By the way: there's another very good reason to not skimp on that policy max: insurance is, essentially a gamble (yeah, yeah, I know) and it's a lot easier to come up with an extra three or four thousand dollars than 10's or 100's of thousands.

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Tuesday, 9 July 2019

Another STM Dilemma

A Twitter friend pointed out that:

If someone tries 2sell U a health insurance plan and says it is #ACA compliant, affordable and covers U from day 1, Stop, get the name of the company and get a 2nd opinion. ACA plans do not cover U from day 1 and cannot B purchased after open enrollment without an SEP situation. https://t.co/2jQdv5iRGr
— Sheron E Sidbury (@SheronESidbury) July 8, 2019

Although I knew what she was saying, I asked for clarification (to make sure we were on the same page), and she helpfully responded:

"When you sign up 1-15 you are not covered until the First of the following month. Form the 16-31st the plan starts the 1st of the second month."

That is, if you sign up on June 3rd, your coverage doesn't begin until July 1st. And if you sign up September 17, your coverage doesn't start until November 1st.

This is where a Short Term Medical plan could come in mighty handy (too bad for the folks in states such as Connecticut and California, that outlaw them).

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Sexist Stats

So, got this yesterday from the CDA (The Council for Disability Awareness):

"In a new survey of the awareness and ownership of disability insurance across today’s workforce, The Council for Disability Awareness (The CDA) uncovered that the 32 million, unmarried women workers, who make up 25 percent of today’s American workforce are underinsured for a disability."

Which is, no question., a shame.

But I immediately replied:

"That’s interesting.

How about similar stats on men, who make up 66% of the workforce?

I’ll wait…."

Breath status:

[x] NOT held.

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Monday, 8 July 2019

Off Topic: Two Great Causes

So last Friday evening, we attended a local food truck rally (and very cool fireworks display) and learned about two very worthy causes:

■ Warrior Weekend to Remember honors combat injured vets and Gold Star families (and even first responders and their families) with an incredible weekend experience that includes:

- Indoor Kart racing
- Skydiving
- Hot air balloon rides
- A bonfire and concert

And more!

Click here to learn more about this fantastic program.

* The 1st Annual PNC Community Mutt Strut is coming up in October, and includes a dog parade, vendors and food, even door prizes. Approximately 22 veterans a day commit suicide, and it's the Mutt Strut's purpose to change that by providing service dogs to vets with PTSD, brain injuries, and other combat-related mental health issues.

You can learn more about the organization, and the parade, by clicking here.

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